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NORTHLAKE GASTROENTEROLOGY
NPI 1861484842
Specialist in Hammond, LA

Active since August 17, 2005CLIA Certified · 3 labs
16061 DOCTORS BLVD, SUITE B, HAMMOND, LA 70403(985) 542-1334(985) 318-1004 Get Directions Write a Review

NPPES record last updated: August 17, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 17, 2026, Jul 21, 2022, Jan 9, 2020 (3 updates tracked since 2020).

About Northlake Gastroenterology NPPES

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

NORTHLAKE GASTROENTEROLOGY (NPI 1861484842) is a healthcare organization registered as a specialist in Hammond, Louisiana and active in the NPI registry since August 2005. The organization holds 3 active CLIA laboratory certificates and lists Roy Holder, Administrator, as its authorized official.

NPPES Registry Identity

NPI1861484842
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameNORTHLAKE GASTROENTEROLOGY
Location Address16061 DOCTORS BLVD, SUITE BHammond, LA 70403-1479
Mailing Address16061 Doctors Blvd Ste BHammond, LA 70403-1499 · (985) 542-1334 · Fax (985) 318-1005
Phone(985) 542-1334
Fax(985) 318-1004
Organization SubpartNo
Authorized OfficialRoy HolderAdministrator · (985) 542-1334
Enumeration DateAugust 17, 2005
Last NPPES UpdateAugust 17, 20263 updates tracked since enumeration
NPPES CertifiedAugust 17, 2026
✔ NPI 1861484842 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
16061 DOCTORS BLVD, Hammond, LA 70403
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Northlake Gastroenterology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

12

Medicare enrollment records show 12 clinicians reassign Medicare billing to Northlake Gastroenterology, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 8 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Gastroenterology5
Nurse Practitioner5
Diagnostic Radiology1
Internal Medicine1

Clinicians, nearest first (12)

Wendi Neal, FNP-C
Nurse Practitioner
NPI 1396200960
16061 DOCTORS BLVD
Hammond, LA 70403
(985) 524-1334
✔ PECOS✔ Accepts MedicareSame address
Alisa Picou, FNP-C
Nurse Practitioner
NPI 1346705100
16061 DOCTORS BLVD
Hammond, LA 70403
(985) 542-1334
✔ PECOS✔ Accepts MedicareSame address
Jason Reina, MD
Gastroenterology
NPI 1548236391
16061 DOCTORS BLVD SUITE B
Hammond, LA 70403
(504) 338-4746
✔ PECOS✔ Accepts MedicareSame address
Whitney Morgan, FNP-C
Nurse Practitioner
NPI 1740922400
16061 DOCTORS BLVD STE B
Hammond, LA 70403
(985) 542-1334
✔ PECOSSame address
Dennis Booth, M.D.
Gastroenterology
NPI 1639174741
16061 DOCTORS BLVD STE B
Hammond, LA 70403
(985) 542-1334
✔ PECOS✔ Accepts MedicareSame address
Gregory Mula, M.D.
Gastroenterology
NPI 1265437362
16061 DOCTORS BLVD STE B
Hammond, LA 70403
(985) 542-1334
✔ PECOS✔ Accepts MedicareSame address
Russell Wardlaw, MD
Gastroenterology
NPI 1376734210
16061 DOCTORS BLVD SUITE B
Hammond, LA 70403
(985) 542-1334
✔ PECOS✔ Accepts MedicareSame address
Roy Divittorio, MD
Diagnostic Radiology
NPI 1679564264
15837 PAUL VEGA MD DR SUITE 200
Hammond, LA 70403
(985) 542-8190
✔ PECOS✔ Accepts Medicare0.6 mi
Wendy Peterson, CFNP
Nurse Practitioner
NPI 1841443272
7015 HIGHWAY 190 EAST SERVICE RD STE 102
Covington, LA 70433
(985) 893-9592
✔ PECOS✔ Accepts Medicare22 mi
Lara Boudreaux, MD
Internal Medicine
NPI 1992267272
7015 HIGHWAY 190 EAST SERVICE RD STE 102
Covington, LA 70433
(985) 893-9592
✔ PECOS✔ Accepts Medicare22 mi
Lawrence Gensler, M.D.
Gastroenterology
NPI 1841295953
7015 HIGHWAY 190 STE 102
Covington, LA 70433
(985) 542-1334
✔ PECOS✔ Accepts Medicare23 mi
Alexandra Morgan, FNP-C
Nurse Practitioner
NPI 1831831593
1393 E SEGO LILY DR
Sandy, UT 84092
(801) 619-9000
✔ PECOS1,387 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 3

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 19D2310961

Northlake Gastroenterology Associates, LLP · Hammond, LA
Active · expires Sep 12, 2028
CLIA Number19D2310961
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 13, 2026
Certificate Expiration DateSeptember 12, 2028
Laboratory DirectorGregory Mula
Laboratory Phone(985) 542-1334
Laboratory LocationNorthlake Gastroenterology Associates, LLP16061 Doctors Blvd Suite B, Hammond, LA 70403
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 19D2310962

Northlake Gastroenterology Associates, LLP · Covington, LA
Active · expires Sep 12, 2028
CLIA Number19D2310962
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 13, 2026
Certificate Expiration DateSeptember 12, 2028
Laboratory DirectorGregory Mula
Laboratory Phone(985) 542-1334
Laboratory LocationNorthlake Gastroenterology Associates, LLP7015 Hwy 190 E Service Rd, Covington, LA 70433
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 19D2310963

Northlake Gastroenterology Associates, LLP · Franklinton, LA
Active · expires Sep 12, 2028
CLIA Number19D2310963
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 13, 2026
Certificate Expiration DateSeptember 12, 2028
Laboratory DirectorGregory Mula
Laboratory Phone(985) 542-1334
Laboratory LocationNorthlake Gastroenterology Associates, LLP809 Boat Ramp Rd, Franklinton, LA 70438
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Northlake Gastroenterology's NPI number?

The NPI number for Northlake Gastroenterology is 1861484842. It was assigned to this organization in the NPPES registry on August 17, 2005.

Where is Northlake Gastroenterology located?

Northlake Gastroenterology is located at 16061 Doctors Blvd Suite B, Hammond, LA 70403. The listed phone number is (985) 542-1334.

What is Northlake Gastroenterology's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Northlake Gastroenterology enrolled in Medicare?

Yes. Northlake Gastroenterology is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Northlake Gastroenterology?

According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 4 Medicare specialties reassign their Medicare billing to Northlake Gastroenterology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Gastroenterology (5), Nurse Practitioner (5) and Diagnostic Radiology (1). Of these, 7 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Northlake Gastroenterology hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Northlake Gastroenterology accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Blue Cross and Blue Shield of Louisiana and 1 other insurer list Northlake Gastroenterology 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 Northlake Gastroenterology was last updated on August 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.