Individual provider Active NPI

Allan Quibilan Larcena, MD

  • Internal Medicine Physician
  • Slidell, LA
National Provider Identifier
1275579724
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11339R Issued in LA
Practice address
105 Medical Center Dr
Suite 301
Slidell, LA 70461-5544
Phone
(985) 646-0123
Fax
(985) 641-0330
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11339R LA Primary

Addresses

Primary practice location

105 Medical Center Dr
Suite 301
Slidell, LA 70461-5544

Mailing address

105 Medical Center Dr
Suite 301
Slidell, LA 70461-5544
Phone (985) 646-0123

Other identifiers 1

IdentifierTypeStateIssuer
1662097MedicaidLA

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
I20060501000011 LA Practitioner - Internal Medicine 8820980667 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

105 Medical Ctr Dr
Suite 301
Slidell, LA 70461-5539
Phone (985) 646-0123

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11339RLAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Slidell Internal Medicine Clinic LLC Internal Medicine CurrentSince Feb 23, 2006 Accepting new patients
Concerned Care Palliative Services LLC CurrentSince May 23, 2024 Accepting new patients

Locations

125 N Theard St
Ste C
Covington, LA 70433
Phone (504) 210-1971

3621 Ridgelake Dr
Ste 201
Metairie, LA 70002
Phone (504) 210-1971

105 Medical Center Dr
Ste 301
Slidell, LA 70461
Phone (985) 646-0123

Organizations & group practices 2

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 4

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1275579724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MEDICAL CENTER DR",
            "address_2": "SUITE 301",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615544",
            "telephone_number": "985-646-0123",
            "fax_number": "985-641-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MEDICAL CENTER DR",
            "address_2": "SUITE 301",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615544",
            "telephone_number": "985-646-0123",
            "fax_number": "985-641-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARCENA",
        "first_name": "ALLAN",
        "middle_name": "QUIBILAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "11339R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1662097",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.