Organization Active NPI

Access Health Louisiana

Doing business as Ruth U Fertel/Tulane Community Health Center

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
National Provider Identifier
1063759066
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ACCESS HEALTH LOUISIANA
Doing business as
Ruth U Fertel/Tulane Community Health Center
Practice address
711 N Broad St
New Orleans, LA 70119-4206
Phone
(985) 307-1600
Fax
(504) 575-3691
NPI assigned
Jan 10, 2013
Last updated
Aug 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Authorized official

Name
Mr. Mark Keiser
Title
President
Phone
(504) 575-3712

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Medicine Physician 207Q00000X LA

Addresses

Primary practice location

711 N Broad St
New Orleans, LA 70119-4206

Mailing address

2900 Indiana Ave
Kenner, LA 70065-4605
Phone (504) 575-3712

Other identifiers 1

IdentifierTypeStateIssuer
2324161MedicaidLA

Other names 1

  • Ruth U Fertel/Tulane Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000053 LA Part B Supplier - Clinic/Group Practice 3678484276 Receives reassigned benefits from 4 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Belle Chasse, LA; New Orleans, LA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470355200000",
    "number": "1063759066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 INDIANA AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700654605",
            "telephone_number": "504-575-3712",
            "fax_number": "504-575-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N BROAD ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701194206",
            "telephone_number": "985-307-1600",
            "fax_number": "504-575-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HEALTH LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-10",
        "last_updated": "2016-08-05",
        "status": "A",
        "authorized_official_last_name": "KEISER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-575-3712",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2324161",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ruth U Fertel/Tulane Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.