Individual provider Active NPI

Kamir Boodoo, M.B.B.S

  • Internal Medicine Physician
  • New Orleans, LA
National Provider Identifier
1356726137
Registry record updated Sep 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P31332 Issued in MD
Practice address
2000 Canal Street 4 C Clinic
New Orleans, LA 70112-5216
Phone
(504) 568-5031
NPI assigned
Jul 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P31332 MD Primary

Addresses

Primary practice location

2000 Canal Street 4 C Clinic
New Orleans, LA 70112-5216

Mailing address

4419 Saint Charles Avenue Unit 4
New Orleans, LA 70115
Phone (443) 310-3533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20200723001388 MS Practitioner - Internal MedicinePractitioner - Infectious Disease 3971809187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P31332MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 27, 2020 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 27, 2020 Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2500 N State St
Ste 4200
Jackson, MS 39216

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535846400000",
    "number": "1356726137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 SAINT CHARLES AVENUE UNIT 4",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70115",
            "telephone_number": "443-310-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CANAL STREET 4 C CLINIC",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701125216",
            "telephone_number": "504-568-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOODOO",
        "first_name": "KAMIR",
        "credential": "M.B.B.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-22",
        "last_updated": "2018-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "P31332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.