Mary Jo Broussard

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

046359-3340 Issued in LA

Practice address

1541 Tulane Ave
New Orleans, LA 70112-2821

Phone

(504) 903-1301

NPI assigned

May 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Medical Center Management CorporationGroup PAC ID 7012150311, 91 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center New Orleans Hospital, New Orleans, LA, CCN 190005

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as group

Quality

88.07

Improvement activities

40

Cost

74.42

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• University Medical Center Management Corporation

  • Family Medicine Physician
  • New Orleans, LA
  • NPI 1083655567
  Medicare reassignment Care Compare group

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

• University Medical Center Management Corporation

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1568403111
  Care Compare affiliation

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285844571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 TULANE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 TULANE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122821",
            "telephone_number": "504-903-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "MARY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "046359-3340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD NURSING",
            "identifier": "046359-3340",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Monique Broussard, M.D.
• Karlo D Broussard
• Laura Broussard
• Lauren Elise Broussard, MD
• Mark Broussard
• Samantha Broussard
• Taylor Alise Broussard
• Tiffany Broussard, NP
• Glenn Jospeh Brousseaur, RESPIRATORY THERAPY
• Brower Family and Sports Chiropractic Center, Inc.

• Nurse Practitioner in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.