Ochsner Clinic LLC
Organization Active NPI Internal Medicine Physician · New Orleans, LA
NPI 1003379124 · NPPES record last updated Apr 8, 2019
Key facts
- NPI
- 1003379124
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- OCHSNER CLINIC LLC
- Practice address
- 701 Poydras St Ste 107
New Orleans, LA 70139-7713 - Phone
- (504) 703-1355
- NPI assigned
- Apr 8, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- OCHSNER CLINIC LLC
Authorized official
- Name
- Eduardo Benitez
- Title
- Director
- Phone
- (504) 842-6933
Corporate family (same tax ID) 13
Practitioners 28
-
Laurel Coulon, AUD
-
Santiago Gomez, MD
-
John M Gordon, M.D.
-
Sharon Rocio Lagos, PA-C
-
Walter Lam, MD
-
Michelle H Mata, CRNA
-
Micah J Metrailer, CRNA
-
Carmen Dorina Mironovici, M.D.
-
Krzysztof Moroz, M.D.
-
Stephen Anthony Morse, DO, MPH&TM
-
Jennifer Pecquet, FNP-C
-
Kori Lackey Robinson, PA-C
-
Heidi Lee Sinclair, MD, MPH
-
Amanda Stromeyer, PA
-
Kathryn Wheeler, CPNP-PC
-
Jessica Wolff, MD
-
Andrea A. Birch, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031126000513 | LA | Part B Supplier - Clinic/Group Practice | 8224933619 |
Receives reassigned benefits from 4,981 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Ochsner Clinic of Baton
- Part of
- Ochsner Clinic of Baton
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
701 Poydras St Ste 107
New Orleans, LA 70139-7713
Mailing address
1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1030228 | Medicaid | KY |
Other names
- Ochsner Urgent Care & Occupational Health - CBD
Other providers in New Orleans, LA
- Ochsner Clinic Foundation
- Ochsner Clinic Foundation
- Ochsner Clinic Foundation
- Ochsner Clinic LLC
- Ochsner Clinic LLC
- Ochsner Clinic LLC
- Ochsner Clinic LLC
- Ochsner Clinic LLC
- Ochsner Clinic LLC
- Ochsner Clinic LLC
All providers in New Orleans, LA · Internal Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.