Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dimitri Nicholas Pagoulato, PAC

Individual provider Physician Assistant · NPI 1194988915

Dimitri Nicholas Pagoulato, PAC is a Physician Assistant in Baker, Louisiana. Qualified in 2008, 18 years ago. Practices with Our Lady of the Lake Physician Group LLC, a 635-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
18
Licensed in
LA
In the registry since
2008
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

See every abbreviation used in this directory →

Practice location Address checks out

6516 E Myrtle Ave
Baker, LA 70714-4348
Phone: (225) 774-7320
Fax: (225) 774-5432
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12525 Perkins Rd, Baton Rouge, LA 70810-1907 — (225) 819-8857

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 200193 (LA)

Record details

NPI number1194988915
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedJuly 2, 2008
Last updated in NPPESMarch 14, 2025
Certification dateMarch 14, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Our Lady Of The Lake Physician Group Llc — 635 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Baker