Active NPI
Donna M Mancuso, MD
- Psychiatry Physician
- New Orleans, LA
National Provider Identifier
1649245069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 17303
- Practice address
- 1301 Antonine St
Suite 500
New Orleans, LA 70115-3601 - Phone
- (504) 208-1035
- Fax
- (504) 891-3039
- NPI assigned
- Feb 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychoanalyst | 102L00000X | 17303 | LA | |
| Forensic Psychiatry Physician | 2084F0202X | 17303 | LA | |
| Psychiatry Physician | 2084P0800X | 17303 | LA | Primary |
Addresses
Primary practice location
1301 Antonine St
Suite 500
New Orleans, LA 70115-3601
Mailing address
1301 Antonine Street
Suite 500
New Orleans, LA 70115
Phone (504) 208-1035
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1371297 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 11, 2015 through Nov 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17303 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430784000000",
"number": "1649245069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 ANTONINE STREET",
"address_2": "SUITE 500",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "70115",
"telephone_number": "504-208-1035",
"fax_number": "504-891-3039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 ANTONINE ST",
"address_2": "SUITE 500",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701153601",
"telephone_number": "504-208-1035",
"fax_number": "504-891-3039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCUSO",
"first_name": "DONNA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-20",
"last_updated": "2015-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "LA",
"license": "17303",
"primary": false
},
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "LA",
"license": "17303",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "LA",
"license": "17303",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1371297",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.