Individual provider Active NPI

Indira Mohan Kailas, M.D.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Marrero, LA
National Provider Identifier
1316005853
Registry record updated Jun 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
R#005403, L#017047 Issued in LA
Practice address
5001 Westbank Expressway
Marrero, LA 70072
Phone
(504) 349-8708
Fax
(504) 838-5714
NPI assigned
Dec 5, 2006
Last updated
Jun 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X R#005403, L#017047 LA Primary
Psychiatry Physician 2084P0800X R#005403, L#017047 LA

Addresses

Primary practice location

5001 Westbank Expressway
Marrero, LA 70072

Mailing address

3300 West Esplanade Ave
Suite 213
Metairie, LA 70002
Phone (504) 838-5312

Other identifiers 1

IdentifierTypeStateIssuer
1916544MedicaidLA

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
I20050505000595 LA Practitioner - Psychiatry 8123068483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JeffcareGroup PAC ID 7911125513, 21 clinicians

Practice addresses (Care Compare)

3616 S I 10 Service Rd W
Suite 100
Metairie, LA 70001-1884
Phone (504) 838-5215

5001 Westbank Expressway
Suite 100
Marrero, LA 70072-2954
Phone (504) 838-5215

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R#005403, L#017047LAMDAddiction Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffcare CurrentSince Oct 24, 2014 Accepting new patients
Jeffcare CurrentSince Oct 24, 2014 Accepting new patients
Jefferson Parish Human Services Authority PastSince Feb 24, 2022 Accepting new patients
Jefferson Parish Human Services Authority PastSince Jul 24, 2022 Accepting new patients
Jefferson Parish Human Services Authority PastSince Feb 24, 2022 Accepting new patients

Locations

5001 Westbank Expy
Ste 100
Marrero, LA 70072
Phone (504) 349-8801

3616 S I 10 Service Rd W
Ste 100
Metairie, LA 70001
Phone (504) 838-5215

3616 S I 10 Service Rd W
Ste 200
Metairie, LA 70001
Phone (504) 535-2430

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308182400000",
    "number": "1316005853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 WEST ESPLANADE AVE",
            "address_2": "SUITE 213",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70002",
            "telephone_number": "504-838-5312",
            "fax_number": "504-838-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 WESTBANK EXPRESSWAY",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-8708",
            "fax_number": "504-838-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAILAS",
        "first_name": "INDIRA",
        "middle_name": "MOHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2011-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "LA",
            "license": "R#005403, L#017047",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "R#005403, L#017047",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1916544",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.