Organization Active NPI

Quynh Mai Clinic LLC

  • Family Medicine Physician
  • Kenner, LA
National Provider Identifier
1568416709
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
QUYNH MAI CLINIC LLC
Practice address
705 W Esplanade Ave
Kenner, LA 70065-2867
Phone
(504) 465-0185
Fax
(504) 467-1528
NPI assigned
May 20, 2006
Last updated
Nov 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Authorized official

Name
Quynh Mai, MDNPI 1982668190
Title
Director
Phone
(504) 465-0185

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LA Primary

Addresses

Primary practice location

705 W Esplanade Ave
Kenner, LA 70065-2867

Mailing address

PO Box 73701
Metairie, LA 70033-3701
Phone (877) 241-1811

Other identifiers 2

IdentifierTypeStateIssuer
5CF86OtherLAMEDICARE PTAN
1448940MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041021000565 LA Part B Supplier - Clinic/Group Practice 2668433806 Receives reassigned benefits from 5 practitioners
Practice locations: Kenner, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1014295Quynh Mai Clinic, LLC705 West Esplanade Suite a, Kenner, LA 70065Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory

Locations

705 W Esplanade Ave
Kenner, LA 70065
Phone (504) 465-0185

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383264000000",
    "number": "1568416709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73701",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700333701",
            "telephone_number": "877-241-1811",
            "fax_number": "888-849-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W ESPLANADE AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652867",
            "telephone_number": "504-465-0185",
            "fax_number": "504-467-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUYNH MAI CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2013-11-01",
        "status": "A",
        "authorized_official_last_name": "MAI",
        "authorized_official_first_name": "QUYNH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "504-465-0185",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "5CF86",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1448940",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenner, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.