Laksamana Perintis Nusantara, NP
NPI 1205610607ActiveIndividual· Nurse Practitioner, Primary Care· Lafayette, LA
Nurse Practitioner, Primary Care (NP) in Lafayette, Louisiana, licensed in LA and FL, with an NPI issued in August 2023. Collegium Pharmaceutical, Inc. was the largest of 2 companies reporting payments in 2025, $34.27 in all, mostly food and beverage.
Overview
| NPI | 1205610607 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | NP |
| Sole proprietor | No |
| NPI issued | Aug 24, 2023 |
| Last updated in NPPES | Oct 23, 2025 |
| Certified by provider | Oct 23, 2025 |
| Reactivated | May 30, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | 234786 | LA |
| Nurse Practitioner, Family | 363LF0000X | 11027192 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Industry payments (Open Payments)
- 2025$34.27 · 2 payments from 2 companies
- 2024$236.68 · 7 payments from 6 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Collegium Pharmaceutical, Inc. | $19.81 | 1 |
| Millicent US Inc | $14.46 | 1 |
What the 2025 payments were for
- Food and Beverage$34.27 · 2 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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