Organization Active NPI

Pervez Mussarat MD PMC

  • Specialist
  • Hammond, LA
National Provider Identifier
1922285907
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
08635R Issued in LA
Legal business name
PERVEZ MUSSARAT MD PMC
Practice address
15784 Medical Arts Dr
Suite a
Hammond, LA 70403-1446
Phone
(985) 542-9441
Fax
(985) 542-9414
NPI assigned
Jan 22, 2008
Last updated
Jan 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Authorized official

Name
Dr. Pervez Mussarat, M.D.NPI 1134121999
Title
Doctor
Phone
(985) 542-9441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 08635R LA Primary

Addresses

Primary practice location

15784 Medical Arts Dr
Suite a
Hammond, LA 70403-1446

Mailing address

15784 Medical Arts Dr
Suite a
Hammond, LA 70403-1446
Phone (985) 542-9441

Other identifiers 1

IdentifierTypeStateIssuer
1932396MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100921000288 LA Part B Supplier - Clinic/Group Practice 9739204264 Receives reassigned benefits from 3 practitioners
Practice locations: Mandeville, LA

National Provider Directory

National Provider Directory

Locations

619 W 19th Ave
Covington, LA 70433
Phone (985) 400-5344

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1922285907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15784 MEDICAL ARTS DR",
            "address_2": "SUITE A",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031446",
            "telephone_number": "985-542-9441",
            "fax_number": "985-542-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15784 MEDICAL ARTS DR",
            "address_2": "SUITE A",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031446",
            "telephone_number": "985-542-9441",
            "fax_number": "985-542-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERVEZ MUSSARAT MD PMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "MUSSARAT",
        "authorized_official_first_name": "PERVEZ",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "985-542-9441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "08635R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932396",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.