Individual provider Active NPI

Jeremy B Nguyen, M.D.

  • Diagnostic Radiology Physician
  • Marrero, LA
National Provider Identifier
1508896564
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
200373 Issued in LA
Practice address
1111 Medical Center Blvd
Suite N-108
Marrero, LA 70072-3151
Phone
(504) 349-1461
Fax
(504) 349-1470
NPI assigned
Jul 4, 2006
Last updated
Aug 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 200373 LA Primary

Addresses

Primary practice location

1111 Medical Center Blvd
Suite N-108
Marrero, LA 70072-3151

Mailing address

1101 Medical Center Blvd
Radiology Dept
Marrero, LA 70072-3147
Phone (504) 349-1461

Other identifiers 7

IdentifierTypeStateIssuer
8W2044OtherTXBCBSTX
1576239MedicaidLA
182370001MedicaidTX
586402327OtherTRICARE
009941591MedicaidAL
P00377885OtherGARAILROAD MEDICARE
01084889MedicaidMS

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
I20050919000063 LA Practitioner - Diagnostic Radiology 4587644919 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical School at San Antonio, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1415 Tulane Ave
New Orleans, LA 70112-2600

Hospital & facility affiliations

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 Aug 1, 2010 Accepting new patients
Jefferson Radiology Associates, Inc Diagnostic Radiology CurrentSince Jul 1, 2008 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Aug 1, 2010 Accepting new patients
Northeast Missouri Imaging Associates, Inc. Diagnostic Radiology Past Accepting new patients
Ozarks Medical Center Diagnostic Radiology Past Accepting new patients
Tulane University Health Sciences Center Diagnostic Radiology Past Accepting new patients

Locations

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

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

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

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453

1324 Tulane Ave
Ste 100
New Orleans, LA 70112

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

1415 Tulane Ave
#71
New Orleans, LA 70112
Phone (504) 988-5881

1430 Tulane Ave
#54
New Orleans, LA 70112
Phone (504) 988-2651

Organizations & group practices 6

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 4

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1508896564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CENTER BLVD",
            "address_2": "RADIOLOGY DEPT",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723147",
            "telephone_number": "504-349-1461",
            "fax_number": "504-349-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE N-108",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-1461",
            "fax_number": "504-349-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JEREMY",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "200373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8W2044",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1576239",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182370001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "586402327",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009941591",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00377885",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01084889",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.