Matti Palo (NPI# 1013949619, PAC ID# 0345375960) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1013949619 |
| PAC ID by PECOS | 0345375960 |
| Professional Enrollment ID | I20100320000062 |
| Full Name | Matti Palo |
| Organization Legal Name | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| Address |
70411 Hwy 21 Covington LA 70433-8243 |
| Phone Number | 9854005566 |
| Gender | M |
| Medical School | UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE |
| Graduation Year | 1998 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 4587849781 |
| Number of Group Practice Members | 474 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190267 | FAIRWAY MEDICAL CENTER |
| 190064 | OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER |
| 190045 | ST TAMMANY PARISH HOSPITAL |
| 190303 | CYPRESS POINTE SURGICAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 7777 Hennessy Blvd, Baton Rouge, LA 70808-4363 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC | |
| 70411 Hwy 21, Covington, LA 70433-8243 | 9854005566 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| Organization Legal Name | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| Physicians | 443 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James Michael Robinson | Family Medicine | Our Lady of The Lake Physician Group LLC | 12525 Perkins Rd A, Baton Rouge, LA 70810-1907 |
| Kori Fogg Juban | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 34870 La Hwy 1019, Denham Springs, LA 70706-0659 |
| Michelle Duhe | Family Medicine | Our Lady of The Lake Physician Group LLC | 26739 La Hwy 1032, Denham Springs, LA 70726-4926 |
| Swapna G Kallu | Internal Medicine | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Montrell Martin-duhe | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 4463 La Hwy 1 S A, Port Allen, LA 70767-5990 |
| Joshua R Clark | Family Medicine | Our Lady of The Lake Physician Group LLC | 59315 River W Dr, Suite C, Plaquemine, LA 70764-6553 |
| Hollie B Ortis | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 13489 Hwy 431, Suite A, Saint Amant, LA 70774-3213 |
| Shantan Ravula | Family Medicine | Our Lady of The Lake Physician Group LLC | 14225 Hwy 73, Prairieville, LA 70769-3616 |
| Daniel Kevin Lavie | Hematology/oncology | Our Lady of The Lake Physician Group LLC | 4950 Essen Ln, Suite 400, Baton Rouge, LA 70809-3738 |
| Sheri A Ammons | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 5428 Odonovan Dr B, Baton Rouge, LA 70808-4374 |
| Street Address |
70411 HWY 21 |
| City | COVINGTON |
| State | LA |
| Zip | 70433-8243 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy Devraj | Orthopedic Surgery | Our Lady of The Lake Physician Group LLC | 70411 Hwy 21, Covington, LA 70433-8243 |
| Vernon K Palmisano | Family Medicine | Our Lady of The Lake Physician Group LLC | 70411 Hwy 21, Covington, LA 70433-8243 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cindy Pechon | Clinical Social Worker | 5001 U S Hwy 190 D4, Covington, LA 70433 | |
| Richard B Drude | Gastroenterology | Richard B. Drude, Jr., M.d., Apmc | 69150 Hwy 190, Covington, LA 70433 |
| Bruce S Samuels | Internal Medicine | 189 Greenbriar Blvd, Suite C, Covington, LA 70433 | |
| Nicholas J Viviano | Dermatology | 7031 Hwy 190, Covington, LA 70433 | |
| Thomas W Nielsen Jr. | Clinical Social Worker | 5001 Hwy 190, Suite B 1, Covington, LA 70433 | |
| Glenn D Hedgpeth | Gastroenterology | Dr. Bruce S. Samuels, LLC | 189 Greenbriar Blvd, Covington, LA 70433 |
| Brian C Cochran | Physical Therapy | Covington Physical Therapy Center | 129 Corporate Dr, Covington, LA 70433-1057 |
| Jonathan S Mitchell | Physical Therapy | Covington Physical Therapy Center | 129 Corporate Dr, Covington, LA 70433-1057 |
| Charles Balette | Family Medicine | 1119 S Tyler St, Covington, LA 70433-2327 | |
| Roy C Saguiguit | Internal Medicine | 1113 S Tyler St, Covington, LA 70433-2327 | |
| Find all physicians in zip 70433 | |||
| City | COVINGTON |
| Zip Code | 70433 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | COVINGTON + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Matti Palo.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.