NPIMap

Organization Active NPI

Jeffcare

  • Federally Qualified Health Center (FQHC)
  • Marrero, LA
National Provider Identifier
1154747327
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
JEFFCARE
Practice address
5001 Westbank Expy
Suite 100
Marrero, LA 70072-2954
Phone
(504) 349-8833
Fax
(504) 838-5714
NPI assigned
Mar 12, 2014
Organization subpart
Yes
Parent organization
JEFFERSON PARISH HUMAN SERVICES AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Authorized official

Name
Rosanna Dichiro Derbes, PSY.D
Title
Executive Director
Phone
(504) 838-5215

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

5001 Westbank Expy
Suite 100
Marrero, LA 70072-2954

Mailing address

3616 S I 10 Service Rd W Ste 200
Metairie, LA 70001-1874
Phone (504) 838-5215

Other identifiers 1

IdentifierTypeStateIssuer
2369393MedicaidLA

Other names 1

  • JeffCare West Jefferson Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140822001842 LA Part A Provider - Federally Qualified Health Center (FQHC) 7911125513 Practice locations: Marrero, LA
O20140827000480 LA Part B Supplier - Clinic/Group Practice 7911125513 Receives reassigned benefits from 44 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Metairie, LA; Marrero, LA

Federally qualified health center certification: CCN 191923

Legal name
JEFFCARE
Doing business as
JEFFCARE WEST JEFFERSON
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 21, 2014
Last certification
Aug 21, 2014
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
5001 Westbank Expressway Suite 100
Jeffcare West Jefferson
Marrero, LA 70072-2954

Other NPIs with the same Medicare PAC ID 1

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

  • Jeffcare
    • Federally Qualified Health Center (FQHC)
    • Metairie, LA
    • NPI 1518383785

    7911125513

    Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Jeffcare3 organizations share this tax ID, including this one
Part of
Kenner Substance Abuse

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Jermaine Baptiste Individual OtherVice Chair May 16, 2023
Alan Caroll Individual OtherJphsa Liaison Nov 16, 2021
Rosanna Dichiro Derbes Individual Corporate OfficerExecutive Director Sep 1, 2021
Toni Kawash Individual Other Aug 21, 2018
Chandra Carr Lamothe Individual W-2 Managing EmployeeRevenue Cycle Opts Manager Dec 28, 2021
Patty Militello Individual Other Aug 16, 2022
Jefferson Parish Human Services Authority Organization, Metairie, LA Operational/Managerial Control Nov 1, 2013 100%
Jeffcare Organization, Metairie, LA Non-profit Operational/Managerial Control May 1, 2019
William Renaudin Individual Other Jan 16, 2024
Dana Tozel Individual Other Jan 16, 2024

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jeffcare East JeffersonMetairie, LA, CCN 191929 Federally qualified health center Operational/Managerial Control May 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Jeffcare
    • Federally Qualified Health Center (FQHC)
    • Metairie, LA
    • NPI 1518383785

    Operational/Managerial Control

    CMS ownership

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • Jeffcare
    • Federally Qualified Health Center (FQHC)
    • Metairie, LA
    • NPI 1518383785

    Jeffcare, Jefferson Parish Human Services Authority

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1154747327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3616 S I 10 SERVICE RD W STE 200",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011874",
            "telephone_number": "504-838-5215",
            "fax_number": "504-838-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 WESTBANK EXPY",
            "address_2": "SUITE 100",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700722954",
            "telephone_number": "504-349-8833",
            "fax_number": "504-838-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEFFERSON PARISH HUMAN SERVICES AUTHORITY",
        "enumeration_date": "2014-03-12",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "DICHIRO DERBES",
        "authorized_official_first_name": "ROSANNA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "504-838-5215",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2369393",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JeffCare West Jefferson",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JeffCare West Jefferson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.