NPIMap

Organization Active NPI

Excelth, Incorporated

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
National Provider Identifier
1134440977
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EXCELTH, INCORPORATED
Practice address
6600 Franklin Ave Ste A7
New Orleans, LA 70122-5719
Phone
(504) 524-1210
Fax
(504) 524-1183
NPI assigned
Jun 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Authorized official

Name
Matilda A Tennessee
Title
Revenue Cycle Manager
Phone
(504) 524-1210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

6600 Franklin Ave Ste A7
New Orleans, LA 70122-5719

Mailing address

1515 Poydras St
Suite 1070
New Orleans, LA 70112-3723
Phone (504) 524-1210

Other names 1

  • EXCELth Family Health Center-Gentilly Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111206000462 LA Part A Provider - Federally Qualified Health Center (FQHC) 9830364629 Practice locations: New Orleans, LA
O20200529000069 LA Part B Supplier - Clinic/Group Practice 9830364629 Receives reassigned benefits from 15 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baton Rouge, LA; New Orleans, LA

Federally qualified health center certification: CCN 191887

Legal name
EXCELTH, INCORPORATED
Doing business as
EXCELTH FAMILY HEALTH CENTER-GENTILLY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 6, 2011
Last certification
Dec 6, 2011
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
6600 Franklin Ave
Ste A7
New Orleans, LA 70122-5719

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Excelth Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Soledad T Tan Individual Corporate DirectorBoard Member Jan 5, 2020
Matilda a Tennessee Individual Corporate DirectorRevenue Cycle Manager Jan 1, 2016
W-2 Managing EmployeeRCM Jan 1, 2016
Michael Andry Individual Corporate Director Jul 15, 1992
Loyce Pierce Wright Individual Corporate Director Jan 1, 2021

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1134440977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 POYDRAS ST",
            "address_2": "SUITE 1070",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701123723",
            "telephone_number": "504-524-1210",
            "fax_number": "504-524-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 FRANKLIN AVE STE A7",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701225719",
            "telephone_number": "504-524-1210",
            "fax_number": "504-524-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELTH, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-16",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "TENNESSEE",
        "authorized_official_first_name": "MATILDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "504-524-1210"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EXCELth Family Health Center-Gentilly",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.