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NORTHSHORE PLASTIC SURGERY, LLC
NPI 1568690469
Plastic Surgery in Mandeville, LA

Active since June 30, 2009CLIA 19D2275131 · Waiver
3401 E CAUSEWAY APPROACH, MANDEVILLE, LA 70448(985) 237-6050 Get Directions Write a Review

NPPES record last updated: April 1, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Northshore Plastic Surgery, Llc NPPES

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

NORTHSHORE PLASTIC SURGERY, LLC (NPI 1568690469) is a healthcare organization registered as a plastic surgery in Mandeville, Louisiana and active in the NPI registry since June 2009. The organization holds a CLIA Waiver certificate valid through January 16, 2027 and lists Benjamin J Boudreaux, Manager, as its authorized official.

NPPES Registry Identity

NPI1568690469
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NameNORTHSHORE PLASTIC SURGERY, LLC
Location Address3401 E CAUSEWAY APPROACHMandeville, LA 70448-3447
Mailing Address3401 E Causeway ApproachMandeville, LA 70448-3447 · (985) 237-6050
Phone(985) 237-6050
Organization SubpartNo
Authorized OfficialBenjamin J BoudreauxManager · (225) 588-4644
Enumeration DateJune 30, 2009
Last NPPES UpdateApril 1, 2021
NPPES CertifiedApril 1, 2021
✔ NPI 1568690469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in LA · MD.201940
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
3401 E CAUSEWAY APPROACH, Mandeville, LA 70448
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 19D2275131

Northshore Plastic Surgery LLC · Mandeville, LA
Active · expires Jan 16, 2027
CLIA Number19D2275131
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJanuary 17, 2025
Certificate Expiration DateJanuary 16, 2027
Laboratory DirectorBenjamin J. Boudreaux
Laboratory Phone(985) 237-6050
Laboratory LocationNorthshore Plastic Surgery LLC3401 East Causeway Approach, Mandeville, LA 70448
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

DR. JEFFREY REID CLAIBORNE M.D.
Plastic Surgery
3401 E CAUSEWAY APPROACH
MANDEVILLE, LA 70448
St. Tammany Parish (985) 237-6050
LAUREN BRUMFIELD
Specialist/Technologist, Other (Surgical Assistant)
3401 E CAUSEWAY APPROACH
MANDEVILLE, LA 70448
St. Tammany Parish (985) 237-6050
DR. BENJAMIN JOSEPH BOUDREAUX M.D.
Plastic Surgery
3401 E CAUSEWAY APPROACH
MANDEVILLE, LA 70448
St. Tammany Parish (985) 237-6050
NORTHSHORE PLASTIC SURGERY
Specialist/Technologist, Other (Surgical Assistant)
3401 E CAUSEWAY APPROACH
MANDEVILLE, LA 70448
St. Tammany Parish (985) 237-6050

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 Northshore Plastic Surgery, LLC's NPI number?

The NPI number for Northshore Plastic Surgery, LLC is 1568690469. It was assigned to this organization in the NPPES registry on June 30, 2009.

Where is Northshore Plastic Surgery, LLC located?

Northshore Plastic Surgery, LLC is located at 3401 E Causeway Approach, Mandeville, LA 70448. The listed phone number is (985) 237-6050.

What is Northshore Plastic Surgery, LLC's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Does Northshore Plastic Surgery, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 19D2275131) is associated with this NPI, valid through January 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Northshore Plastic Surgery, LLC was last updated on April 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.