Individual provider Active NPI

Dale Moreland Maccurdy, M.D.

  • Diagnostic Radiology Physician
  • Slidell, LA
National Provider Identifier
1104892363
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
014766 Issued in LA
Practice address
1001 Gause Blvd
Slidell, LA 70458-2939
Phone
(985) 646-0691
Fax
(985) 646-0750
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Louisiana State University School of Medicine in New Orleans, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Radiology, LLC 40 clinicians

Practice addresses (Care Compare)

1202 S Tyler St
Covington, LA 70433-2330
Phone (985) 898-4000

Hospital & facility affiliations

  • Touro Infirmary Hospital, New Orleans, LA, CCN 190046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060928000174 LA Practitioner - Diagnostic Radiology 8022916972 Reassigns benefits to 2 organizations
I20111114000687 MS Practitioner - Diagnostic Radiology 8022916972 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014766LAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Southwest Louisiana Diagnostic Radiology CurrentSince Sep 1, 2014 Accepting new patients
Northlake Radiology Consultants, Apmc Diagnostic Radiology Current Accepting new patients
Bluebonnet Imaging Center, LLC CurrentSince Jan 1, 2022 Accepting new patients
River Bend Imaging LLC CurrentSince Jan 1, 2022 Accepting new patients
Regional Radiology, LLC Diagnostic Radiology CurrentSince Mar 31, 2022 Accepting new patients
Lafayette Health Ventures, Inc Past Accepting new patients
Louisiana Pet Imaging of Alexandria, LLC Past Accepting new patients
Second Avenue MRI LLC Diagnostic Radiology PastSince Jul 19, 2014 Accepting new patients

Locations (25 of 44)

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

3311 Prescott Rd
Ste 4001
Alexandria, LA 71301

5419 Jackson Street Ext
#A
Alexandria, LA 71303
Phone (318) 441-2226

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

3425 North Blvd
Ste A
Alexandria, LA 71301
Phone (318) 473-1921

221 Windermere Blvd
Alexandria, LA 71303
Phone (318) 427-3300

224 Pecan Park Ave
Alexandria, LA 71303
Phone (318) 427-7900

651 N Bolton Ave
Alexandria, LA 71301
Phone (318) 443-3511

301 4th St
Alexandria, LA 71301
Phone (318) 441-1030

5413 Jackson Street Ext
Alexandria, LA 71303
Phone (318) 442-8399

3704 North Blvd
Alexandria, LA 71301
Phone (318) 448-8211

3311 Prescott Rd
Ste 100
Alexandria, LA 71301
Phone (318) 442-3384

433 Plaza St
Bogalusa, LA 70427
Phone (985) 730-6700

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

16282 Highway 1085
Covington, LA 70433
Phone (985) 898-4140

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

82525 Highway 25
Folsom, LA 70437
Phone (985) 839-9895

187 Ninth St
Jena, LA 71342
Phone (318) 992-9200

1322 Elton Rd
Ste F
Jennings, LA 70546
Phone (337) 824-8868

409 W Pont des Mouton Rd
Lafayette, LA 70507

2770 3rd Ave
Ste 125
Lake Charles, LA 70601
Phone (337) 494-2674

1750 Ryan St
Lake Charles, LA 70601
Phone (337) 433-3001

1747 Imperial Blvd
Ste B
Lake Charles, LA 70605
Phone (337) 312-8284

600 Bayou Pines East Dr
Ste A
Lake Charles, LA 70601
Phone (337) 493-5310

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 014766 LA Primary

Addresses

NPPES NPI Registry

Primary practice location

1001 Gause Blvd
Slidell, LA 70458-2939

Mailing address

PO Box 2710
Slidell, LA 70459-2710
Phone (985) 646-0691

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
00018026MedicaidMS
1194387MedicaidLA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104892363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2710",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704592710",
            "telephone_number": "985-646-0691",
            "fax_number": "985-646-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 GAUSE BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582939",
            "telephone_number": "985-646-0691",
            "fax_number": "985-646-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCURDY",
        "first_name": "DALE",
        "middle_name": "MORELAND",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "014766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018026",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194387",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.