Individual provider Active NPI

Nicholas J Persich, MD

  • Gastroenterology Physician
  • Metairie, LA
National Provider Identifier
1235245705
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
019601 Issued in LA
Practice address
4228 Houma Blvd
Suite 120
Metairie, LA 70006-3002
Phone
(504) 456-6701
Fax
(504) 456-6843
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 019601 LA Primary

Addresses

Primary practice location

4228 Houma Blvd
Suite 120
Metairie, LA 70006-3002

Mailing address

4228 Houma Blvd
Suite 120
Metairie, LA 70006-3002
Phone (504) 456-6701

Other identifiers 4

IdentifierTypeStateIssuer
5372667009OtherCIGNA
4413302OtherAETNA
1930989MedicaidLA
4334849824EOtherLABLUE CROSS

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
I20040407000476 LA Practitioner - GastroenterologyPractitioner - Internal Medicine 2365341542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019601LAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC Gastroenterology CurrentSince Jan 1, 2021 Accepting new patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince Jan 1, 2021 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G Past Accepting new patients
Metairie Physician Services Inc. Past Accepting new patients
Lsu Medical Center Past Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G Past Accepting new patients

Locations

1111 Medical Center Blvd
Ste S450
Marrero, LA 70072
Phone (504) 349-6401

4224 Houma Blvd
Ste 400
Metairie, LA 70006
Phone (504) 456-8020

764 N Acadia Rd
Ste A
Thibodaux, LA 70301
Phone (985) 446-1958

Organizations & group practices 6

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1235245705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 HOUMA BLVD",
            "address_2": "SUITE 120",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700063002",
            "telephone_number": "504-456-6701",
            "fax_number": "504-456-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 HOUMA BLVD",
            "address_2": "SUITE 120",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700063002",
            "telephone_number": "504-456-6701",
            "fax_number": "504-456-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSICH",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "LA",
            "license": "019601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5372667009",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4413302",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1930989",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4334849824E",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.