NPIMap

Individual provider Active NPI

David Michael Theriot, M.D.

  • Diagnostic Radiology Physician
  • Marrero, LA
National Provider Identifier
1821400904
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
320813 Issued in LA
Practice address
1111 Medical Center Blvd Ste 108
Marrero, LA 70072-3152
Phone
(504) 349-1461
NPI assigned
May 23, 2014
Last updated
Jun 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 320813 LA
Diagnostic Radiology Physician 2085R0202X 320813 LA Primary

Addresses

Primary practice location

1111 Medical Center Blvd Ste 108
Marrero, LA 70072-3152

Mailing address

1111 Medical Center Blvd Ste 108
Marrero, LA 70072-3152
Phone (504) 349-1461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200610001269 LA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 3971806332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Louisiana State University School of Medicine in New Orleans, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson Radiology Associates, Inc.Group PAC ID 0143289363, 14 clinicians

Practice addresses (Care Compare)

1101 Medical Ctr Blvd
Marrero, LA 70072-3191
Phone (504) 349-1461

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Radiology Associates Diagnostic Radiology CurrentSince Jul 20, 2020 Accepting new patients
West Jefferson MRI, LLC CurrentSince Jul 1, 2020 Accepting new patients
West Jefferson MRI, LLC CurrentSince Jul 1, 2020 Accepting new patients

Locations

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

1111 Medical Center Blvd
Ste N108
Marrero, LA 70072
Phone (504) 349-1461

1111 Medical Center Blvd
Ste N110
Marrero, LA 70072
Phone (504) 349-6191

4525 Westbank Expy
Ste B
Marrero, LA 70072
Phone (504) 349-6570

2121 Ridgelake Dr
Metairie, LA 70001
Phone (504) 325-2700

3100 Clearview Pkwy
Metairie, LA 70006
Phone (504) 456-5944

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

5620 Read Blvd
New Orleans, LA 70127
Phone (504) 241-2664

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1821400904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD STE 108",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723152",
            "telephone_number": "504-349-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD STE 108",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723152",
            "telephone_number": "504-349-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIOT",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-23",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "LA",
            "license": "320813",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "320813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.