Individual provider Active NPI

Craig John Quintal, O.D.

  • Optometrist
  • Marrero, LA
National Provider Identifier
1649436551
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1948-884AT Issued in LA
Practice address
4225 Lapalco Blvd
Marrero, LA 70072-4338
Phone
(504) 371-9355
Fax
(985) 652-8371
NPI assigned
Jul 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1569-601T LA
Optometrist 152W00000X 1948-884AT LA Primary

Addresses

Primary practice location

4225 Lapalco Blvd
Marrero, LA 70072-4338

Mailing address

7400 Springlake Dr
New Orleans, LA 70126-3049
Phone (504) 957-1545

Other identifiers 2

IdentifierTypeStateIssuer
1814458MedicaidLA
07375720MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1948-884ATLAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1649436551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 SPRINGLAKE DR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701263049",
            "telephone_number": "504-957-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 LAPALCO BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700724338",
            "telephone_number": "504-371-9355",
            "fax_number": "985-652-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTAL",
        "first_name": "CRAIG",
        "middle_name": "JOHN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1569-601T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1948-884AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1814458",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07375720",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.