Individual provider Active NPI

Justin Mercer, PA-C

  • Medical Physician Assistant
  • Terrytown, LA
National Provider Identifier
1629452495
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.200823 Issued in LA
Practice address
2500 Belle Chasse Hwy
Terrytown, LA 70056-7127
Phone
(504) 392-3131
NPI assigned
Jul 12, 2015
Last updated
Nov 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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 PA.200823 LA Primary

Addresses

Primary practice location

2500 Belle Chasse Hwy
Terrytown, LA 70056-7127

Mailing address

15 Glacier CT
New Orleans, LA 70131-8605

Other identifiers 2

IdentifierTypeStateIssuer
02955357MedicaidMS
2400363MedicaidLA

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
I20150909000720 LA Practitioner - Physician Assistant 3870809759 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Sep 14, 2015 Accepting new patients
Ochsner Clinic LLC CurrentSince Sep 14, 2015 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

180 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-8284

1514 Jefferson Hwy
New Orleans, LA 70121

Interoperability endpoints

  • Direct secure messaging: jmercer201579@direct.ochsner.org

Organizations & group practices 6

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": "1436659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1629452495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 GLACIER CT",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701318605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BELLE CHASSE HWY",
            "city": "TERRYTOWN",
            "state": "LA",
            "postal_code": "700567127",
            "telephone_number": "504-392-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCER",
        "first_name": "JUSTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-12",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "PA.200823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02955357",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2400363",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terrytown, LA

Sources for this page

Verify at the official NPI Registry.