Individual provider Active NPI

Shane Erin Sanne

  • Internal Medicine Physician
  • Jefferson, LA
National Provider Identifier
1073757506
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO.000223 Issued in LA
Practice address
301 Brooklyn Ave
Jefferson, LA 70121-2834
Phone
(504) 491-3902
NPI assigned
Apr 28, 2009
Last updated
Nov 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO.000223 LA Primary

Addresses

Primary practice location

301 Brooklyn Ave
Jefferson, LA 70121-2834

Mailing address

301 Brooklyn Ave
Jefferson, LA 70121-2834
Phone (504) 491-3902

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
I20120705000575 LA Practitioner - Internal Medicine 0244495851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Kansas City University of Physicians and Surgeons, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2000 Canal St
New Orleans, LA 70112-3018
Phone (504) 702-3000

2832 Burdette St
New Orleans, LA 70125-2514
Phone (504) 866-2741

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.21 of 100Reported as group
Quality
81.06
Promoting interoperability
100
Improvement activities
40
Cost
71.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO.000223LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jul 1, 2012 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G Current Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jul 1, 2012 Accepting new patients
University Medical Center Management Corporation Past Accepting new patients

Locations

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

1542 Tulane Ave
Ste 659
New Orleans, LA 70112
Phone (504) 568-2314

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

2021 Perdido St
New Orleans, LA 70112
Phone (504) 412-1800

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1073757506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BROOKLYN AVE",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "701212834",
            "telephone_number": "504-491-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BROOKLYN AVE",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "701212834",
            "telephone_number": "504-491-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANNE",
        "first_name": "SHANE",
        "middle_name": "ERIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-28",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "DO.000223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, LA

Sources for this page

Verify at the official NPI Registry.