Individual provider Active NPI

Bijan Motaghedi, M.D.

  • Otolaryngic Allergy Physician
  • La Place, LA
National Provider Identifier
1346421633
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
04347R Issued in LA
Practice address
501 Rue de Sante
Suite11
La Place, LA 70068-5400
Phone
(985) 652-4229
Fax
(985) 652-4270
NPI assigned
Nov 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 04347R LA
Otolaryngic Allergy Physician 207YX0602X 04347R LA Primary

Addresses

Primary practice location

501 Rue de Sante
Suite11
La Place, LA 70068-5400

Mailing address

501 Rue de Sante
Suite11
La Place, LA 70068-5400
Phone (985) 652-4229

Other identifiers 1

IdentifierTypeStateIssuer
1309583MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04347RLAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1346421633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 RUE DE SANTE",
            "address_2": "SUITE11",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700685400",
            "telephone_number": "985-652-4229",
            "fax_number": "985-652-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 RUE DE SANTE",
            "address_2": "SUITE11",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700685400",
            "telephone_number": "985-652-4229",
            "fax_number": "985-652-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTAGHEDI",
        "first_name": "BIJAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-15",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "04347R",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "LA",
            "license": "04347R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1309583",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Place, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.