Individual provider Active NPI

Robert Carl McMyne Jr., M.D.

  • Interventional Pain Medicine Physician
  • Metairie, LA
National Provider Identifier
1588825160
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
MD.203467 Issued in LA
Practice address
4320 Houma Blvd
FL 6
Metairie, LA 70006-2961
Phone
(504) 503-4109
Fax
(504) 503-4103
NPI assigned
Jun 17, 2008
Last updated
Jan 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X MD.203467 LA Primary

Addresses

Primary practice location

4320 Houma Blvd
FL 6
Metairie, LA 70006-2961

Mailing address

4320 Houma Blvd
FL 6
Metairie, LA 70006-2961
Phone (504) 503-4109

Other identifiers 1

IdentifierTypeStateIssuer
1096776MedicaidLA

Other names 1

  • Dr. Robert Carl McMyne Jr. Professional 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130604000129 LA Practitioner - Pain ManagementPractitioner - Physical Medicine and Rehabilitation 2365680360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Louisiana State University School of Medicine in New Orleans, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4320 Houma Blvd
FL 6
Metairie, LA 70006-2961
Phone (504) 503-4109

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.203467LAMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Jefferson Physicians Group LLC CurrentSince Sep 26, 2021 Accepting new patients

Locations

4224 Houma Blvd
Ste 520
Metairie, LA 70006
Phone (504) 885-4003

4300 Houma Blvd
Ste 202
Metairie, LA 70006
Phone (504) 503-6791

4320 Houma Blvd
Fl 6
Metairie, LA 70006
Phone (504) 503-4109

Interoperability endpoints

  • Direct secure messaging: robert.mcmyne@direct.ejgh.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1588825160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 HOUMA BLVD",
            "address_2": "FL 6",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062961",
            "telephone_number": "504-503-4109",
            "fax_number": "504-503-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 HOUMA BLVD",
            "address_2": "FL 6",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062961",
            "telephone_number": "504-503-4109",
            "fax_number": "504-503-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMYNE",
        "first_name": "ROBERT",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "LA",
            "license": "MD.203467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1096776",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "MCMYNE",
            "middle_name": "CARL",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.