NPIMap

Individual provider Active NPI

Richard Michael Jeansonne Jr., M.D.

  • Family Medicine Physician
  • Mandeville, LA
National Provider Identifier
1467468447
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.025708 Issued in LA
Practice address
521 Asbury Drive
Mandeville, LA 70471
Phone
(985) 630-9618
Fax
(985) 231-7010
NPI assigned
Jul 31, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18605 MS
Family Medicine Physician 207Q00000X MD.025708 LA Primary

Addresses

Primary practice location

521 Asbury Drive
Mandeville, LA 70471

Mailing address

716 Tunica BND
Covington, LA 70433-4573
Phone (601) 493-4229

Other practice location 1

141 Lakeview Cir
Covington, LA 70433-7513
Phone (985) 630-9618

Other identifiers 2

IdentifierTypeStateIssuer
09702861MedicaidMS
1048585MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, LA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040929001252 MS Practitioner - Internal MedicinePractitioner - Family Practice 5698744241 Reassigns benefits to 1 organization
I20090820000415 LA Practitioner - Family Practice 5698744241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

521 Asbury Dr
Mandeville, LA 70471-3132
Phone (985) 630-9618

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions12
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18605MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mandeville Private Physician Group Family Medicine CurrentSince Jul 14, 2014 Accepting new patients
Natchez Clinic Company LLC Family Medicine CurrentSince May 1, 2015 Accepting new patients
Natchez Hma Physician Management LLC Family Medicine Past Accepting new patients

Locations

141 Lakeview Cir
Covington, LA 70433
Phone (985) 231-6751

521 Asbury Dr
Mandeville, LA 70471
Phone (985) 630-9618

129 Jefferson Davis Blvd
Natchez, MS 39120
Phone (601) 445-6200

150 Jefferson Davis Blvd
Ste 130
Natchez, MS 39120
Phone (601) 445-4616

150 Jefferson Davis Blvd
Ste 140
Natchez, MS 39120
Phone (601) 445-4616

46 Sgt Prentiss Dr
Ste 100
Natchez, MS 39120
Phone (601) 442-1616

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Acg HospiceHammond, LA, CCN 191639 Hospice Contracted Managing Employee Mar 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1467468447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 TUNICA BND",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704334573",
            "telephone_number": "601-493-4229",
            "fax_number": "985-231-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 ASBURY DRIVE",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "70471",
            "telephone_number": "985-630-9618",
            "fax_number": "985-231-7010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 Lakeview Cir",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704337513",
            "country_code": "US",
            "telephone_number": "985-630-9618",
            "fax_number": "985-231-7010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEANSONNE",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "18605",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.025708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09702861",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1048585",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.