Individual provider Active NPI

Diana Moustoukas Peterson, MD

  • Pediatrics Physician
  • New Orleans, LA
National Provider Identifier
1780845503
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD.205215 Issued in LA
Practice address
1315 Jefferson Hwy
New Orleans, LA 70121-2406
Phone
(504) 842-3900
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD.205215 LA Primary

Addresses

Primary practice location

1315 Jefferson Hwy
New Orleans, LA 70121-2406

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2302451MedicaidLA
00923576MedicaidMS

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
I20120808000688 LA Practitioner - Pediatric Medicine 1557539384 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.205215LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Aug 1, 2012 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 1, 2012 Accepting new patients

Locations

1315 Jefferson Hwy
New Orleans, LA 70121
Phone (504) 842-5200

1514 Jefferson Hwy
New Orleans, LA 70121

Interoperability endpoints

  • Direct secure messaging: dpeterson98826@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.

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1780845503",
    "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": "1315 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212406",
            "telephone_number": "504-842-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DIANA",
        "middle_name": "MOUSTOUKAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.205215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2302451",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00923576",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.