Individual provider Active NPI

Mary Christine D'Antonio, MD

  • Ophthalmology Physician
  • Metairie, LA
National Provider Identifier
1295793693
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD.023344 Issued in LA
Practice address
4720 S I 10 Service Rd W Ste 406
Metairie, LA 70001-1242
Phone
(504) 457-2020
Fax
(504) 456-3113
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD.023344 LA Primary

Addresses

Primary practice location

4720 S I 10 Service Rd W Ste 406
Metairie, LA 70001-1242

Mailing address

4720 S I 10 Service Rd W
Suite 406
Metairie, LA 70001-7404
Phone (504) 457-2020

Other identifiers 1

IdentifierTypeStateIssuer
1496448MedicaidLA

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
I20060207000147 LA Practitioner - Ophthalmology 4981619392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in New Orleans, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey Singer, MD (Apmc)Group PAC ID 9032123492, 6 clinicians

Practice addresses (Care Compare)

4720 S I 10 Service Rd W
Suite 406
Metairie, LA 70001-1242
Phone (504) 456-3155

National Provider Directory

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

Organizations & group practices 1

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1295793693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 S I 10 SERVICE RD W",
            "address_2": "SUITE 406",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700017404",
            "telephone_number": "504-457-2020",
            "fax_number": "504-456-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 S I 10 SERVICE RD W STE 406",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011242",
            "telephone_number": "504-457-2020",
            "fax_number": "504-456-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANTONIO",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "MD.023344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1496448",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.