NPIMap

Individual provider Active NPI

Gordon Frederick Wadge, M.D.

  • Hematology & Oncology Physician
  • Gretna, LA
National Provider Identifier
1043585326
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD.208087 Issued in LA
Practice address
120 Ochsner Blvd Ste 460
Gretna, LA 70056-5282
Phone
(504) 371-9355
NPI assigned
Mar 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD.208087 LA
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X MD.208087 LA Primary

Addresses

Primary practice location

120 Ochsner Blvd Ste 460
Gretna, LA 70056-5282

Mailing address

1514 Jefferson Highway
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other practice location 1

1514 Jefferson Hwy
Brent House Room 634
New Orleans, LA 70121-2429
Phone (504) 842-3000

Other identifiers 2

IdentifierTypeStateIssuer
2196537MedicaidLA
06588588MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150922000268 LA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 7315161254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Louisiana State University School of Medicine in New Orleans, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

Hospital & facility affiliations

  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
  • St Tammany Parish Hospital Hospital, Covington, LA, CCN 190045
  • Slidell Memorial Hospital Hospital, Slidell, LA, CCN 190040
  • Ochsner Medical Center - Baton Rouge Hospital, Baton Rouge, LA, CCN 190202
  • Ochsner Medical Center-Hancock Hospital, Bay Saint Louis, MS, CCN 250162

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.208087LAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Aug 18, 2015 Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 18, 2015 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Terrebonne Parish Hospital Service District #1 PastSince Oct 10, 2019 Accepting new patients
Ochsner Pharmacy and Wellness, LLC PastSince Aug 6, 2019 Accepting new patients

Locations

900 Ochsner Blvd
Covington, LA 70433
Phone (985) 249-2383

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

1514 Jefferson Hwy
Rm 634
New Orleans, LA 70121
Phone (504) 842-7518

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

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

1001 Gause Blvd
Slidell, LA 70458
Phone (985) 280-2200

Interoperability endpoints

  • Direct secure messaging: gwadge90219@direct.ochsner.org

Organizations & group practices 6

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 7

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": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1043585326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HIGHWAY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 OCHSNER BLVD STE 460",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565282",
            "telephone_number": "504-371-9355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1514 Jefferson Hwy",
            "address_2": "Brent House Room 634",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701212429",
            "country_code": "US",
            "telephone_number": "504-842-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADGE",
        "first_name": "GORDON",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "LA",
            "license": "MD.208087",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "LA",
            "license": "MD.208087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2196537",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06588588",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

Verify at the official NPI Registry.