Individual provider Active NPI

Michael Lester Lifsey, MD

  • Otolaryngology Physician
  • Metairie, LA
National Provider Identifier
1053465005
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
015167 Issued in LA
Practice address
4770 S I 10 Service Rd W Ste 110
Metairie, LA 70001
Phone
(504) 454-3277
Fax
(504) 887-8934
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 015167 LA Primary

Addresses

Primary practice location

4770 S I 10 Service Rd W Ste 110
Metairie, LA 70001

Mailing address

4770 S I 10 Service Rd W Ste 110
Metairie, LA 70001-1224
Phone (504) 454-3277

Other identifiers 1

IdentifierTypeStateIssuer
1341673MedicaidLA

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
I20051006000783 LA Practitioner - Otolaryngology 9032134234

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015167LAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Medical Center 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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1053465005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 S I 10 SERVICE RD W STE 110",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011224",
            "telephone_number": "504-454-3277",
            "fax_number": "504-887-8934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 S I 10 SERVICE RD W STE 110",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70001",
            "telephone_number": "504-454-3277",
            "fax_number": "504-887-8934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIFSEY",
        "first_name": "MICHAEL",
        "middle_name": "LESTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "015167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1341673",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.