Individual provider Active NPI

Jonathan James Gisclair, DPM

  • Podiatrist
  • Cut Off, LA
National Provider Identifier
1922020775
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PD0110 Issued in LA
Practice address
16148 West Main Street
Cut Off, LA 70345
Phone
(985) 325-3668
Fax
(985) 325-3670
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PD0110 LA Primary

Addresses

Primary practice location

16148 West Main Street
Cut Off, LA 70345

Mailing address

PO Box 1759
Department 952
Houston, TX 77251-1759
Phone (713) 554-5304

Other identifiers 1

IdentifierTypeStateIssuer
1131211MedicaidLA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051208000789 LA Practitioner - Podiatry 0345261103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.21 of 100Reported as group
Quality
81.06
Promoting interoperability
100
Improvement activities
40
Cost
71.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PD0110LAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jan 2, 2018 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jan 2, 2018 Accepting new patients

Locations

4500 10th St
Ste B
Marrero, LA 70072
Phone (504) 412-1960

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

2025 Gravier St
Fl 6
New Orleans, LA 70112

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231977600000",
    "number": "1922020775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1759",
            "address_2": "DEPARTMENT 952",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772511759",
            "telephone_number": "713-554-5304",
            "fax_number": "713-554-5324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16148 WEST MAIN STREET",
            "city": "CUT OFF",
            "state": "LA",
            "postal_code": "70345",
            "telephone_number": "985-325-3668",
            "fax_number": "985-325-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GISCLAIR",
        "first_name": "JONATHAN",
        "middle_name": "JAMES",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2009-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "LA",
            "license": "PD0110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1131211",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cut Off, LA

Sources for this page

Verify at the official NPI Registry.