Individual provider Active NPI

Jan Ada Cooper, MD

  • Internal Medicine Physician
  • New Orleans, LA
National Provider Identifier
1104914092
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
017475 Issued in LA
Practice address
1415 Tulane Ave
New Orleans, LA 70112-2600
Phone
(504) 988-7518
Fax
(504) 988-8252
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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 017475 LA Primary

Addresses

Primary practice location

1415 Tulane Ave
New Orleans, LA 70112-2600

Mailing address

1430 Tulane Ave
TW22
New Orleans, LA 70112-2632
Phone (504) 988-2300

Other identifiers 1

IdentifierTypeStateIssuer
1366374MedicaidLA

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
I20100625000463 LA Practitioner - Internal Medicine 6406987098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
LCMC Health Clinical Services LLCGroup PAC ID 3274883681, 12 clinicians

Practice addresses (Care Compare)

5620 Read Blvd
New Orleans, LA 70127-3106
Phone (504) 592-6437

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
LCMC Health Clinical Services, LLC CurrentSince Jul 20, 2018 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Jul 1, 1988 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Jul 1, 1988 Accepting new patients
Administrators of the Tulane Education Fund PastSince Jul 31, 2023 Accepting new patients

Locations

1430 Tulane Ave
#22
New Orleans, LA 70112

5620 Read Blvd
Ste 600
New Orleans, LA 70127
Phone (504) 592-6437

5646 Read Blvd
Ste 200
New Orleans, LA 70127
Phone (504) 241-1127

1430 Tulane Ave
New Orleans, LA 70112
Phone (504) 585-6485

5620 Read Blvd
New Orleans, LA 70127
Phone (504) 241-2664

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

1450 Poydras St
New Orleans, LA 70112
Phone (504) 903-2373

Networks

  • LA PPO C-SNP

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1104914092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE",
            "address_2": "TW22",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-988-2300",
            "fax_number": "504-988-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 TULANE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122600",
            "telephone_number": "504-988-7518",
            "fax_number": "504-988-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JAN",
        "middle_name": "ADA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "017475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366374",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.