Individual provider Active NPI

Thomas Moulthrop, MD

  • Otolaryngology Physician
  • New Orleans, LA
National Provider Identifier
1376636407
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
14720R Issued in LA
Practice address
1415 Tulane Ave
New Orleans, LA 70112-2600
Phone
(504) 988-2300
Fax
(504) 584-1183
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 14720R LA Primary

Addresses

Primary practice location

1415 Tulane Ave
New Orleans, LA 70112-2600

Mailing address

1430 Tulane Ave
TW22
New Orleans, LA 70112-2632
Phone (504) 988-2300

Other identifiers 1

IdentifierTypeStateIssuer
1733938MedicaidLA

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
I20031204001188 LA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Otolaryngology 1254236920 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Sep 1, 2003 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Sep 1, 2003 Accepting new patients
The Administrators of the Tulane Educational Fund Past Accepting new patients
Administrators of the Tulane Education Fund PastSince Jul 31, 2023 Accepting new patients

Locations

1450 Poydras St
New Orleans, LA 70112
Phone (504) 903-2373

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1430 Tulane Ave
#22
New Orleans, LA 70112

1430 Tulane Ave
#27
New Orleans, LA 70112
Phone (318) 767-2131

1430 Tulane Ave
#59
New Orleans, LA 70112
Phone (504) 988-5453

Organizations & group practices 4

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1376636407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE",
            "address_2": "TW22",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-988-2300",
            "fax_number": "504-584-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 TULANE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122600",
            "telephone_number": "504-988-2300",
            "fax_number": "504-584-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTHROP",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "14720R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1733938",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.