Integrated Dermatology of Ponchatoula, LLC
NPI 1508234600 · Dermatology Physician · Ponchatoula, LA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Integrated Dermatology of Ponchatoula, LLC is a Dermatology Physician organization in Ponchatoula, LA (NPI 1508234600).
Provider details
- NPI number
- 1508234600
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Queen, Manager(561) 314-2000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2015-09-04
- Last updated
- 2019-05-21
Frequently asked questions
- What is Integrated Dermatology of Ponchatoula, LLC's NPI number?
- Integrated Dermatology of Ponchatoula, LLC's National Provider Identifier (NPI) is 1508234600, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Integrated Dermatology of Ponchatoula, LLC?
- Integrated Dermatology of Ponchatoula, LLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Integrated Dermatology of Ponchatoula, LLC located?
- Integrated Dermatology of Ponchatoula, LLC's practice location on file with NPPES is 180 N 5th St, Ponchatoula, LA 70454-2532.
- What is Integrated Dermatology of Ponchatoula, LLC's phone number?
- The practice phone number listed in the NPPES registry for Integrated Dermatology of Ponchatoula, LLC is (985) 370-7546.
- Does Integrated Dermatology of Ponchatoula, LLC accept Medicare?
- Integrated Dermatology of Ponchatoula, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Integrated Dermatology of Ponchatoula, LLC?
- The authorized official listed on Integrated Dermatology of Ponchatoula, LLC's NPPES record is Jeffrey Queen, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Integrated Dermatology of Ponchatoula, LLC's NPI active?
- Yes — Integrated Dermatology of Ponchatoula, LLC's NPI (1508234600) is active in the NPPES registry as of the last update on 2019-05-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.