NPIMap

Organization Active NPI

Ochsner Clinic LLC

Doing business as Ochsner CHRISTUS Health Center - Tybee Lane

  • Internal Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1306318928
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
OCHSNER CLINIC LLC
Doing business as
Ochsner CHRISTUS Health Center - Tybee Lane
Practice address
1960 Tybee LN
Lake Charles, LA 70605-4173
Phone
(337) 421-0090
NPI assigned
Dec 20, 2018
Organization subpart
Yes
Parent organization
OCHSNER CLINIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Authorized official

Name
Eduardo Benitez
Title
Director
Phone
(504) 842-6933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1960 Tybee LN
Lake Charles, LA 70605-4173

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other identifiers 1

IdentifierTypeStateIssuer
1798118MedicaidLA

Other names 1

  • Ochsner CHRISTUS Health Center - Tybee Lane Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000513 LA Part B Supplier - Clinic/Group Practice 8224933619 Receives reassigned benefits from 4,981 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Ochsner Clinic Houma Bayou222 organizations share this tax ID, including this one
Part of
Ochsner Clinic Houma Bayou

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545264000000",
    "number": "1306318928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 TYBEE LN",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054173",
            "telephone_number": "337-421-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCHSNER CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OCHSNER CLINIC LLC",
        "enumeration_date": "2018-12-20",
        "last_updated": "2018-12-20",
        "status": "A",
        "authorized_official_last_name": "BENITEZ",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "504-842-6933"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1798118",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ochsner CHRISTUS Health Center - Tybee Lane",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.