Active NPI
Elizabeth Mortazavi, D.O.
- Interventional Pain Medicine Physician
- Thibodaux, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- License
- 333030
- Practice address
- 602 N Acadia Rd
Thibodaux, LA 70301-4823 - Phone
- (985) 447-5500
- NPI assigned
- Apr 13, 2017
- Last updated
- Dec 20, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Interventional Pain Medicine Physician | 208VP0014X | 333030 | LA | Primary |
Addresses
Primary practice location
602 N Acadia Rd
Thibodaux, LA 70301-4823
Mailing address
5251 Magazine St
New Orleans, LA 70115-1851
Phone (813) 495-4893
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pain Management
- Education
- Nova Southeastern College of Osteo Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
726 N Acadia Rd
Suite 2400
Thibodaux, LA 70301-5078
Phone (985) 493-4080
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.55 of 100
- Quality
- 67.62
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.34
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thibodaux Regional Network Development Corporation | Current | Accepting new patients | |
| Thibodaux Regional Network Development Corporation | Current | Accepting new patients | |
| Thibodaux Regional Network Development Corporation | Current | Accepting new patients | |
| Thibodaux Regional Network Development Corporation | Past | Accepting new patients |
Locations
1238 Saint Charles St
Houma, LA 70360
Phone (985) 872-9430
4560 Highway 1
Ste 3
Raceland, LA 70394
Phone (985) 251-4250
602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544
726 N Acadia Rd
Ste 2400
Thibodaux, LA 70301
Phone (985) 493-4080
Interoperability endpoints
- elizabeth.mortazavi@direct.thibodaux.la-hie.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Thibodaux, LA
- NPI 1285658310
-
dba Thibodaux Regional Plastic & Reconstructive Surgery Clinic
- Plastic and Reconstructive Surgery Physician
- Thibodaux, LA
- NPI 1003430257
-
- Clinical Cardiac Electrophysiology Physician
- Thibodaux, LA
- NPI 1770435851
-
dba Thibodaux Regional Radiology
- Diagnostic Radiology Physician
- Thibodaux, LA
- NPI 1467427336
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Thibodaux, LA
- NPI 1902465065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671494400000",
"number": "1164956389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5251 MAGAZINE ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701151851",
"telephone_number": "813-495-4893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 N ACADIA RD",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703014823",
"telephone_number": "985-447-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTAZAVI",
"first_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-13",
"last_updated": "2022-12-20",
"certification_date": "2022-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "LA",
"license": "333030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Thibodaux, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.