Individual provider Active NPI

Edmund Kenneth Kerut, MD

  • Cardiovascular Disease Physician
  • Marrero, LA
National Provider Identifier
1215993019
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
07339R Issued in LA
Practice address
1111 Medical Center Blvd
N613
Marrero, LA 70072-3151
Phone
(504) 349-6800
Fax
(504) 349-6621
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 07339R LA Primary

Addresses

Primary practice location

1111 Medical Center Blvd
N613
Marrero, LA 70072-3151

Mailing address

1111 Medical Center Blvd
N613
Marrero, LA 70072-3151
Phone (504) 349-6800

Other identifiers 1

IdentifierTypeStateIssuer
1372854MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS2 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
I20100625000528 LA Practitioner - Cardiovascular Disease (Cardiology) 3476641432 Reassigns benefits to 1 organization
I20250924004735 MS Practitioner - Internal Medicine 3476641432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Mississippi School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Orleans Physician Services IncGroup PAC ID 5294057824, 177 clinicians

Practice addresses (Care Compare)

1101 Medical Ctr Blvd
Marrero, LA 70072-3147
Phone (504) 349-2427

1101 Medical Ctr Blvd ER
Marrero, LA 70072-3147
Phone (504) 349-1533

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

4513 Westbank Expressway
Marrero, LA 70072
Phone (504) 349-6360

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.64 of 100Reported as group
Quality
68.02
Improvement activities
40
Cost
76.01

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 13, 2025 Accepting new patients
New Orleans Physician Services Inc Cardiovascular Disease CurrentSince Sep 1, 2014 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 13, 2025 Accepting new patients
Lsu Medical Center Past Accepting new patients

Locations

2845 Manhattan Blvd
Harvey, LA 70058
Phone (504) 349-6930

3909 Lapalco Blvd
Ste 200
Harvey, LA 70058
Phone (504) 349-6216

1111 Medical Center Blvd
Marrero, LA 70072
Phone (504) 349-2332

1111 Medical Center Blvd
Ste S850
Marrero, LA 70072
Phone (504) 349-6450

1111 Medical Center Blvd
Ste N613
Marrero, LA 70072
Phone (504) 349-6622

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

Interoperability endpoints

  • Direct secure messaging: ekerut205345@ummc.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1215993019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "N613",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6800",
            "fax_number": "504-349-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "N613",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6800",
            "fax_number": "504-349-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERUT",
        "first_name": "EDMUND",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "07339R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1372854",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.