Individual provider Active NPI

Harold Robert Neitzschman III, M.D.

  • Specialist
  • Slidell, LA
National Provider Identifier
1942357900
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
L020894 Issued in LA
Practice address
1850 Gause Blvd E Ste 102
Slidell, LA 70461-5434
Phone
(985) 641-3742
Fax
(985) 641-7181
NPI assigned
Jan 4, 2007
Last updated
Mar 27, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X L020894 LA Primary

Addresses

Primary practice location

1850 Gause Blvd E Ste 102
Slidell, LA 70461-5434

Mailing address

170 Crapemyrtle Rd
Covington, LA 70433-4766
Phone (985) 871-7130

Other identifiers 2

IdentifierTypeStateIssuer
00116828MedicaidMS
1682110MedicaidLA

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
I20080501000087 LA Practitioner - Urology 5092894147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Louisiana State University School of Medicine in New Orleans, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1150 Robert Blvd
Slidell, LA 70458-2008
Phone (985) 641-3742

1150 Robert Blvd Sutie
Suite 350
Slidell, LA 70458-2008

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Prostate resection21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L020894LAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Harold R Neitzschman III MD Apmc Urology CurrentSince Jan 4, 2010 Accepting new patients

Locations

1150 Robert Blvd
Ste 350
Slidell, LA 70458
Phone (504) 649-6660

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1942357900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 CRAPEMYRTLE RD",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704334766",
            "telephone_number": "985-871-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 GAUSE BLVD E STE 102",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615434",
            "telephone_number": "985-641-3742",
            "fax_number": "985-641-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEITZSCHMAN",
        "first_name": "HAROLD",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "L020894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116828",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1682110",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.