Individual provider Active NPI

Bruce Leonard Wilson, M.D., M.S.P.H

  • Cardiovascular Disease Physician
  • New Orleans, LA
National Provider Identifier
1457667487
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA09945200 Issued in NJ
Practice address
10200 Chef Menteur Hwy Ste a
New Orleans, LA 70127-4264
Phone
(504) 603-6190
NPI assigned
Aug 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA09945200 NJ Primary

Addresses

Primary practice location

10200 Chef Menteur Hwy Ste a
New Orleans, LA 70127-4264

Mailing address

10200 Chef Menteur Hwy Ste a
New Orleans, LA 70127-4264
Phone (504) 603-6190

Other identifiers 1

IdentifierTypeStateIssuer
22-3052989OtherNJTAX ID#

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
I20181008001162 LA Practitioner - Internal Medicine 9335435593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.64 of 100Reported as group
Quality
68.02
Improvement activities
40
Cost
76.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09945200NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Health Institute- New Orleans Internal Medicine Current Accepting new patients
New Orleans Physician Services Inc Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
West Jefferson Holdings, LLC Past Accepting new patients

Locations

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

10200 Chef Menteur Hwy
Ste A
New Orleans, LA 70127
Phone (504) 603-6190

Organizations & group practices 3

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": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1457667487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 CHEF MENTEUR HWY STE A",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701274264",
            "telephone_number": "504-603-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 CHEF MENTEUR HWY STE A",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701274264",
            "telephone_number": "504-603-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRUCE",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "M.D., M.S.P.H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-27",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA09945200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "22-3052989",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.