NPIMap

Individual provider Active NPI

Richard Lee Shomo, PA

  • Medical Physician Assistant
  • New Orleans, LA
National Provider Identifier
1609853720
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA04261 Issued in TX
Practice address
2300 General Meyer Ave
BLDG H100
New Orleans, LA 70142-0001
Phone
(504) 678-8148
Fax
(504) 678-1596
NPI assigned
Dec 29, 2005
Last updated
Jun 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA04261 TX Primary

Addresses

Primary practice location

2300 General Meyer Ave
BLDG H100
New Orleans, LA 70142-0001

Mailing address

1009 Deborah Dr
Slidell, LA 70461-5368
Phone (504) 678-8148

Other identifiers 4

IdentifierTypeStateIssuer
1037052MedicaidLA
1049767OtherNATIONAL CERTIFICATION
PA04261OtherTXLICENSE
PA200160OtherLALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110510000422 TX Practitioner - Physician Assistant 4688751639 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.86 of 100Reported as group
Quality
92.78
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leading Edge Emergency Physicians, Inc CurrentSince Jul 16, 2017 Accepting new patients
Foucher Emergency Physicians Past Accepting new patients
Louisiana Em-1 Medical Services, PA Past Accepting new patients
River City Emergency Physicians, PLLC Past Accepting new patients
Methodist Health Centers Past Accepting new patients
River City Observation Services PLLC Past Accepting new patients
St. David's Carenow Urgent Care PLLC Past Accepting new patients
River City Pediatric Emergency Physicians, PLLC Past Accepting new patients

Locations

16088 San Pedro Ave
San Antonio, TX 78232
Phone (210) 402-4092

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1609853720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 DEBORAH DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615368",
            "telephone_number": "504-678-8148",
            "fax_number": "504-678-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GENERAL MEYER AVE",
            "address_2": "BLDG H100",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701420001",
            "telephone_number": "504-678-8148",
            "fax_number": "504-678-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOMO",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA04261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1037052",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERTIFICATION",
            "identifier": "1049767",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA04261",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA200160",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.