Integrated Dermatology of Ponchatoula, LLC
NPI 1508234600ActiveOrganization· Dermatology· Ponchatoula, LA
Dermatology in Ponchatoula, Louisiana, registered in NPPES in September 2015. The authorized official on file is Jeffrey Queen, Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1508234600 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 4, 2015 |
| Last updated in NPPES | May 21, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (LA) |
|---|
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