Gabriel L Dersam, MD in Lafayette, LA - Medicare Orthopaedic Surgery

Gabriel L Dersam, MD is a medicare enrolled "Orthopaedic Surgery - Pediatric Orthopaedic Surgery" physician in Lafayette, Louisiana. His current practice location is 4704 Ambassador Caffery Pkwy Fl 1, Lafayette, Louisiana. You can reach out to his office (for appointments etc.) via phone at (337) 470-5920.

Gabriel L Dersam is licensed to practice in Louisiana (license number MD.201862) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1487844650.

Contact Information

	Gabriel L Dersam, MD
	4704 Ambassador Caffery Pkwy Fl 1, Lafayette, LA 70508-6908
	(337) 470-5920
	(885) 431-6868

Map and Direction

Physician's Profile

Full Name	Gabriel L Dersam
Gender	Male
Speciality	Orthopaedic Surgery - Pediatric Orthopaedic Surgery
Location	4704 Ambassador Caffery Pkwy Fl 1, Lafayette, Louisiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487844650
Provider Enumeration Date: 07/25/2007
Last Update Date: 12/19/2022

Medicare PECOS Information:

PECOS PAC ID: 2860585213
Enrollment ID: I20080506000465

Medical Identifiers

Medical identifiers for Gabriel L Dersam such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487844650	NPI	-	NPPES
1033553	Medicaid	LA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207X00000X	Orthopaedic Surgery	103060 (Minnesota)	Secondary
207XP3100X	Orthopaedic Surgery - Pediatric Orthopaedic Surgery	036136684 (Illinois)	Secondary
207XP3100X	Orthopaedic Surgery - Pediatric Orthopaedic Surgery	MD.201862 (Louisiana)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gabriel L Dersam allows following entities to bill medicare on his behalf.

Entity Name	Our Lady Of The Lake Physician Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377

Entity Name	Lourdes Physician Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437405883 PECOS PAC ID: 7214177757 Enrollment ID: O20130705000541

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gabriel L Dersam is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Gabriel L Dersam, MD 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (225) 526-0474	Gabriel L Dersam, MD 4704 Ambassador Caffery Pkwy Fl 1, Lafayette, LA 70508-6908 Ph: (337) 470-5920

Reviews and Comments

Orthopaedic Surgery Doctors in Lafayette, LA

Otis Rashad Drew, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 4212 W Congress St Ste 3100, Lafayette, LA 70506 Phone: 337-703-3201 Fax: 337-703-3202
David Scott Muldowny, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1103 Kaliste Saloom Rd, Suite 102, Lafayette, LA 70508 Phone: 337-234-5234 Fax: 337-235-2121
John Novotny, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 4704 Ambassador Caffery Pkwy Fl 1, Lafayette, LA 70508 Phone: 337-470-5920 Fax: 855-431-6868
Dr. Julio Petilon, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 105 Patriot St, Lafayette, LA 70508 Phone: 337-981-2125 Fax: 337-981-2174
Dr. James Barrett Kyle, M.D., D.V.M. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 108 Rue Louis Xiv, Lafayette, LA 70508 Phone: 337-235-8007 Fax: 855-270-5479
Dr. J Hugh Larriviere, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 2600 Johnston St, Ste 200, Lafayette, LA 70503 Phone: 337-232-1234
Thomas T Wood, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 108 Rue Louis Xiv, Lafayette, LA 70508 Phone: 337-235-8007 Fax: 337-235-8008

Gabriel L Dersam, MD - Medicare Orthopaedic Surgery in Lafayette, LA