Individual provider Active NPI

Mordecai Potash, M.D.

  • Psychiatry Physician
  • New Orleans, LA
National Provider Identifier
1104879659
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD.024030 Issued in LA
Practice address
1440 Canal St
Tulane Psychiatry Department, 10TH Floor, TB-48
New Orleans, LA 70112-2703
Phone
(504) 988-5405
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Psychiatry Physician 2084P0800X MD.024030 LA Primary

Addresses

Primary practice location

1440 Canal St
Tulane Psychiatry Department, 10TH Floor, TB-48
New Orleans, LA 70112-2703

Mailing address

1440 Canal St
Tulane Psychiatry Department, 10TH Floor, TB-48
New Orleans, LA 70112-2703
Phone (504) 988-5405

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
I20041027000879 LA Practitioner - PsychiatryPractitioner - Pain Management 2264494756 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.024030LAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund Specialist CurrentSince Jul 27, 2004 Accepting new patients
Administrators of the Tulane Education Fund PastSince Jul 31, 2023 Accepting new patients

Locations

71211 Highway 21
Ste B
Covington, LA 70433
Phone (985) 893-9922

4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1430 Tulane Ave
#22
New Orleans, LA 70112

1440 Canal St
Ofc Tulane
New Orleans, LA 70112
Phone (504) 988-4272

1415 Tulane Ave
#15
New Orleans, LA 70112
Phone (504) 588-2300

Organizations & group practices 2

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1104879659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 CANAL ST",
            "address_2": "TULANE PSYCHIATRY DEPARTMENT, 10TH FLOOR, TB-48",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122703",
            "telephone_number": "504-988-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 CANAL ST",
            "address_2": "TULANE PSYCHIATRY DEPARTMENT, 10TH FLOOR, TB-48",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122703",
            "telephone_number": "504-988-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTASH",
        "first_name": "MORDECAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "MD.024030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.