Individual provider Active NPI

Richard Douglas Demoss, MD

  • Anatomic Pathology Physician
  • Metairie, LA
National Provider Identifier
1003927849
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
026255 Issued in LA
Practice address
4200 Houma Blvd
Metairie, LA 70006
Phone
(504) 545-5683
Fax
(504) 456-8195
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 026255 LA Primary

Addresses

Primary practice location

4200 Houma Blvd
Metairie, LA 70006

Mailing address

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 545-5683

Other identifiers 1

IdentifierTypeStateIssuer
1052469MedicaidLA

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
I20070608000028 LA Practitioner - Pathology 3870691231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Louisiana State University School of Medicine in New Orleans, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

602 N Acadia Rd
Thibodaux, LA 70301-4823

602 N Acadia Rd
Thibodaux, LA 70301-4847

608 N Acadia Rd
Thibodaux, LA 70301-4847

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.55 of 100Reported as group
Quality
67.62
Promoting interoperability
100
Improvement activities
40
Cost
71.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026255LAMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodaux Regional Network Development Corporation CurrentSince Jan 1, 2018 Accepting new patients
Thibodaux Regional Network Development Corporation Current Accepting new patients
Thibodaux Regional Network Development Corporation CurrentSince Jan 1, 2018 Accepting new patients
Thibodaux Regional Network Development Corporation Past Accepting new patients
Jefferson Pathology LLC Past Accepting new patients

Locations

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

Organizations & group practices 5

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 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003927849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70006",
            "telephone_number": "504-545-5683",
            "fax_number": "504-456-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70006",
            "telephone_number": "504-545-5683",
            "fax_number": "504-456-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMOSS",
        "first_name": "RICHARD",
        "middle_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "LA",
            "license": "026255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1052469",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.