Individual provider Active NPI

Oleitha Wilson-Ruffin, M.D.

  • Pediatrics Physician
  • Marrero, LA
National Provider Identifier
1174519045
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
025015 Issued in LA
Practice address
4225 Lapalco Blvd
Marrero, LA 70072-4324
Phone
(504) 391-7337
Fax
(504) 398-7213
NPI assigned
Sep 26, 2005
Last updated
Dec 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 025015 LA Primary

Addresses

Primary practice location

4225 Lapalco Blvd
Marrero, LA 70072-4324

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other practice location 1

1055 David Dr.
Morgan City, LA 70380
Phone (985) 384-2430

Other identifiers 1

IdentifierTypeStateIssuer
1422371MedicaidLA

Other names 1

  • Oleitha Wilson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, NE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031103000479 LA Practitioner - Pediatric Medicine 4183536725 Reassigns benefits to 1 organization
I20250723003291 NE Practitioner - Pediatric Medicine 4183536725 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025015LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Nov 18, 2019 Accepting new patients
North Platte Nebraska Hospital Corporation Pediatrics CurrentSince Jul 1, 2025 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
North Platte Nebraska Hospital Corporation Current Accepting new patients
Ochsner Clinic LLC CurrentSince Nov 18, 2019 Accepting new patients
HPC Biologicals Inc Past Accepting new patients
Pediatric Clinic of St Mary Parish Apmc Pediatrics PastSince Jan 1, 1990 Accepting new patients

Locations

4225 Lapalco Blvd
Marrero, LA 70072
Phone (504) 391-7337

1514 Jefferson Hwy
New Orleans, LA 70121

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

625 W William Ave
#100
North Platte, NE 69101
Phone (308) 568-3580

Interoperability endpoints

  • Direct secure messaging: owilsonruffin883639@direct.ochsner.org
  • Direct secure messaging: phys_oleitha_wilson-ruffin__md@yourcarecommunity.org

Organizations & group practices 7

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1174519045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 LAPALCO BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700724324",
            "telephone_number": "504-391-7337",
            "fax_number": "504-398-7213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 David Dr.",
            "address_purpose": "LOCATION",
            "city": "Morgan City",
            "state": "LA",
            "postal_code": "70380",
            "country_code": "US",
            "telephone_number": "985-384-2430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON-RUFFIN",
        "first_name": "OLEITHA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "025015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1422371",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLEITHA",
            "last_name": "WILSON",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.