Individual provider Active NPI

Paul Thomas Sunderhaus, DPM

  • Podiatrist
  • Alexandria, LA
National Provider Identifier
1669449260
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DPMPD205R Issued in LA
Practice address
1587 N Bolton Ave
Suite 1100
Alexandria, LA 71303-4205
Phone
(318) 445-9210
Fax
(318) 445-1509
NPI assigned
Mar 2, 2006
Last updated
Jul 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DPMPD205R LA Primary

Addresses

Primary practice location

1587 N Bolton Ave
Suite 1100
Alexandria, LA 71303-4205

Mailing address

1587 N Bolton Ave
Suite 1100
Alexandria, LA 71303-4205
Phone (318) 445-9210

Other identifiers 2

IdentifierTypeStateIssuer
1532924MedicaidLA
480025072OtherLARAILROAD MEDICARE-PALMETT

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818000215 LA Practitioner - Podiatry 1951437847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cenla Family Medicine Associates, LLCGroup PAC ID 7517010705, 18 clinicians

Practice addresses (Care Compare)

1587 N Bolton Ave
Suite 1100
Alexandria, LA 71303-4255
Phone (318) 445-9823

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue74
Removal of skin lesions1-10
Removal of nail tissue631
Removal or shaving of skin growth109
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DPMPD205RLAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cenla Family Medicine Associates, LLC Podiatrist CurrentSince Aug 1, 2014 Accepting new patients

Locations

1587 N Bolton Ave
Ste 1100
Alexandria, LA 71303
Phone (318) 445-9823

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEDCAA

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1669449260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1587 N BOLTON AVE",
            "address_2": "SUITE 1100",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713034205",
            "telephone_number": "318-445-9210",
            "fax_number": "318-445-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1587 N BOLTON AVE",
            "address_2": "SUITE 1100",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713034205",
            "telephone_number": "318-445-9210",
            "fax_number": "318-445-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERHAUS",
        "first_name": "PAUL",
        "middle_name": "THOMAS",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "LA",
            "license": "DPMPD205R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1532924",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-PALMETT",
            "identifier": "480025072",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.