Active NPI
Trac T Le, MD
- Nephrology Physician
- Marrero, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 022297
- Practice address
- 1111 Medical Center Blvd
Suite N511
Marrero, LA 70072 - Phone
- (504) 349-6301
- Fax
- (504) 349-6308
- NPI assigned
- Nov 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 022297 | LA | Primary |
Addresses
Primary practice location
1111 Medical Center Blvd
Suite N511
Marrero, LA 70072
Mailing address
4409 Utica St
Suite 100
Metairie, LA 70006
Phone (504) 457-3687
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1480401 | Medicaid | LA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- University of Louisville School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Westbank Expy
Westwego, LA 70094-4156
Phone (504) 347-6942
1101 Medical Ctr Blvd
Marrero, LA 70072-3147
Phone (504) 349-1202
141 S Jamie Blvd
Avondale, LA 70094-2861
Phone (504) 342-7773
148 Hector Ave
Gretna, LA 70056-2531
Phone (504) 376-1603
3631 Behrman PL
New Orleans, LA 70114-0906
Phone (504) 366-0808
4409 Utica St
Suite 100
Metairie, LA 70006-6579
Phone (504) 457-3687
7325 Westbank Expy
Marrero, LA 70072-2448
Phone (504) 341-6699
Hospital & facility affiliations
- DaVita Westbank Chronic Renal Center
- DaVita Oakwood Dialysis Center
- West Jefferson Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022297 | LA | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westbank Nephrology, Apmc | Nephrology | Past | Accepting new patients |
| Michael G Russo MD a Professionsl LLC | Past | Accepting new patients |
Interoperability endpoints
- tle24783@direct.acumenmd.com
Organizations & group practices 3
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.
-
- Nephrology Physician
- Metairie, LA
- NPI 1437254984
-
- Family Medicine Physician
- Marrero, LA
- NPI 1710146808
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Gretna, LA
- NPI 1417975442
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- New Orleans, LA
- NPI 1265491252
Dialysis facility
-
- General Acute Care Hospital
- Marrero, LA
- NPI 1265437644
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346222452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4409 UTICA ST",
"address_2": "SUITE 100",
"city": "METAIRIE",
"state": "LA",
"postal_code": "70006",
"telephone_number": "504-457-3687",
"fax_number": "504-620-0250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 MEDICAL CENTER BLVD",
"address_2": "SUITE N511",
"city": "MARRERO",
"state": "LA",
"postal_code": "70072",
"telephone_number": "504-349-6301",
"fax_number": "504-349-6308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LE",
"first_name": "TRAC",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "LA",
"license": "022297",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1480401",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marrero, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.