Janine Lissard, MD
Individual provider Active NPI Pediatrics Physician · River Ridge, LA
NPI 1902800451 · NPPES record last updated Nov 15, 2016
Key facts
- NPI
- 1902800451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 023752 (LA)
- Practice address
- 9605 Jefferson Hwy
River Ridge, LA 70123-2550 - Phone
- (504) 738-1604
- Fax
- (504) 738-7860
- NPI assigned
- Jun 10, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161212000872 | LA | Practitioner - Pediatric Medicine | 9537449418 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023752 | LA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ochsner Clinic LLC | Current | Accepting new patients | |
| Ochsner Clinic LLC | Current |
Accepting new patients | |
| Ochsner Clinic LLC | Current |
Accepting new patients |
Locations
708 W Esplanade Ave
Kenner, LA 70065
Phone (504) 461-9660
1514 Jefferson Hwy
New Orleans, LA 70121
9605 Jefferson Hwy
Ste E
River Ridge, LA 70123
Phone (504) 738-1600
9605 Jefferson Hwy
River Ridge, LA 70123
Phone (504) 738-1604
Interoperability endpoints
- jlissard403426@direct.ochsner.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 023752 | LA | Yes |
Addresses
Primary practice location
9605 Jefferson Hwy
River Ridge, LA 70123-2550
Mailing address
1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 896-9827
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1484911 | Medicaid | LA |
Other providers in River Ridge, LA
- Austin Laurent
- Ngoc Thuy Le
- Leo Savoie Cpo
- Taylor M Leon
- Fredericka Lewis
- Louisiana CVS Pharmacy, L.L.C.
- Louisiana State University
- M.D.O. Transportation LLC
- Magnolia Compcare
- Manger Chiropractic
All providers in River Ridge, LA · Pediatrics Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.