NATALIE J. GILMORE MD
NPI 1275102709
Hospitalist in Lafayette, LA

NPI Status: Active since June 19, 2021

Contact Information

4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA
ZIP 70508
Phone: (337) 470-2605
Fax: (337) 470-4595

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  • Individual
  • Female
  • Years of Experience 5
  • Hospitalist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About NATALIE GILMORE

This page provides the complete NPI Profile along with additional information for Natalie Gilmore, a provider established in Lafayette, Louisiana with a medical specialization in Hospitalist and more than 5 years of experience. The healthcare provider is registered in the NPI registry with number 1275102709 assigned on June 2021. The practitioner's primary taxonomy code is 208M00000X with license number 341172 (LA). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI
1275102709
Provider Name
NATALIE J. GILMORE MD
Other Name
NATALIE A JURISICH
Other Name Type
Former Name (1)
Gender
Female
Entity Type
Individual
Location Address
4801 AMBASSADOR CAFFERY PKWY LAFAYETTE, LA 70508
Location Phone
(337) 470-2605
Location Fax
(337) 470-4595
Mailing Address
5959 S SHERWOOD FOREST BLVD BATON ROUGE, LA 70816
Mailing Phone
(337) 470-2605
Mailing Fax
(337) 470-4595
Medical School Name
OTHER
Graduation Year
2021
Is Sole Proprietor?
Yes
Enumeration Date
06-19-2021
Last Update Date
12-31-2024
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Location Map

Secondary Locations

  • 1501 Kings Hwy
    Shreveport, LA 71103
    (318) 626-0434

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Hospitalist

Taxonomy Code
208M00000X
Type
Allopathic & Osteopathic Physicians
License No.
341172
License State
LA
Taxonomy Description
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
  • Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
  • Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
  • Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
  • Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
  • Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
  • Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits - POS
  • Precision Blue 80/60 $3200 with 2 $0 PCP Virtual Visits (BR) - POS
  • Precision Blue 80/60 $3200 with 2 $0 PCP Virtual Visits (M) - POS
  • Precision Blue 90/70 $9900 with 2 $0 PCP Virtual Visits (M) HSA Eligible - POS
  • Precision Blue Copay (PCP) 50/50 $7500 Standardized (BR) HSA Eligible - POS
  • Precision Blue Copay (PCP) 50/50 $7500 Standardized (M) HSA Eligible - POS
  • Precision Blue Copay (PCP) 60/40 $6000 Standardized (BR) - POS
  • Precision Blue Copay (PCP) 60/40 $6000 Standardized (M) - POS
  • Precision Blue Copay (PCP) 75/55 $2000 Standardized (BR) - POS
  • Precision Blue Copay (PCP) 75/55 $2000 Standardized (M) - POS
  • Signature Blue 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
  • Signature Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
  • Signature Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
  • Signature Blue Copay (PCP) 60/40 $6000 Standardized - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Natalie Gilmore is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Natalie Gilmore is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 1355719915

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20240827000181

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.15 for a new patient copayment and $23.77 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 70508 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $124.6
  • Minimum New Patient Price $53.43
  • Maximum New Patient Price $164.73
  • Average New Patient Copayment $31.15
  • Minimum New Patient Copayment $13.35
  • Maximum New Patient Copayment $41.18

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $95.09
  • Minimum Established Patient Price $16.64
  • Maximum Established Patient Price $133.62
  • Average Established Patient Copayment $23.77
  • Minimum Established Patient Copayment $4.16
  • Maximum Established Patient Copayment $33.4

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Natalie Gilmore is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC4801 AMBASSADOR CAFFERY PARKWAY
LAFAYETTE, LA 70508
(337) 470-2000Acute Care Hospitals

Reviews for NATALIE J. GILMORE MD

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1275102709, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
5
Unchanged
Pos 5
1
Doubled → 2
Pos 6
0
Unchanged
Pos 7
2
Doubled → 4
Pos 8
7
Unchanged
Pos 9
0
Doubled → 0
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 1 → 2 2 → 4 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 4 + 5 + 2 + 0 + 4 + 7 + 0 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1275102709.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Surgery
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Nurse Anesthetist, Certified Registered
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Physician Assistant (Medical)
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Nurse Anesthetist, Certified Registered
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Surgery
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Family Medicine
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Radiology (Diagnostic Radiology)
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Psychologist (Clinical)
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Nurse Practitioner (Adult Health)
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Nurse Practitioner
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Physical Medicine & Rehabilitation
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Psychiatry & Neurology (Neurology)
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Emergency Medicine
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Nurse Practitioner (Family)
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Nurse Practitioner (Family)
4801 AMBASSADOR CAFFERY PKWY, SUITE 360
LAFAYETTE, LA 70508
Physician Assistant
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Dietitian, Registered
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Nurse Practitioner (Family)
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Radiology (Diagnostic Radiology)
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Radiology (Diagnostic Radiology)
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275102709, enumerated as an "individual" on June 19, 2021.

The provider is located at 4801 AMBASSADOR CAFFERY PKWY LAFAYETTE, LA 70508 and the phone number is (337) 470-2605.

Hospitalist with taxonomy code 208M00000X.

The provider might be accepting Accepts: HMO Louisiana. Please consult your insurance carrier or call the provider to verify.

Natalie Gilmore is affiliated with: OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC.