Individual provider Active NPI

Luis Federico Matta II, M.D.

  • Emergency Medicine Physician
  • Covington, LA
National Provider Identifier
1003817941
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
019575 Issued in LA
Practice address
71205 Highway 21 Ste 1
Covington, LA 70433-7121
Phone
(985) 809-8868
NPI assigned
Aug 2, 2005
Last updated
Apr 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 019575 LA Primary

Addresses

Primary practice location

71205 Highway 21 Ste 1
Covington, LA 70433-7121

Mailing address

71205 Highway 21 Ste 1
Covington, LA 70433-7121
Phone (985) 809-8868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041129000846 LA Practitioner - Emergency MedicinePractitioner - Family Practice 6305801523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

614 W 11TH Ave
Covington, LA 70433-3630
Phone (985) 809-8868

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
019575LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Tchefuncta Urgent Care, Inc. CurrentSince Nov 24, 2008 Accepting new patients
Premier After Hours Past Accepting new patients
South Louisiana ENT, Facial Plastic & Hair Restoration, Apmc Past Accepting new patients

Locations

614 W 11th Ave
Covington, LA 70433
Phone (985) 809-8868

71205 Highway 21
#1
Covington, LA 70433
Phone (985) 809-8868

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1003817941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71205 HIGHWAY 21 STE 1",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337121",
            "telephone_number": "985-809-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71205 HIGHWAY 21 STE 1",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337121",
            "telephone_number": "985-809-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA",
        "first_name": "LUIS",
        "middle_name": "FEDERICO",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "019575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.