Individual provider Active NPI

Pavankumar Thota, MD

  • Internal Medicine Physician
  • New Orleans, LA
National Provider Identifier
1013478668
Registry record updated Jul 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
331480 Issued in LA
Practice address
1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone
(866) 624-7637
NPI assigned
Mar 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 331480 LA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1514 Jefferson Hwy
New Orleans, LA 70121-2429

Mailing address

4301 Tulane Ave Apt 366
New Orleans, LA 70119-6761
Phone (940) 704-8096

Other practice location 1

10301 Gateway Blvd W
El Paso, TX 79925-7701
Phone (915) 595-9000

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
I20220915003063 LA Practitioner - Internal Medicine 5496130163 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Belle Chasse Physician Services LLCGroup PAC ID 9335379379, 258 clinicians

Practice addresses (Care Compare)

2500 Belle Chasse Hwy
Terrytown, LA 70056-7127
Phone (504) 392-3131

Hospital & facility affiliations

  • Ochsner Medical Center-Kenner Hospital, Kenner, LA, CCN 190274

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
331480LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Internal Medicine CurrentSince Jul 18, 2022 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Belle Chasse Physician Services LLC CurrentSince Dec 3, 2022 Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 18, 2022 Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

100 Medical Center Dr
Slidell, LA 70461
Phone (504) 392-3131

2500 Belle Chasse Hwy
Terrytown, LA 70056
Phone (504) 391-5157

Interoperability endpoints

  • Direct secure messaging: pthota1478129@direct.ochsner.org
  • Direct secure messaging: pavankumar.thota@hca8.eclinicaldirectplus.com

Organizations & group practices 4

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

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657411200000",
    "number": "1013478668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 TULANE AVE APT 366",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701196761",
            "telephone_number": "940-704-8096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "866-624-7637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10301 Gateway Blvd W",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799257701",
            "country_code": "US",
            "telephone_number": "915-595-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOTA",
        "first_name": "PAVANKUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2022-07-10",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "331480",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.