Individual provider Active NPI

Amanda Cenac Martin, PA-C

  • Physician Assistant
  • Marrero, LA
National Provider Identifier
1558701631
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.200632 Issued in LA
Practice address
1111 Medical Center Blvd
Suite S350
Marrero, LA 70072-3151
Phone
(504) 349-6350
Fax
(504) 934-8701
NPI assigned
Jul 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.200632 LA Primary

Addresses

Primary practice location

1111 Medical Center Blvd
Suite S350
Marrero, LA 70072-3151

Mailing address

1111 Medical Center Blvd
Suite S350
Marrero, LA 70072-3151
Phone (504) 349-6350

Other identifiers 2

IdentifierTypeStateIssuer
2370316MedicaidLA
00287527MedicaidMS

Other names 1

  • Ms. Amanda Clair Cenac Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140502001521 LA Practitioner - Physician Assistant 4385877059 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1401 Jefferson Hwy
Jefferson, LA 70121-2426
Phone (504) 842-4747

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

1516 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3470

71380 Hwy 21
Covington, LA 70433-7245
Phone (985) 661-3534

Hospital & facility affiliations

  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
  • Ochsner Medical Center-Kenner Hospital, Kenner, LA, CCN 190274
  • St Bernard Parish Hospital Hospital, Chalmette, LA, CCN 190308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Aug 4, 2014 Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 4, 2014 Accepting new patients

Locations

180 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-8284

1057 Paul Maillard Rd
Luling, LA 70070
Phone (985) 785-3655

2820 Napoleon Ave
New Orleans, LA 70115
Phone (504) 842-4960

1514 Jefferson Hwy
New Orleans, LA 70121

Interoperability endpoints

  • Direct secure messaging: amartin159271@direct.ochsner.org

Organizations & group practices 7

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 3

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": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1558701631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE S350",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6350",
            "fax_number": "504-934-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE S350",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6350",
            "fax_number": "504-934-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AMANDA",
        "middle_name": "CENAC",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2370316",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00287527",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "CENAC",
            "middle_name": "CLAIR",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.