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GABRIEL L DERSAM MD
NPI 1487844650
Orthopaedic Surgery - Pediatric Orthopaedic Surgery in Lafayette, LA

Active since July 25, 2007PECOS EnrolledAccepts Medicare Assignment
4704 AMBASSADOR CAFFERY PKWY FL 1, LAFAYETTE, LA 70508(337) 470-5920(885) 431-6868 Get Directions Write a Review

NPPES record last updated: December 19, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 19, 2022, Mar 9, 2022, Feb 13, 2020 (3 updates tracked since 2020).

About Gabriel L Dersam Md NPPES

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

GABRIEL L DERSAM MD (NPI 1487844650) is an individual pediatric orthopaedic surgery provider in Lafayette, Louisiana, licensed in Louisiana (MD.201862) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS and is a graduate of University Of Arizona College Of Medicine (2000).

NPPES Registry Identity

NPI1487844650
Entity TypeIndividualMale
Primary Taxonomy207XP3100X
Provider Legal NameGABRIEL L DERSAMCredential: MD
Location Address4704 AMBASSADOR CAFFERY PKWY FL 1Lafayette, LA 70508-6908
Mailing Address5959 S Sherwood Forest BlvdBaton Rouge, LA 70816-6038 · (225) 526-0474 · Fax (225) 765-9196
Phone(337) 470-5920
Fax(885) 431-6868
Sole ProprietorNo
Medical School CMSUniversity Of Arizona College Of MedicineGraduated 2000
Enumeration DateJuly 25, 2007
Last NPPES UpdateDecember 19, 20223 updates tracked since enumeration
NPPES CertifiedDecember 19, 2022
✔ NPI 1487844650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Pediatric Orthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207XP3100X
Licenses✔ Licensed in LA · MD.201862✔ Licensed in IL · 036136684
Definition
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.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License 103060 (MN)
4704 AMBASSADOR CAFFERY PKWY FL 1, Lafayette, LA 70508
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Other Identifiers 1

Medicaid1033553LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of Louisiana, HMO Louisiana and more.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

Gabriel L Dersam Md 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 ID2860585213
PECOS Enrollment IDI20080506000465
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.

Other Providers at the Same Location NPPES

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

CAROLINE LANDRY HANKS PA-C
Physician Assistant
4704 AMBASSADOR CAFFERY PKWY FL 1
LAFAYETTE, LA 70508
Lafayette Parish (337) 470-5920

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 Gabriel Dersam's NPI number?

The NPI number for Gabriel Dersam is 1487844650. It was assigned to this individual provider in the NPPES registry on July 25, 2007.

Where is Gabriel Dersam located?

Gabriel Dersam practices at 4704 Ambassador Caffery Pkwy Fl 1, Lafayette, LA 70508. The listed phone number is (337) 470-5920.

What is Gabriel Dersam's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Pediatric Orthopaedic Surgery, with taxonomy code 207XP3100X.

Is Gabriel Dersam enrolled in Medicare?

Yes. Gabriel Dersam 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 Gabriel Dersam accept?

Health plans from AmeriHealth Caritas Next, Blue Cross and Blue Shield of Louisiana, HMO Louisiana and UnitedHealthcare list Gabriel Dersam 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.

When was this NPI record last updated?

The NPPES record for Gabriel Dersam was last updated on December 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.