Amy Victoria Prudhomme, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DO.000436 Issued in LA

Practice address

200 Henry Clay Ave
New Orleans, LA 70118-5720

Phone

(337) 257-7735

NPI assigned

May 1, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Pediatric Medicine

Education

Kansas City University of Physicians and Surgeons, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Louisiana State University School of Med in New Orleans Faculty GrouGroup PAC ID 9739358722, 71 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Louisiana State University School of Med in New Orleans Faculty Grou

  dba LSU Healthcare Network

  • Pediatrics Physician
  • New Orleans, LA
  • NPI 1932492626
  Medicare reassignment Care Compare group NPD
• Children's Hospital

  dba Manning Family Children's

  • Specialist
  • New Orleans, LA
  • NPI 1043230873

  Pediatrics

  Medicare reassignment NPD
• Children's Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New Orleans, LA
  • NPI 1568597649
  NPD
• Children's Hospital

  • Children's Hospital
  • New Orleans, LA
  • NPI 1104819366
  NPD (past)

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1083972715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "337-257-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "337-257-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUDHOMME",
        "first_name": "AMY",
        "middle_name": "VICTORIA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "DO.000436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Community Housing
• Gail Jones Provost
• Leticia Provost, L.C.S.W.
• Emily Provosty
• Stacie Marie Provosty, M.A. CCC-SLP
• Derrick Pruitt, B.S PSYCHOLOGY
• Kristen Pruitt, D.O.
• Karen L. Pryor, NP
• Prytania Pathology Associates LLC
• Prytania Pathology Associates, LLC

• Pediatrics Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.