Theresa Lynn Dise, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

07313R Issued in LA

Practice address

200 Broadway St
Suite 230
New Orleans, LA 70118-3557

Phone

(504) 988-9000

Fax

(504) 988-9099

NPI assigned

Sep 29, 2006

Last updated

Jun 20, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Administrators of the Tulane Educational Fund

  dba Tulane University Medical Group

  • Specialist
  • New Orleans, LA
  • NPI 1528014164
  Medicare reassignment NPD
• Children's Hospital

  dba Manning Family Children's

  • Specialist
  • New Orleans, LA
  • NPI 1043230873

  Pediatrics

  Medicare reassignment NPD
• Childrens Hospital Medical Practice Corporation

  • Pediatrics Physician
  • New Orleans, LA
  • NPI 1821090713
  Medicare reassignment NPD
• Children's Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New Orleans, LA
  • NPI 1568597649
  NPD
• Administrators of the Tulane Educational Fund

  • Specialist
  • Hattiesburg, MS
  • NPI 1033395298
  NPD
• Children's Hospital

  dba Manning Family Children's - Physician Billing

  • Specialist
  • New Orleans, LA
  • NPI 1306156138

  Pediatrics

  NPD (past)
• University Healthcare System, L.C.

  dba East Jefferson General Hospital

  • General Acute Care Hospital
  • Metairie, LA
  • NPI 1497792527
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1518059146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE",
            "address_2": "SL-37",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-988-5001",
            "fax_number": "504-988-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BROADWAY ST",
            "address_2": "SUITE 230",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701183557",
            "telephone_number": "504-988-9000",
            "fax_number": "504-988-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISE",
        "first_name": "THERESA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "07313R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1378291",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thuy-Hang Thi Dinh
• Derek Dinkier
• Juliet D Dinkins, M.A.
• Caroline Dipretore, LCSW
• Nicholas Joseph Disalvo
• Lindy Disman
• Tashanne Distin, MD
• Terri L Ditta, MD
• Diversified Healthcare-New Orleans, LLC (Jo Ellen Smith Convalescent Center)
• Divine Care Hospice, LLC

• Pediatrics Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.