Individual provider Active NPI

David Patrick Kennedy, M.D.

  • Ophthalmology Physician
  • Metairie, LA
National Provider Identifier
1518258755
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
207639 Issued in LA
Practice address
4224 Houma Blvd Ste 100
Metairie, LA 70006-2934
Phone
(504) 454-1000
Fax
(504) 456-8010
NPI assigned
Apr 21, 2011
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X P9617 TX
Student in an Organized Health Care Education/Training Program 390200000X BP20041200 TX
Ophthalmology Physician 207W00000X 207639 LA Primary

Addresses

Primary practice location

4224 Houma Blvd Ste 100
Metairie, LA 70006-2934

Mailing address

4224 Houma Blvd Ste 100
Metairie, LA 70006-2934
Phone (504) 454-1000

Other practice location 1

5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone (214) 645-2020

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
I20150706000244 LA Practitioner - Ophthalmology 6507082153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in New Orleans, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf South Eye Associates ApmcGroup PAC ID 4183797673, 5 clinicians

Practice addresses (Care Compare)

4628 Rye St
Metairie, LA 70006-5314
Phone 5044541000106

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207639LAMDOphthalmology Physician
P9617TXMDOphthalmology Physician
BP20041200TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Heitmeier & Armani Medical & Surgical Eyecare LLC Ophthalmology CurrentSince Mar 12, 2018 Accepting new patients
Heitmeier Physicians Optical Ophthalmology CurrentSince Jul 5, 2018 Accepting new patients

Locations

1111 Medical Center Blvd
Ste N111
Marrero, LA 70072

1111 Medical Center Blvd
Ste 111
Marrero, LA 70072
Phone (504) 347-6330

3501 Holiday Dr
Ste 201
New Orleans, LA 70114
Phone (504) 293-3333

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.

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": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1518258755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 HOUMA BLVD STE 100",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062934",
            "telephone_number": "504-454-1000",
            "fax_number": "504-456-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 HOUMA BLVD STE 100",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062934",
            "telephone_number": "504-454-1000",
            "fax_number": "504-456-8010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753907208",
            "country_code": "US",
            "telephone_number": "214-645-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "DAVID",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "P9617",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP20041200",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "207639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.