Individual provider Active NPI

Marissa B Lejeune, PA

  • Physician Assistant
  • Metairie, LA
National Provider Identifier
1124635164
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
324366 Issued in LA
Practice address
4421 Conlin St Ste 101
Metairie, LA 70006-2145
Phone
(504) 455-2002
Fax
(504) 885-4383
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 324366 LA Primary

Addresses

Primary practice location

4421 Conlin St Ste 101
Metairie, LA 70006-2145

Mailing address

4421 Conlin St Ste 101
Metairie, LA 70006-2145
Phone (504) 455-2002

Other names 1

  • Marissa Burnett Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201023002543 LA Practitioner - Physician Assistant 5991125379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuromedical CenterGroup PAC ID 6103716477, 114 clinicians

Practice addresses (Care Compare)

10101 Park Rowe Ave
Suite 200
Baton Rouge, LA 70810-1685
Phone 22576922002164

4920 Church St
Suite H
Zachary, LA 70791-3943
Phone (225) 769-2200

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 765-6565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: marissa.lejeune.1@25776.direct.athenahealth.com
  • Direct secure messaging: mlejeune30441@direct.casso.us.com

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": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1124635164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 CONLIN ST STE 101",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062145",
            "telephone_number": "504-455-2002",
            "fax_number": "504-455-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 CONLIN ST STE 101",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062145",
            "telephone_number": "504-455-2002",
            "fax_number": "504-885-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEJEUNE",
        "first_name": "MARISSA",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "324366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "BURNETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.