NPIMap

Organization Active NPI

Jefferson Radiology Associates, Inc

  • Diagnostic Radiology Physician
  • Marrero, LA
National Provider Identifier
1366490849
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
JEFFERSON RADIOLOGY ASSOCIATES, INC
Practice address
1101 Medical Center Blvd
Radiology Dept.
Marrero, LA 70072
Phone
(504) 349-1461
Fax
(504) 349-1461
NPI assigned
May 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Authorized official

Name
Michael Joseph Alline, M.D.NPI 1740238385
Title
President
Phone
(504) 349-1461

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
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1101 Medical Center Blvd
Radiology Dept.
Marrero, LA 70072

Mailing address

1111 Medical Center Blvd.
Suite N-108
Marrero, LA 70072
Phone (504) 349-1461

Other identifiers 2

IdentifierTypeStateIssuer
09012562MedicaidMS
1794449MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041005000144 LA Part B Supplier - Clinic/Group Practice 0143289363 Receives reassigned benefits from 17 practitioners
Practice locations: Marrero, LA; Metairie, LA; New Orleans, LA

National Provider Directory

National Provider Directory

Locations

3909 Lapalco Blvd
Ste 100
Harvey, LA 70058
Phone (504) 349-6900

4521 Westbank Expy
Marrero, LA 70072
Phone (504) 349-1461

1111 Medical Center Blvd
Ste N108
Marrero, LA 70072
Phone (504) 349-1461

5646 Read Blvd
#200
New Orleans, LA 70127

5646 Read Blvd
Ste 200240
New Orleans, LA 70127
Phone (504) 246-1452

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428537600000",
    "number": "1366490849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD.",
            "address_2": "SUITE N-108",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-1461",
            "fax_number": "504-349-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CENTER BLVD",
            "address_2": "RADIOLOGY DEPT.",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-1461",
            "fax_number": "504-349-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON RADIOLOGY ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2015-04-09",
        "status": "A",
        "authorized_official_last_name": "ALLINE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-349-1461",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09012562",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1794449",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.