Organization Active NPI

Obyrne Eye Clinic, L.L.C.

  • Specialist
  • Mandeville, LA
National Provider Identifier
1649471335
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
016256 Issued in LA
Legal business name
OBYRNE EYE CLINIC, L.L.C.
Practice address
1580 W Causeway Approach
Suite 3
Mandeville, LA 70471-3033
Phone
(985) 624-5573
Fax
(985) 624-9106
NPI assigned
May 30, 2007
Last updated
Apr 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Authorized official

Name
Marilu Obyrne, M.D.NPI 1083772453
Title
Ownerm.D.
Phone
(985) 624-5573

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 016256 LA Primary

Addresses

Primary practice location

1580 W Causeway Approach
Suite 3
Mandeville, LA 70471-3033

Mailing address

1580 W Causeway Approach
Suite 3
Mandeville, LA 70471-3033
Phone (985) 624-5573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070711000949 LA Part B Supplier - Clinic/Group Practice 9335249937 Receives reassigned benefits from 3 practitioners
Practice locations: Mandeville, LA; Slidell, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1649471335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 W CAUSEWAY APPROACH",
            "address_2": "SUITE 3",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713033",
            "telephone_number": "985-624-5573",
            "fax_number": "985-624-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 W CAUSEWAY APPROACH",
            "address_2": "SUITE 3",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713033",
            "telephone_number": "985-624-5573",
            "fax_number": "985-624-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBYRNE EYE CLINIC, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "OBYRNE",
        "authorized_official_first_name": "MARILU",
        "authorized_official_title_or_position": "OWNERM.D.",
        "authorized_official_telephone_number": "985-624-5573",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "016256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.