Active NPI
Alejandro Penzo
- Internal Medicine Physician
- Pineville, LA
National Provider Identifier
1043320765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 04671R
- Practice address
- 352 Hospital Blvd.
Pineville, LA 71361-5352 - Phone
- (318) 448-0811
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 04671R | LA | Primary |
Addresses
Primary practice location
352 Hospital Blvd.
Pineville, LA 71361-5352
Mailing address
2004 Albert St
Alexandria, LA 71301-6309
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19733 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04671R | LA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Administrators of the Tulane Educational Fund | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- New Orleans, LA
- NPI 1528014164
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043320765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2004 ALBERT ST",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713016309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "352 HOSPITAL BLVD.",
"city": "PINEVILLE",
"state": "LA",
"postal_code": "713615352",
"telephone_number": "318-448-0811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENZO",
"first_name": "ALEJANDRO",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "LA",
"license": "04671R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "19733",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pineville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.