Individual provider Active NPI

Marius Marcel Commodore, MD

  • Internal Medicine Physician
  • New Orleans, LA
National Provider Identifier
1568660652
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
323144 Issued in LA
Practice address
1523 Saint Charles Ave
New Orleans, LA 70130-4445
Phone
(215) 707-1800
Fax
(215) 707-3644
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 115712 IL
Internal Medicine Physician 207R00000X MD446997 PA
Psychiatry Physician 2084P0800X MD446997 PA
Psychiatry Physician 2084P0800X 115712 IL
Psychiatry Physician 2084P0800X 323144 LA
Internal Medicine Physician 207R00000X 323144 LA Primary

Addresses

Primary practice location

1523 Saint Charles Ave
New Orleans, LA 70130-4445

Mailing address

1523 Saint Charles Ave
New Orleans, LA 70130-4445

Other practice location 1

2627 W Cermak Rd
Chicago, IL 60608-3514
Phone (773) 389-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, LA2 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
I20170306001235 IL Practitioner - Internal MedicinePractitioner - Psychiatry 2668564188 Reassigns benefits to 1 organization
I20250221001735 LA Practitioner - Internal Medicine 2668564188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Emory University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marillac Community Health CentersGroup PAC ID 3678755535, 70 clinicians

Practice addresses (Care Compare)

1523 Saint Charles Ave
New Orleans, LA 70130-4445
Phone (504) 374-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
115712ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marillac Community Health Centers CurrentSince Dec 12, 2024 Accepting new patients
Marillac Community Health Centers Current Accepting new patients
Marillac Community Health Centers CurrentSince Dec 12, 2024 Accepting new patients
Absolutecare of Illinois, PLLC CurrentSince May 1, 2025 Accepting new patients
Marillac Community Health Centers Past Accepting new patients
Absolutecare of Louisiana, LLC Past Accepting new patients

Locations

2627 W Cermak Rd
Chicago, IL 60608
Phone (773) 389-3000

3201 S Carrollton Ave
New Orleans, LA 70118
Phone (504) 207-3019

1523 Saint Charles Ave
New Orleans, LA 70130
Phone (504) 374-1000

10175 Little Patuxent Pkwy
Ste 800
Columbia, MD 21044

Interoperability endpoints

  • Direct secure messaging: mcommodore134346@uchospital.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1568660652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 SAINT CHARLES AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701304445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 SAINT CHARLES AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701304445",
            "telephone_number": "215-707-1800",
            "fax_number": "215-707-3644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2627 W Cermak Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606083514",
            "country_code": "US",
            "telephone_number": "773-389-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMMODORE",
        "first_name": "MARIUS",
        "middle_name": "MARCEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "115712",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD446997",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD446997",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "115712",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "323144",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "323144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.