NPIMap

Organization Active NPI

Mary L. Puissegur Lupo

Doing business as Lupo Center for Aesthetic & General Dermatology

  • Dermatology Physician
  • New Orleans, LA
National Provider Identifier
1346449949
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MARY L. PUISSEGUR LUPO
Doing business as
Lupo Center for Aesthetic & General Dermatology
Practice address
145 Robert E Lee Blvd
Suite 302
New Orleans, LA 70124-2552
Phone
(504) 777-3047
Fax
(504) 288-1535
NPI assigned
Jul 13, 2007
Last updated
Sep 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Authorized official

Name
Mary Lupo, MDNPI 1649273152
Title
Owner
Phone
(504) 777-3047

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

145 Robert E Lee Blvd
Suite 302
New Orleans, LA 70124-2552

Mailing address

145 Robert E Lee Blvd
Suite 302
New Orleans, LA 70124-2552
Phone (504) 777-3047

Other names 1

  • Lupo Center for Aesthetic & General Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200714003936 LA Part B Supplier - Clinic/Group Practice 0244653871 Receives reassigned benefits from 2 practitioners
Practice locations: New Orleans, LA

National Provider Directory

National Provider Directory

Locations

145 Allen Toussaint Blvd
Ste 302
New Orleans, LA 70124
Phone (504) 288-2381

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1346449949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 ROBERT E LEE BLVD",
            "address_2": "SUITE 302",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701242552",
            "telephone_number": "504-777-3047",
            "fax_number": "504-288-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 ROBERT E LEE BLVD",
            "address_2": "SUITE 302",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701242552",
            "telephone_number": "504-777-3047",
            "fax_number": "504-288-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY L. PUISSEGUR LUPO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "LUPO",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-777-3047",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lupo Center for Aesthetic & General Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lupo Center for Aesthetic & General Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.