Individual provider Active NPI

Jessica R Montegudo, MD

  • Internal Medicine Physician
  • Metairie, LA
National Provider Identifier
1700830585
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.013823 Issued in LA
Practice address
2005 Veterans Memorial Blvd
Metairie, LA 70002-6320
Phone
(504) 836-9820
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.013823 LA Primary

Addresses

Primary practice location

2005 Veterans Memorial Blvd
Metairie, LA 70002-6320

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other identifiers 2

IdentifierTypeStateIssuer
00125007MedicaidMS
1304760MedicaidLA

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Past Accepting new patients
Ochsner Clinic LLC Internal Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1700830585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 VETERANS MEMORIAL BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700026320",
            "telephone_number": "504-836-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEGUDO",
        "first_name": "JESSICA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.013823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125007",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1304760",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.