Brad Giarrusso (NPI# 1104844455, PAC ID# 3971547852) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1104844455 |
| PAC ID by PECOS | 3971547852 |
| Professional Enrollment ID | I20050613000014 |
| Full Name | Brad Giarrusso |
| Organization Legal Name | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| Address |
6516 E Myrtle Ave Baker LA 70714-4348 |
| Phone Number | 2257747320 |
| Gender | M |
| Credential | MD |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduation Year | 2003 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | PEDIATRIC MEDICINE |
| Group Practice PAC ID | 4587849781 |
| Number of Group Practice Members | 474 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190064 | OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER |
| 190020 | LANE REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 6516 E Myrtle Ave, Baker, LA 70714-4348 | 2257747320 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| 6516 E Myrtle Ave, Louisiana Cardiology Associates, Baker, LA 70714-4348 | 2257673900 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| 7777 Hennessy Blvd, Baton Rouge, LA 70808-4363 | 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 |
6516 E MYRTLE AVE |
| City | BAKER |
| State | LA |
| Zip | 70714-4348 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bradford J Smith | Internal Medicine | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Wenjie Xu | Cardiac Electrophysiology | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Carl Swayze Rigby | Thoracic Surgery | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Emily T Santa Ana | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Alice C Powell | Physician Assistant | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Charles A Smith | Cardiac Electrophysiology | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| T Lane M Folse | Internal Medicine | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Chad M Klug | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Manpreet Singh | Interventional Cardiology | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Ballard J Mann | Physician Assistant | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Oreal Shantell Perkins | Nurse Practitioner | 17511 Wisdom Dr, Baker, LA 70714-1527 | |
| Andre B Stewart | Nurse Practitioner | 3612 Baker Blvd, Baker, LA 70714-2513 | |
| Julian C Mcculloch | Physical Therapy | 4971 Groom Rd, Baker, LA 70714-3145 | |
| Michael D Gaines | Clinical Social Worker | 2944 Ray Weiland Dr, Baker, LA 70714-3250 | |
| Rodolfo M Manalac | General Practice | 3034 Ray Weiland Dr, Baker, LA 70714-3252 | |
| Rick L Prewitt | Chiropractic | 3121 Van Buren St, Suite B, Baker, LA 70714-3464 | |
| Annisa L Stover | Nurse Practitioner | 330 Main St, Baker, LA 70714-3767 | |
| Kent M Rhodes | Pediatric Medicine | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Sarah Mestepey | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Vicki Z Munson-whetsone | Family Practice | Our Lady of The Lake Physician Group LLC | 6516 E Myrtle Ave, Baker, LA 70714-4348 |
| Find all physicians in zip 70714 | |||
| City | BAKER |
| Zip Code | 70714 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | BAKER + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Brad Giarrusso.
| 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.