Individual provider Active NPI

Susan J Berry, MD

  • Pediatrics Physician
  • New Orleans, LA
National Provider Identifier
1205858941
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
08306R Issued in LA
Practice address
200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone
(504) 896-2791
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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 08306R LA Primary

Addresses

Primary practice location

200 Henry Clay Ave
New Orleans, LA 70118-5720

Mailing address

300 Henry Clay Ave
New Orleans, LA 70118-5722
Phone (504) 412-1835

Other identifiers 1

IdentifierTypeStateIssuer
1399710MedicaidLA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110420000004 LA Practitioner - Pediatric Medicine 6406031368 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
08306RLAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Sep 11, 2017 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Sep 11, 2017 Accepting new patients
Louisiana State University School of Med in New Orleans Faculty Grou Pediatrics CurrentSince Sep 11, 2017 Accepting new patients

Locations

200 W Esplanade Ave
Ste 41
Kenner, LA 70065
Phone (504) 464-2940

200 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-2940

200 W Esplanade Ave
Ste 412
Kenner, LA 70065
Phone (504) 464-2940

3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880

3700 Saint Charles Ave
New Orleans, LA 70115
Phone (504) 895-7428

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

Organizations & group practices 3

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1205858941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185722",
            "telephone_number": "504-412-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-896-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "08306R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1399710",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.