Individual provider Active NPI

Amy Glick, MD

  • Pediatrics Physician
  • Metairie, LA
National Provider Identifier
1861440760
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD.13012R Issued in LA
Practice address
4901 Veterans Memorial Blvd
Metairie, LA 70006-5210
Phone
(504) 887-1133
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD.13012R LA Primary

Addresses

Primary practice location

4901 Veterans Memorial Blvd
Metairie, LA 70006-5210

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1560359MedicaidLA

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
I20241016000244 LA Practitioner - Pediatric Medicine 1254863269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Medical Practice CorporationGroup PAC ID 5597944579, 48 clinicians

Practice addresses (Care Compare)

4845 Veterans Memorial Blvd
Metairie, LA 70006-5209
Phone (504) 883-3703

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.13012RLAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Medical Practice Corporation Pediatrics CurrentSince Nov 20, 2024 Accepting new patients
Children's Hospital Pediatrics Past Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

141 Ormond Center Ct
Destrehan, LA 70047
Phone (985) 764-7337

3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880

4845 Veterans Memorial Blvd
#48
Metairie, LA 70006
Phone (504) 883-3703

4845 Veterans Memorial Blvd
Metairie, LA 70006

1100 Poydras St
Ste 2500
New Orleans, LA 70163
Phone (504) 527-9953

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1861440760",
    "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": "4901 VETERANS MEMORIAL BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700065210",
            "telephone_number": "504-887-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "AMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.13012R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1560359",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.