Individual provider Active NPI

William Patrick Coleman IV, M.D.

  • Procedural Dermatology Physician
  • Metairie, LA
National Provider Identifier
1104038439
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
MD.200588 Issued in LA
Practice address
4425 Conlin St
Metairie, LA 70006-2123
Phone
(504) 455-3180
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD.200588 LA
Clinical & Laboratory Dermatological Immunology Physician 207NI0002X MD.200588 LA
Procedural Dermatology Physician 207NS0135X MD.200588 LA Primary

Addresses

Primary practice location

4425 Conlin St
Metairie, LA 70006-2123

Mailing address

4425 Conlin St
Metairie, LA 70006-2123
Phone (504) 455-3180

Other identifiers 1

IdentifierTypeStateIssuer
4K824OtherLAMEDICARE PTAN

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
I20071108000649 LA Practitioner - Dermatology 1052409091 Reassigns benefits to 1 organization
Practice locations: Metairie, LA

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Tulane University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4425 Conlin St
Metairie, LA 70006-2181
Phone (504) 455-3180

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision58
Removal of tissue1-10
Removal of skin lesions704
Removal or shaving of skin growth1-10
Skin biopsy223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.200588LAMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Nola Dermatology CurrentSince Oct 24, 2018 Accepting new patients

Locations

4425 Conlin St
Metairie, LA 70006
Phone (504) 455-3180

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1104038439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 CONLIN ST",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062123",
            "telephone_number": "504-455-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 CONLIN ST",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062123",
            "telephone_number": "504-455-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "WILLIAM",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "MD.200588",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "LA",
            "license": "MD.200588",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "LA",
            "license": "MD.200588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4K824",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.