Individual provider Active NPI

Mary T Killackey, MD

  • Transplant Surgery Physician
  • Metairie, LA
National Provider Identifier
1538129135
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
License
MD.201122 Issued in LA
Practice address
4320 Houma Blvd
Metairie, LA 70006-2961
Phone
(504) 988-5344
NPI assigned
Mar 27, 2006
Last updated
Feb 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X MD.201122 LA Primary

Addresses

Primary practice location

4320 Houma Blvd
Metairie, LA 70006-2961

Mailing address

1430 Tulane Ave # 2682
New Orleans, LA 70112-2632
Phone (504) 988-2317

Other practice location 1

1430 Tulane Ave # 8622
New Orleans, LA 70112-2632
Phone (504) 988-2317

Other identifiers 2

IdentifierTypeStateIssuer
1455172MedicaidLA
101398841MedicaidPA

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
I20070227000647 LA Practitioner - General Surgery 8729970447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Columbia University College of Physicians and Surgeons, 1998
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
Phone (504) 988-5800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.201122LAMDTransplant Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Oct 1, 2006 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Oct 1, 2006 Accepting new patients
Tuhc Physician Group LLC Past Accepting new patients
Administrators of the Tulane Education Fund PastSince Jul 31, 2023 Accepting new patients
Anil S. Paramesh, M.D., S.C. Surgery Past Accepting new patients

Locations

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

4320 Houma Blvd
Ste 700
Metairie, LA 70006
Phone (504) 988-5344

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

1415 Tulane Ave
#15
New Orleans, LA 70112
Phone (504) 588-2300

1415 Tulane Ave
#35
New Orleans, LA 70112
Phone (504) 988-0783

1415 Tulane Ave
Fl 6
New Orleans, LA 70112
Phone (504) 988-5110

1430 Tulane Ave
#2682
New Orleans, LA 70112

1430 Tulane Ave
#8622
New Orleans, LA 70112
Phone (504) 988-2306

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

Organizations & group practices 5

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1538129135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE # 2682",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-988-2317",
            "fax_number": "504-988-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062961",
            "telephone_number": "504-988-5344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 Tulane Ave # 8622",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122632",
            "country_code": "US",
            "telephone_number": "504-988-2317",
            "fax_number": "504-988-7510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLACKEY",
        "first_name": "MARY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "LA",
            "license": "MD.201122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455172",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101398841",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.