Individual provider Active NPI

Thomas Gerard Nuttli Sr., M.D.

  • Pulmonary Disease Physician
  • Metairie, LA
National Provider Identifier
1356310783
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
017964 Issued in LA
Practice address
4200 Houma Blvd
FL 3
Metairie, LA 70006-2970
Phone
(504) 503-5205
Fax
(504) 503-6019
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 017964 LA Primary

Addresses

Primary practice location

4200 Houma Blvd
FL 3
Metairie, LA 70006-2970

Mailing address

4200 Houma Blvd
FL 3
Metairie, LA 70006-2970
Phone (504) 503-5205

Other identifiers 1

IdentifierTypeStateIssuer
1388114MedicaidLA

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
I20100712000311 LA Practitioner - Pulmonary Disease 0244375426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Tulane University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4224 Houma Blvd
Suite 140
Metairie, LA 70006-2934
Phone (504) 503-7280

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017964LAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Jefferson Physicians Group LLC CurrentSince Sep 26, 2021 Accepting new patients

Locations

4224 Houma Blvd
Ste 520
Metairie, LA 70006
Phone (504) 885-4003

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

4300 Houma Blvd
Ste 202
Metairie, LA 70006
Phone (504) 503-6791

4320 Houma Blvd
Fl 6
Metairie, LA 70006
Phone (504) 503-4109

4200 Houma Blvd
Fl 3
Metairie, LA 70006
Phone (504) 454-5205

4300 Houma Blvd
Metairie, LA 70006
Phone (504) 454-1724

4224 Houma Blvd
Ste 140
Metairie, LA 70006
Phone (504) 454-7721

1100 Poydras St
Ste 2500
New Orleans, LA 70163
Phone (504) 527-9953

Interoperability endpoints

  • Direct secure messaging: thomas.nuttli@direct.ejgh.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1356310783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "address_2": "FL 3",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062970",
            "telephone_number": "504-503-5205",
            "fax_number": "504-503-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "address_2": "FL 3",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062970",
            "telephone_number": "504-503-5205",
            "fax_number": "504-503-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTLI",
        "first_name": "THOMAS",
        "middle_name": "GERARD",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "LA",
            "license": "017964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1388114",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.