Individual provider Active NPI

Leslie K Reilly, MD

  • Pediatrics Physician
  • New Orleans, LA
National Provider Identifier
1922325612
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD.207234 Issued in LA
Practice address
200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone
(504) 896-2143
Fax
(504) 896-2720
NPI assigned
Apr 21, 2010
Last updated
Sep 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 2013-01632 NC
Hospitalist Physician 208M00000X 2013-01632 NC
Pediatrics Physician 208000000X MD.207234 LA Primary

Addresses

Primary practice location

200 Henry Clay Ave
New Orleans, LA 70118-5720

Mailing address

1823 Dauphine St
New Orleans, LA 70116-1926
Phone (501) 658-4419

Other identifiers 3

IdentifierTypeStateIssuer
1177130MedicaidLA
1922325612MedicaidNC
NC1850MedicaidSC

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150123002178 LA Practitioner - Pediatric Medicine 8224262266 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-01632NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Pediatrics CurrentSince Dec 14, 2024 Accepting new patients
Children's Hospital CurrentSince Dec 14, 2024 Accepting new patients
Childrens Hospital Medical Practice Corporation Pediatrics CurrentSince Jan 1, 2020 Accepting new patients
Louisiana State University School of Med in New Orleans Faculty Grou Pediatrics CurrentSince Sep 1, 2014 Accepting new patients
Children's Hospital Past Accepting new patients

Locations

141 Ormond Center Ct
Destrehan, LA 70047
Phone (985) 764-7337

3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880

4545 Veterans Memorial Blvd
Metairie, LA 70006
Phone (504) 896-9822

4740 S I 10 Service Rd W
Ste 200
Metairie, LA 70001
Phone (504) 894-5479

1401 Foucher St
New Orleans, LA 70115
Phone (504) 897-7011

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1922325612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 DAUPHINE ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701161926",
            "telephone_number": "501-658-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-896-2143",
            "fax_number": "504-896-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "LESLIE",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2013-01632",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2013-01632",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.207234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1177130",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922325612",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1850",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.