Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. NICOLETTE DENEE SHAFTO PA
NPI 1417325218
Physician Assistant - Medical in Shreveport, LA

Active since September 10, 2015PECOS EnrolledAccepts Medicare Assignment
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210, SHREVEPORT, LA 71105(318) 212-3858(318) 212-3958 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 5, 2026, Apr 7, 2021, Dec 18, 2020 and 2 more (5 updates tracked since 2019).

About Mrs. Nicolette Denee Shafto Pa NPPES

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

MRS. NICOLETTE DENEE SHAFTO PA (NPI 1417325218) is an individual medical provider in Shreveport, Louisiana, licensed in Louisiana (PA.200885) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS, is affiliated with Our Lady Of The Lake Regional Medical Center, and maintains a secondary practice location in Baton Rouge.

NPPES Registry Identity

NPI1417325218
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. NICOLETTE DENEE SHAFTOCredential: PA
Location Address1811 E BERT KOUNS INDUSTRIAL LOOP STE 210Shreveport, LA 71105-5740
Mailing Address1202 Louisiana AveShreveport, LA 71101-3910 · (318) 716-4908 · Fax (318) 716-4854
Fax(318) 212-3958
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateSeptember 10, 2015
Last NPPES UpdateJune 24, 20265 updates tracked since enumeration
NPPES CertifiedJune 24, 2026
NPI 1417325218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in LA · PA.200885
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210, Shreveport, LA 71105

Secondary Practice Location 1

Location 17777 Hennessy Blvd Ste 1008Baton Rouge, LA 70808-4368 · Phone (225) 766-0416

Accepted 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

Mrs. Nicolette Denee Shafto Pa 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 ID9436455706
PECOS Enrollment IDI20160311002111
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 3

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.
210 services164 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.
26 services26 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
21 services16 patients

Hospital Affiliations CMS Care Compare

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

Our Lady Of The Lake Regional Medical Center

Acute Care Hospitals · Baton Rouge, LA
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number190064
Location5000 Hennessy BlvdBaton Rouge, LA 70808 · E. Baton Rouge County
Emergency services

Other Providers at the Same Location NPPES 12

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

Physician Assistant
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210
SHREVEPORT, LA 71105
Nurse Practitioner (Family)
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210
SHREVEPORT, LA 71105
Nurse Practitioner
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210
SHREVEPORT, LA 71105
Internal Medicine (Cardiovascular Disease)
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210
SHREVEPORT, LA 71105
Internal Medicine (Cardiovascular Disease)
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210
SHREVEPORT, LA 71105
Internal Medicine (Cardiovascular Disease)
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210
SHREVEPORT, LA 71105
Internal Medicine (Cardiovascular Disease)
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210
SHREVEPORT, LA 71105
Nurse Practitioner (Acute Care)
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210
SHREVEPORT, LA 71105

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicolette Shafto's NPI number?

The NPI number for Nicolette Shafto is 1417325218. It was assigned to this individual provider in the NPPES registry on September 10, 2015.

Where is Nicolette Shafto located?

Nicolette Shafto practices at 1811 E Bert Kouns Industrial Loop Ste 210, Shreveport, LA 71105. The listed phone number is (318) 212-3858.

What is Nicolette Shafto's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Nicolette Shafto enrolled in Medicare?

Yes. Nicolette Shafto is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Nicolette Shafto accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter from Superior HealthPlan and AmeriHealth Caritas Next and 3 other insurers list Nicolette Shafto as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nicolette Shafto affiliated with any hospitals?

According to CMS data, Nicolette Shafto is affiliated with Our Lady Of The Lake Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Nicolette Shafto was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 43 days 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.