Individual provider Active NPI

Mary Lelia Upchurch

  • Physician Assistant
  • Jefferson, LA
National Provider Identifier
1598243982
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
310296 Issued in LA
Practice address
1514 Jefferson Hwy
Jefferson, LA 70121
Phone
(504) 842-3000
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 310296 LA Primary

Addresses

Primary practice location

1514 Jefferson Hwy
Jefferson, LA 70121

Mailing address

3061 Dwight Ave
Pittsburgh, PA 15216-1816
Phone (251) 605-4311

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
I20181008001928 LA Practitioner - Physician Assistant 3971855669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
310296LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Sep 17, 2018 Accepting new patients
Ochsner Clinic LLC CurrentSince Sep 17, 2018 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

Interoperability endpoints

  • Direct secure messaging: mupchurch608649@direct.ochsner.org

Organizations & group practices 3

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 1

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1598243982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 DWIGHT AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152161816",
            "telephone_number": "251-605-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "70121",
            "telephone_number": "504-842-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPCHURCH",
        "first_name": "MARY",
        "middle_name": "LELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "310296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, LA

Sources for this page

Verify at the official NPI Registry.