NPIMap

Organization Active NPI

Ochsner Mississippi, LLC

Doing business as OCMC Pediatric Orthopedics

  • Internal Medicine Physician
  • Madison, MS
National Provider Identifier
1891290243
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
OCHSNER MISSISSIPPI, LLC
Doing business as
OCMC Pediatric Orthopedics
Practice address
7730 Old Canton Rd
Madison, MS 39110-9299
Phone
(504) 842-3970
Fax
(504) 842-6784
NPI assigned
Mar 28, 2018
Last updated
Jul 7, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
OCHSNER MISSISSIPPI, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Eduardo Benitez
Title
Director
Phone
(504) 430-0025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

7730 Old Canton Rd
Madison, MS 39110-9299

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
09627255MedicaidMS

Other names 1

  • OCMC Pediatric Orthopedics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180216000366 MS Part B Supplier - Clinic/Group Practice 0143580993 Receives reassigned benefits from 325 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay Saint Louis, MS; Picayune, MS; McComb, MS; Madison, MS; Hattiesburg, MS; Gulfport, MS; Flowood, MS; Diamondhead, MS…

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Ochsner Mississippi LLC25 organizations share this tax ID, including this one
Part of
Ochsner Mississippi LLC

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

4540 Shepherd Sq
Diamondhead, MS 39525
Phone (228) 255-8216

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1891290243",
    "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",
            "fax_number": "504-842-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 OLD CANTON RD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391109299",
            "telephone_number": "504-842-3970",
            "fax_number": "504-842-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCHSNER MISSISSIPPI, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OCHSNER MISSISSIPPI, LLC",
        "enumeration_date": "2018-03-28",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "BENITEZ",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "504-430-0025"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09627255",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OCMC Pediatric Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.