Individual provider Active NPI

Juan Jorge Gershanik, MD

  • Neonatal-Perinatal Medicine Physician
  • New Orleans, LA
National Provider Identifier
1588725527
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
011837 Issued in LA
Practice address
1303 Henry Clay Avenue
Neonatal Medical Group
New Orleans, LA 70118
Phone
(504) 896-2229
Fax
(504) 896-8835
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 011837 LA Primary

Addresses

Primary practice location

1303 Henry Clay Avenue
Neonatal Medical Group
New Orleans, LA 70118

Mailing address

1303 Henry Clay Avenue
Neonatal Medical Group
New Orleans, LA 70118
Phone (504) 896-2229

Other identifiers 1

IdentifierTypeStateIssuer
1144762MedicaidLA

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
I20090721000160 LA Practitioner - Pediatric Medicine 9739231887

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011837LAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neonatal Medical Group Neonatal-Perinatal Medicine CurrentSince May 4, 2008 Accepting new patients

Locations

4818 Prytania St
New Orleans, LA 70115
Phone (504) 896-2229

Organizations & group practices 1

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588725527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 HENRY CLAY AVENUE",
            "address_2": "NEONATAL MEDICAL GROUP",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70118",
            "telephone_number": "504-896-2229",
            "fax_number": "504-896-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 HENRY CLAY AVENUE",
            "address_2": "NEONATAL MEDICAL GROUP",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70118",
            "telephone_number": "504-896-2229",
            "fax_number": "504-896-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSHANIK",
        "first_name": "JUAN",
        "middle_name": "JORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "LA",
            "license": "011837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144762",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.