Jared Young Robertson IV

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

330711 Issued in LA

Practice address

4200 Houma Blvd FL 6
Metairie, LA 70006-2970

Phone

(504) 503-4331

Fax

(504) 503-4341

NPI assigned

Mar 18, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Internal Medicine

Education

Louisiana State University School of Medicine in New Orleans, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Jefferson Physicians Group LLCGroup PAC ID 4587660402, 211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176
• East Jefferson General Hospital - SNF Nursing home, Metairie, LA, CCN 195199

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• East Jefferson Physicians Group LLC

  • Internal Medicine Physician
  • New Orleans, LA
  • NPI 1922293372
  Medicare reassignment Care Compare group NPD
• East Jefferson Physicians Group Urgent Care

  • Urgent Care Clinic/Center
  • Kenner, LA
  • NPI 1053859082
  NPD
• Metairie Physician Services Inc.

  • Internal Medicine Physician
  • Metairie, LA
  • NPI 1801233648
  NPD (past)
• University Healthcare System, L.C.

  dba East Jefferson General Hospital

  • General Acute Care Hospital
  • Metairie, LA
  • NPI 1497792527
  NPD (past)

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

• University Healthcare System, L.C.

  • Ambulance
  • Metairie, LA
  • NPI 1023717683

  Hospital

  Care Compare affiliation
• University Healthcare System, L.C.

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1033611454
  Care Compare affiliation
• University Healthcare System, L.C.

  dba East Jefferson General Hospital

  • General Acute Care Hospital
  • Metairie, LA
  • NPI 1497792527
  Care Compare affiliation
• University Healthcare System, L.C.

  dba East Jefferson General Hospital

  • Skilled Nursing Facility
  • Metairie, LA
  • NPI 1598267890

  Nursing home

  Care Compare affiliation
• University Healthcare System, L.C.

  dba Lakeview Regional Behavioral Health

  • Psychiatric Hospital Unit
  • Covington, LA
  • NPI 1790722825
  Care Compare affiliation

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1316406572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062970",
            "telephone_number": "504-503-6781",
            "fax_number": "504-503-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD FL 6",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062970",
            "telephone_number": "504-503-4331",
            "fax_number": "504-503-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JARED",
        "middle_name": "YOUNG",
        "name_suffix": "IV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "330711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Robertson
• Darrielle Cordea Robertson
• Felicia Ciolino Robertson, FNP
• Gregory Robertson
• Jamani Robertson
• Kournney Elaine Robertson
• Paul L Robertson III
• Ryshawneka Robertson
• Amber Robichaux
• Lynn C. Robichaux, COTA

• Internal Medicine Physician in Metairie, LA
• Providers in Metairie, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.