Individual provider Active NPI

Gabriel Antonio Vargas-Bodas, M.D.

  • Internal Medicine Physician
  • Metairie, LA
National Provider Identifier
1548369671
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.09376R Issued in LA
Practice address
3530 Houma Blvd Ste 300
Metairie, LA 70006-4203
Phone
(504) 264-5142
Fax
(504) 455-2648
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 09376R LA
Internal Medicine Physician 207R00000X MD.09376R LA Primary

Addresses

Primary practice location

3530 Houma Blvd Ste 300
Metairie, LA 70006-4203

Mailing address

3530 Houma Blvd Ste 300
Metairie, LA 70006-4203
Phone (504) 264-5142

Other identifiers 1

IdentifierTypeStateIssuer
1936642MedicaidLA

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
I20040712001064 LA Practitioner - Internal Medicine 2163400557 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
09376RLAMDInternal Medicine Physician
MD.09376RLAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PMR la Holding, LLC CurrentSince Apr 1, 2022 Accepting new patients
David R Powers MD Apmc Past Accepting new patients
Tchefuncte Cardiovascular Associates PastSince Oct 4, 2010 Accepting new patients
Lakeview Regional Physician Group LLC Past Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

501 Lapalco Blvd
Gretna, LA 70056
Phone (504) 393-4376

1918 Williams Blvd
Kenner, LA 70062
Phone (504) 471-4860

3530 Houma Blvd
Ste 300
Metairie, LA 70006
Phone (504) 264-5142

3100 Gentilly Blvd
New Orleans, LA 70122
Phone (504) 383-0599

4710 S Carrollton Ave
New Orleans, LA 70119
Phone (504) 454-9020

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1548369671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 HOUMA BLVD STE 300",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700064203",
            "telephone_number": "504-264-5142",
            "fax_number": "504-455-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 HOUMA BLVD STE 300",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700064203",
            "telephone_number": "504-264-5142",
            "fax_number": "504-455-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS-BODAS",
        "first_name": "GABRIEL",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "09376R",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.09376R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1936642",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.