Individual provider Active NPI

Michael Joseph Marcello, MD

  • Family Medicine Physician
  • Raceland, LA
National Provider Identifier
1366449167
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
013251 Issued in LA
Practice address
111 Acadia Dr.
Raceland, LA 70394
Phone
(985) 537-7575
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 013251 LA Primary

Addresses

Primary practice location

111 Acadia Dr.
Raceland, LA 70394

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other identifiers 3

IdentifierTypeStateIssuer
1164305MedicaidLA
04183560MedicaidMS
080192844OtherLARR MEDICARE

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
I20100802000177 LA Practitioner - Family Practice 6507967684 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

106 Cypress St
Raceland, LA 70394-2764
Phone (985) 537-6841

111 Acadia Park Dr
Raceland, LA 70394-2619
Phone (985) 537-7575

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

1516 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3470

71380 Hwy 21
Covington, LA 70433-7245
Phone (985) 661-3534

Hospital & facility affiliations

  • Ochsner Home Health of Raceland Home health agency, Raceland, LA, CCN 197119
  • Home Health Ctr of Thibodaux Home health agency, Thibodaux, LA, CCN 197187
  • Ochsner St Anne General Hospital Hospital, Raceland, LA, CCN 191324
  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
  • Thibodaux Regional Medical Center Hospital, Thibodaux, LA, CCN 190004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13251LAMDMental Health Counselor
013251LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 1, 2010 Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 1, 2010 Accepting new patients
Ochsner Bayou LLC Current Accepting new patients
Cardiovascular Institute of the South, Apmc Past Accepting new patients
Cardiovascular Institute of the South, LLC Family Medicine Past Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

111 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-7575

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

4608 Highway 1
Raceland, LA 70394
Phone (504) 537-6841

Interoperability endpoints

  • Direct secure messaging: mmarcello12395@direct.ochsner.org

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1366449167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ACADIA DR.",
            "city": "RACELAND",
            "state": "LA",
            "postal_code": "70394",
            "telephone_number": "985-537-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELLO",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "013251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164305",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04183560",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080192844",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raceland, LA

Sources for this page

Verify at the official NPI Registry.