Organization Active NPI

Cardiovascular and Thoracic Surgical Specialists LLC

  • Specialist
  • Covington, LA
National Provider Identifier
1417157223
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD13230R Issued in LA
Legal business name
CARDIOVASCULAR AND THORACIC SURGICAL SPECIALISTS LLC
Practice address
71380 Highway 21
Suite 104
Covington, LA 70433-7245
Phone
(985) 893-5639
Fax
(985) 893-5641
NPI assigned
Jul 19, 2007
Last updated
Mar 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Authorized official

Name
Dr. Fidel F Sendra, M.D.
Title
President
Phone
(985) 641-6150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MD13230R LA Primary

Addresses

Primary practice location

71380 Highway 21
Suite 104
Covington, LA 70433-7245

Mailing address

P O Box 8660
Mandeville, LA 70470-8660
Phone (985) 893-5639

Other identifiers 2

IdentifierTypeStateIssuer
1446505MedicaidLA
09015757MedicaidMS

National Provider Directory

National Provider Directory

Locations

1203 S Tyler St
Ste E
Covington, LA 70433
Phone (985) 871-6014

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1417157223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 8660",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704708660",
            "telephone_number": "985-893-5639",
            "fax_number": "985-893-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71380 HIGHWAY 21",
            "address_2": "SUITE 104",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337245",
            "telephone_number": "985-893-5639",
            "fax_number": "985-893-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR AND THORACIC SURGICAL SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "SENDRA",
        "authorized_official_first_name": "FIDEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-641-6150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "MD13230R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1446505",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015757",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.