Individual provider Active NPI

Edward Madison III, MD

  • Internal Medicine Physician
  • Slidell, LA
National Provider Identifier
1104956382
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
020631 Issued in LA
Practice address
2765 SGT Alfred Dr
Slidell, LA 70458-4013
Phone
(504) 241-0861
Fax
(985) 288-5388
NPI assigned
Mar 6, 2007
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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 020631 LA Primary

Addresses

Primary practice location

2765 SGT Alfred Dr
Slidell, LA 70458-4013

Mailing address

2765 SGT Alfred Dr
Slidell, LA 70458-4013
Phone (504) 241-0861

Other identifiers 1

IdentifierTypeStateIssuer
1480631MedicaidLA

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
I20100713000294 LA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 5698807527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2765 SGT Alfred Dr
Slidell, LA 70458-4013
Phone (504) 241-0861

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020631LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Madison III, L.L.C Internal Medicine CurrentSince Jul 11, 2008 Accepting new patients

Locations

9511 Chef Menteur Hwy
Ste 114
New Orleans, LA 70127
Phone (504) 241-0861

8080 Crowder Blvd
Ste B
New Orleans, LA 70127
Phone (504) 241-0861

2765 Sgt Alfred Dr
Slidell, LA 70458
Phone (504) 241-0861

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1104956382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2765 SGT ALFRED DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704584013",
            "telephone_number": "504-241-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 SGT ALFRED DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704584013",
            "telephone_number": "504-241-0861",
            "fax_number": "985-288-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADISON III",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "020631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1480631",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.