Individual provider Active NPI

Kimberly Asha Mukerjee, MD

  • Pediatrics Physician
  • New Orleans, LA
National Provider Identifier
1609219765
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
302332 Issued in LA
Practice address
1631 Elysian Fields Ave
New Orleans, LA 70117-8208
Phone
(504) 821-2601
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 302332 LA Primary

Addresses

Primary practice location

1631 Elysian Fields Ave
New Orleans, LA 70117-8208

Mailing address

1430 Tulane Ave # SL-37
New Orleans, LA 70112-2632
Phone (504) 988-5458

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
I20160922000129 LA Practitioner - Pediatric Medicine 5193012995 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
302332LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Jul 27, 2016 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Jul 27, 2016 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Jul 27, 2016 Accepting new patients

Locations

71211 Highway 21
Ste B
Covington, LA 70433
Phone (985) 893-9922

1430 Tulane Ave
#8637
New Orleans, LA 70112

1430 Tulane Ave
#37
New Orleans, LA 70112
Phone (504) 988-5456

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

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.

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1609219765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE # SL-37",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-988-5458",
            "fax_number": "504-988-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 ELYSIAN FIELDS AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701178208",
            "telephone_number": "504-821-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKERJEE",
        "first_name": "KIMBERLY",
        "middle_name": "ASHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "302332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.