Active NPI
MQVN Community Development Corporation
- Physical Medicine & Rehabilitation Physician
- New Orleans, LA
National Provider Identifier
1699320382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- Legal business name
- MQVN COMMUNITY DEVELOPMENT CORPORATION
- Practice address
- 13101 Chef Menteur Hwy
New Orleans, LA 70129-1806 - Phone
- (504) 281-4461
- Fax
- (504) 254-6447
- NPI assigned
- Aug 8, 2019
- Organization subpart
- Yes
- Parent organization
- MQVN COMMUNITY DEVELOPMENT CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jace Cacioppo
- Title
- Compliance and Credentialing Office
- Phone
- (504) 249-5834
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | Primary |
Addresses
Primary practice location
13101 Chef Menteur Hwy
New Orleans, LA 70129-1806
Mailing address
13085 Chef Menteur Hwy
New Orleans, LA 70129-1804
Phone (504) 255-8665
Other names 1
- NOELA Wellness Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100312000623 | LA | Part B Supplier - Clinic/Group Practice | 4486789682 |
Receives reassigned benefits from 5 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: New Orleans, LA |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Federally Qualified Health Center (FQHC)
- New Orleans, LA
- NPI 1679875744
O20100312000623
-
- Federally Qualified Health Center (FQHC)
- New Orleans, LA
- NPI 1811220551
O20100312000623
National Provider Directory
National Provider Directory- Part of
- MQVN Community Dev Corp
Locations
13101 Chef Menteur Hwy
New Orleans, LA 70129
Phone (504) 281-4461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565222400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1746662400000",
"number": "1699320382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13085 CHEF MENTEUR HWY",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701291804",
"telephone_number": "504-255-8665",
"fax_number": "504-254-6447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13101 CHEF MENTEUR HWY",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701291806",
"telephone_number": "504-281-4461",
"fax_number": "504-254-6447"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MQVN COMMUNITY DEVELOPMENT CORPORATION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MQVN COMMUNITY DEVELOPMENT CORPORATION",
"enumeration_date": "2019-08-08",
"last_updated": "2025-05-08",
"certification_date": "2025-05-08",
"status": "A",
"authorized_official_last_name": "CACIOPPO",
"authorized_official_first_name": "JACE",
"authorized_official_title_or_position": "COMPLIANCE AND CREDENTIALING OFFICE",
"authorized_official_telephone_number": "504-249-5834"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "NOELA Wellness Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "NOELA Wellness Center",
"code": "3",
"type": "Doing Business As"
}
]
}
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 8, 2025; 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.