DIMITRI NICHOLAS PAGOULATO PAC
NPI 1194988915
Physician Assistant in Baker, LA

Q: What is Dimitri Pagoulato's NPI number?

The NPI number for Dimitri Pagoulato is 1194988915. It was assigned to this individual provider in the NPPES registry on July 2, 2008.

Q: What is Dimitri Pagoulato's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Dimitri Pagoulato was last updated on March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 02, 2008PECOS EnrolledAccepts Medicare Assignment

6516 E MYRTLE AVE, BAKER, LA 70714(225) 774-7320(225) 774-5432 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dimitri Nicholas Pagoulato Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIMITRI NICHOLAS PAGOULATO PAC (NPI 1194988915) is an individual physician assistant in Baker, Louisiana, licensed in Louisiana (200193) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Lane Regional Medical Center, and maintains a secondary practice location in Baton Rouge.

NPPES Registry Identity

NPI1194988915

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameDIMITRI NICHOLAS PAGOULATOCredential: PAC

Location Address6516 E MYRTLE AVEBaker, LA 70714-4348

Mailing Address5959 S Sherwood Forest BlvdBaton Rouge, LA 70816-6038 · (225) 774-7320 · Fax (225) 765-9196

Phone(225) 774-7320

Fax(225) 774-5432

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJuly 2, 2008

Last NPPES UpdateMarch 14, 2025

NPPES CertifiedMarch 14, 2025

✔ NPI 1194988915 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in LA · 200193

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

6516 E MYRTLE AVE, Baker, LA 70714

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Secondary Practice Location 1

Location 112525 Perkins Rd, Ste. BBaton Rouge, LA 70810-1907 · Phone (225) 819-8857 · Fax (225) 767-6822

Other Identifiers 1

Medicaid1189871LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, HMO Louisiana, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dimitri Nicholas Pagoulato Pac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335215243

PECOS Enrollment IDI20081105000004

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

79 services60 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

34 services34 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

31 services29 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

30 services15 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

27 services19 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lane Regional Medical Center

Acute Care Hospitals · Zachary, LA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number190020

Location6300 Main StreetZachary, LA 70791 · E. Baton Rouge County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70714 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.60 typical visit price

range $53.43 – $164.73

Typical copayment $20.90 (range $13.35 – $41.18)

Most-billed visit code 99203

Established Patient

$67.06 typical visit price

range $16.64 – $133.62

Typical copayment $16.76 (range $4.16 – $33.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRAD C GIARRUSSO MD

Internal Medicine