Individual provider Active NPI

Peter Wynhoven Simoneaux, M.D.

  • MOHS-Micrographic Surgery Physician
  • New Orleans, LA
National Provider Identifier
1730137845
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
MD.018423 Issued in LA
Practice address
1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone
(504) 842-3940
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 018423 LA
MOHS-Micrographic Surgery Physician 207ND0101X 018423 LA
MOHS-Micrographic Surgery Physician 207ND0101X MD.018423 LA Primary

Addresses

Primary practice location

1514 Jefferson Hwy
New Orleans, LA 70121-2429

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
1381454MedicaidLA
P00033629OtherLARR MEDICARE
00119119OtherMSMEDICAID

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070404000523 LA Practitioner - DermatologyPractitioner - Other (Physician) 7911001623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Tulane University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1401 Jefferson Hwy
Jefferson, LA 70121-2426
Phone (504) 842-4747

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

1516 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3470

71380 Hwy 21
Covington, LA 70433-7245
Phone (985) 661-3534

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
018423LAMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Jan 1, 2014 Accepting new patients
Ochsner Clinic LLC CurrentSince Jan 1, 2014 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
#9390
Raceland, LA 70394
Phone (225) 336-3100

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

Interoperability endpoints

  • Direct secure messaging: psimoneaux191233@direct.ochsner.org

Organizations & group practices 3

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.

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1730137845",
    "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": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONEAUX",
        "first_name": "PETER",
        "middle_name": "WYNHOVEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "018423",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "LA",
            "license": "018423",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "LA",
            "license": "MD.018423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1381454",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00033629",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "00119119",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.