Individual provider Active NPI

Charles G Haddad Jr., M.D.

  • Orthopaedic Surgery Physician
  • Metairie, LA
National Provider Identifier
1316955495
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
200175 Issued in LA
Practice address
3939 Houma Blvd
Suite 21
Metairie, LA 70006-2921
Phone
(504) 885-6464
Fax
(504) 885-6414
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 200175 LA Primary

Addresses

Primary practice location

3939 Houma Blvd
Suite 21
Metairie, LA 70006-2921

Mailing address

3939 Houma Blvd
Suite 21
Metairie, LA 70006-2921
Phone (504) 885-6464

Other identifiers 2

IdentifierTypeStateIssuer
303309OtherCOVENTRY
1628158MedicaidLA

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
I20050610000007 LA Practitioner - Orthopedic Surgery 7012987639 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Tulane University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pontchartrain Bone and Joint Clinic LTDGroup PAC ID 8426091497, 18 clinicians

Practice addresses (Care Compare)

3939 Houma Blvd
Suite 21
Metairie, LA 70006-2921
Phone (504) 885-6464

Hospital & facility affiliations

  • Vitalcaring Group Home health agency, Metairie, LA, CCN 197786
  • Omni Home Care Home health agency, Mandeville, LA, CCN 197097
  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176
  • Omega Hospital, LLC Hospital, Metairie, LA, CCN 190302
  • St Charles Parish Hospital Hospital, Luling, LA, CCN 190079

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement14
Lower limb (leg) arthroscopy (minimally invasive joint repair)23
Upper limb (arm) arthroscopy (minimally invasive joint repair)19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200175LAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LMG, LLC Orthopaedic Surgery CurrentSince Jan 1, 2017 Accepting new patients
LMG LLC Orthopaedic Surgery CurrentSince Mar 1, 2017 Accepting new patients
Mississippi Sports Medicine & Orthopaedic Center Orthopaedic Surgery Past Accepting new patients

Locations

14041 Highway 90
Boutte, LA 70039
Phone (504) 503-6445

105 Plantation Rd
Ste 110
Destrehan, LA 70047
Phone (504) 464-9016

4633 Wichers Dr
Marrero, LA 70072
Phone (504) 347-5421

3939 Houma Blvd
Ste 21
Metairie, LA 70006
Phone (504) 885-6464

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1316955495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 HOUMA BLVD",
            "address_2": "SUITE 21",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062921",
            "telephone_number": "504-885-6464",
            "fax_number": "504-885-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 HOUMA BLVD",
            "address_2": "SUITE 21",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062921",
            "telephone_number": "504-885-6464",
            "fax_number": "504-885-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "CHARLES",
        "middle_name": "G",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "200175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "303309",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1628158",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.