GABRIEL L. DERSAM MD – NPI #1487844650
Orthopaedic Surgery

An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones.

GABRIEL DERSAM is an orthopaedic surgeon located in LAFAYETTE, LA. NPPES has assigned the NPI number 1487844650 to GABRIEL DERSAM on July 25, 2007. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207XP3100X from the Health Care Provider Taxonomy code set, which is classified as Orthopaedic Surgery, specializing in Pediatric Orthopaedic Surgery

The NPI profile was previously updated about 3 years ago on Dec 19, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GABRIEL DERSAM below.

NPI Profile for
GABRIEL L. DERSAM

NPI Number
1487844650
Enumeration Date

(about 19 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
GABRIEL L. DERSAM
Credentials
MD
Primary location
4704 AMBASSADOR CAFFERY PKWY FL 1
LAFAYETTE, LA 70508-6908
Phone: (337) 470-5920 Fax: (885) 431-6868
1 Other location(s):
1890 W Gauthier Rd Ste 115
Lake Charles, LA 70605-7180
Phone: (337) 470-2907
Fax: (855) 431-6868
Mailing address
5959 S SHERWOOD FOREST BLVD
BATON ROUGE, LA 70816-6038
Phone: (225) 526-0474 Fax: (225) 765-9196
Sole Proprietor
No
Updated
Certification Date
Dec 19, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for GABRIEL DERSAM

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidLA1033553
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207XP3100X
- Orthopaedic Surgery / Pediatric Orthopaedic Surgery (Primary)
IL 036136684
207X00000X
- Orthopaedic Surgery
MN 103060

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

View All Endpoint(s)
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
FMOLHS-EPIC
Content Type
OTHER
Affiliation
N
Endpoint Location
4704 AMBASSADOR CAFFERY PKWY,
LAFAYETTE, LA 77025-1669

Endpoint
https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Endpoint type
FHIR URL
Endpoint Description
FMOLHS FIR URL
Content Type
OTHER
Affiliation
N
Endpoint Location
4704 AMBASSADOR CAFFERY PKWY,
LAFAYETTE, LA 77025-1669

Additional Information

Education
UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE - Graduated 2000
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.