Individual provider Active NPI

Vasanth Kumar Bethala, M.D.

  • Interventional Cardiology Physician
  • Slidell, LA
National Provider Identifier
1548263999
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
09114R Issued in LA
Practice address
1051 Gause Blvd.
Suite 230
Slidell, LA 70458
Phone
(985) 641-7577
Fax
(985) 643-0826
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 09114R LA
Cardiovascular Disease Physician 207RC0000X 13115 MS
Interventional Cardiology Physician 207RI0011X 09114R LA Primary

Addresses

Primary practice location

1051 Gause Blvd.
Suite 230
Slidell, LA 70458

Mailing address

1514 Jefferson Hwy.
New Orleans, LA 70121
Phone (504) 842-4000

Other identifiers 3

IdentifierTypeStateIssuer
00110414MedicaidMS
1930636MedicaidLA
060018918OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041220000772 LA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Nuclear Medicine 3375501562 Reassigns benefits to 1 organization
I20181018000623 MS Practitioner - Cardiovascular Disease (Cardiology) 3375501562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Nuclear Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1001 Gause Blvd
Slidell, LA 70458-2939
Phone (985) 646-5970

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
09114RLAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Jun 15, 2020 Accepting new patients
Ochsner Mississippi, LLC Current Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Jun 15, 2020 Accepting new patients
Ochsner Mississippi, LLC CurrentSince Oct 14, 2020 Accepting new patients
Ochsner Mississippi, LLC CurrentSince Oct 14, 2020 Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

100 Medical Center Dr
Slidell, LA 70461
Phone (504) 392-3131

1001 Gause Blvd
Slidell, LA 70458
Phone (985) 280-2200

1051 Gause Blvd
Ste 340
Slidell, LA 70458

1051 Gause Blvd
Ste 230
Slidell, LA 70458
Phone (985) 280-9855

1051 Gause Blvd
Ste 320
Slidell, LA 70458
Phone (985) 641-7577

149 Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 467-8600

4540 Shepherd Sq
#C
Diamondhead, MS 39525
Phone (228) 255-8526

1839 Cooper Rd
Ste 100
Picayune, MS 39466
Phone (601) 651-3500

Interoperability endpoints

  • Direct secure messaging: vbethala227284@direct.ochsner.org

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1548263999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY.",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70121",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 GAUSE BLVD.",
            "address_2": "SUITE 230",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "70458",
            "telephone_number": "985-641-7577",
            "fax_number": "985-643-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHALA",
        "first_name": "VASANTH",
        "middle_name": "KUMAR",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "09114R",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "13115",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "LA",
            "license": "09114R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00110414",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1930636",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060018918",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.