Individual provider Active NPI

Shelby Putfark, PA

  • Physician Assistant
  • New Orleans, LA
National Provider Identifier
1780406132
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
Tulane Center for Clinical Neurosciences
131 S Robertson St, Ste 1300
New Orleans, LA 70112
Phone
(504) 988-5565
NPI assigned
Oct 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

Tulane Center for Clinical Neurosciences
131 S Robertson St, Ste 1300
New Orleans, LA 70112

Mailing address

3428 Tennessee Ave
Kenner, LA 70065-3827

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250210003067 LA Practitioner - Physician Assistant 2860922515 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Administrators of the Tulane Educational FundGroup PAC ID 0446163760, shared by 3 NPIs, 388 clinicians

Practice addresses (Care Compare)

1415 Tulane Ave
New Orleans, LA 70112-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Nov 10, 2024 Accepting new patients
Administrators of the Tulane Education Fund CurrentSince Nov 10, 2024 Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients

Locations

71211 Highway 21
Ste B
Covington, LA 70433
Phone (985) 893-9922

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

Organizations & group practices 4

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 4

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": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1780406132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3428 TENNESSEE AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700653827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TULANE CENTER FOR CLINICAL NEUROSCIENCES",
            "address_2": "131 S ROBERTSON ST, STE 1300",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70112",
            "telephone_number": "504-988-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTFARK",
        "first_name": "SHELBY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.