Individual provider Active NPI

Thomas Alfred Reinecke, MD

  • Emergency Medicine Physician
  • Hammond, LA
National Provider Identifier
1073545935
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.016275 Issued in LA
Practice address
15790 Paul Vega MD Dr
Revenue Management Department
Hammond, LA 70403-1434
Phone
(985) 230-1682
Fax
(985) 230-1617
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.016275 LA Primary

Addresses

Primary practice location

15790 Paul Vega MD Dr
Revenue Management Department
Hammond, LA 70403-1434

Mailing address

PO Box 2668
Hammond, LA 70404-2668
Phone (985) 230-1332

Other practice location 1

1585 3rd St
Fort Polk, LA 71459-5102
Phone (337) 531-3942

Other identifiers 4

IdentifierTypeStateIssuer
04235008MedicaidMS
1349232MedicaidLA
P01121563OtherLARAILROAD MCARE
1349236MedicaidLA

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

LicenseStateTypeSpecialty
16275LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital Service District of West Feliciana Parish Louisiana Emergency Medicine Past Accepting new patients
North Oaks Medical Center, LLC Past Accepting new patients
Louisiana Emergency & Trauma Specialists Emergency Medicine Past Accepting new patients

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1073545935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2668",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704042668",
            "telephone_number": "985-230-1332",
            "fax_number": "985-230-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15790 PAUL VEGA MD DR",
            "address_2": "REVENUE MANAGEMENT DEPARTMENT",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031434",
            "telephone_number": "985-230-1682",
            "fax_number": "985-230-1617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1585 3rd St",
            "address_purpose": "LOCATION",
            "city": "Fort Polk",
            "state": "LA",
            "postal_code": "714595102",
            "country_code": "US",
            "telephone_number": "337-531-3942",
            "fax_number": "337-531-3175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REINECKE",
        "first_name": "THOMAS",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.016275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04235008",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1349232",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE",
            "identifier": "P01121563",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1349236",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.