Individual provider Active NPI

Charles Edward Griffin III, M.D.

  • Anesthesiology Physician
  • New Orleans, LA
National Provider Identifier
1871852921
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A128675 Issued in CA
Practice address
1514 Jefferson Hwy
Brent House Room 634
New Orleans, LA 70121-2429
Phone
(504) 842-3000
NPI assigned
May 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A128675 CA Primary

Addresses

Primary practice location

1514 Jefferson Hwy
Brent House Room 634
New Orleans, LA 70121-2429

Mailing address

1514 Jefferson Hwy
Brent House Room 634
New Orleans, LA 70121-2429
Phone (504) 842-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160624002069 CA Practitioner - Anesthesiology 1951692714 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Louisiana State University School of Medicine in New Orleans, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Associates PCGroup PAC ID 4385070549, 24 clinicians
South Bay Anesthesia Medical Group IncGroup PAC ID 6406899707, 31 clinicians

Practice addresses (Care Compare)

1300 W 7TH St
San Pedro, CA 90732-3505
Phone (310) 832-3311

4101 Torrance Blvd
Torrance, CA 90503-4607
Phone (310) 540-7676

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A128675CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Anesthesia Medical Group Inc. Anesthesiology CurrentSince Jan 28, 2017 Accepting new patients
Professional Anesthesia Associates PC Anesthesiology CurrentSince Feb 22, 2021 Accepting new patients

Locations

1300 W 7th St
San Pedro, CA 90732
Phone (310) 514-5350

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

Organizations & group practices 2

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 3

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": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1871852921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "address_2": "BRENT HOUSE ROOM 634",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "address_2": "BRENT HOUSE ROOM 634",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A128675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.