Mark Broussard

Primary specialty

Social WorkerTaxonomy code 104100000X

License

12716 Issued in LA

Practice address

239 Nashville Ave
New Orleans, LA 70115-2108

Phone

(435) 491-0531

NPI assigned

Jan 25, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metropolitan Human Services DistrictGroup PAC ID 6901966407, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Metropolitan Human Services District

  • Community/Behavioral Health Agency
  • New Orleans, LA
  • NPI 1790990604
  Medicare reassignment Care Compare group
• Metropolitan Human Services District

  • Community/Behavioral Health Agency
  • New Orleans, LA
  • NPI 1760511919
  NPD
• Metropolitan Human Services District

  • Community/Behavioral Health Agency
  • New Orleans, LA
  • NPI 1316166036
  NPD (past)
• Metropolitan Human Services District

  • Community/Behavioral Health Agency
  • New Orleans, LA
  • NPI 1942428750
  NPD (past)
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1043204811
  NPD (past)

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1669839445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 NASHVILLE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701152108",
            "telephone_number": "435-491-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 NASHVILLE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701152108",
            "telephone_number": "435-491-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-25",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "12716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Broussard
• Erica Monique Broussard, M.D.
• Karlo D Broussard
• Laura Broussard
• Lauren Elise Broussard, MD
• Mary Jo Broussard
• Samantha Broussard
• Taylor Alise Broussard
• Tiffany Broussard, NP
• Glenn Jospeh Brousseaur, RESPIRATORY THERAPY

• Social Worker in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.