Individual provider Active NPI

Thomas Terrell McGinn Jr., O.D

  • Optometrist
  • Metairie, LA
National Provider Identifier
1043385776
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1090-105T Issued in LA
Practice address
4324 Veterans Memorial Blvd
Suite 104
Metairie, LA 70006-5445
Phone
(504) 455-9825
Fax
(504) 883-7669
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1090-105T LA Primary

Addresses

Primary practice location

4324 Veterans Memorial Blvd
Suite 104
Metairie, LA 70006-5445

Mailing address

Dept at 952581
Atlanta, GA 31192-2581
Phone (504) 455-9825

Other identifiers 1

IdentifierTypeStateIssuer
1918709MedicaidLA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090625000123 LA Practitioner - Optometry 6800992249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1090-105TLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Providers, LLC Optometrist Current Accepting new patients
Miles H. Friedlander, Apmc Past Accepting new patients
Zephyr Anesthesia, LLC Past Accepting new patients

Locations

Dept AT 952581
Atlanta, GA 31192

4324 Veterans Memorial Blvd
Ste 102
Metairie, LA 70006

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228435200000",
    "number": "1043385776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT AT 952581",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311922581",
            "telephone_number": "504-455-9825",
            "fax_number": "504-883-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4324 VETERANS MEMORIAL BLVD",
            "address_2": "SUITE 104",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700065445",
            "telephone_number": "504-455-9825",
            "fax_number": "504-883-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGINN",
        "first_name": "THOMAS",
        "middle_name": "TERRELL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1090-105T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1918709",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.