Organization Active NPI

Joshua M. Groetsch, MD LLC

  • Ophthalmology Physician
  • Metairie, LA
National Provider Identifier
1740865864
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
JOSHUA M. GROETSCH, MD LLC
Practice address
2800 Veterans Blvd
Suite 125
Metairie, LA 70002
Phone
(504) 833-5755
Fax
(504) 832-9629
NPI assigned
Mar 10, 2021
Last updated
Mar 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Authorized official

Name
Joshua Mark Groetsch, MDNPI 1669497590
Title
Owner
Phone
(504) 460-1848

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2800 Veterans Blvd
Suite 125
Metairie, LA 70002

Mailing address

2800 Veterans Blvd
Suite 125
Metairie, LA 70002
Phone (504) 833-5755

Other practice location 1

1046 Paul Mallard Rd
Luling, LA 70070-7000
Phone (985) 785-8444

Other identifiers 2

IdentifierTypeStateIssuer
1045284MedicaidLA
2444506MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210607000100 LA Part B Supplier - Clinic/Group Practice 5294134680 Receives reassigned benefits from 8 practitioners
Practice locations: Metairie, LA; Luling, LA

National Provider Directory

National Provider Directory

Locations

2304 S Burnside Ave
Gonzales, LA 70737
Phone (225) 450-6019

2800 Veterans Memorial Blvd
Ste 125
Metairie, LA 70002
Phone (504) 833-5573

2800 Vets Blvd
#125
Metairie, LA 70002
Phone (504) 833-5573

Interoperability endpoints

  • Direct secure messaging: jvinet@jmg.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1740865864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 VETERANS BLVD",
            "address_2": "SUITE 125",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70002",
            "telephone_number": "504-833-5755",
            "fax_number": "504-832-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 VETERANS BLVD",
            "address_2": "SUITE 125",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70002",
            "telephone_number": "504-833-5755",
            "fax_number": "504-832-9629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1046 Paul Mallard Rd",
            "address_purpose": "LOCATION",
            "city": "Luling",
            "state": "LA",
            "postal_code": "700707000",
            "country_code": "US",
            "telephone_number": "985-785-8444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOSHUA M. GROETSCH, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "GROETSCH",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-460-1848",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1045284",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2444506",
            "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 Mar 10, 2021; 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.

Verify at the official NPI Registry.