Individual provider Active NPI

Peter Stephen Reynaud, MD

  • Internal Medicine Physician
  • New Orleans, LA
National Provider Identifier
1942434147
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
020944 Issued in LA
Practice address
1430 Tulane Ave # 8016
New Orleans, LA 70112-2632
Phone
(504) 988-7518
Fax
(504) 988-8252
NPI assigned
May 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 191947 NY
Internal Medicine Physician 207R00000X 020944 LA Primary

Addresses

Primary practice location

1430 Tulane Ave # 8016
New Orleans, LA 70112-2632

Mailing address

1430 Tulane Ave # 8016
New Orleans, LA 70112-2632
Phone (504) 988-7518

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
I20090805000645 LA Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Pediatric Medicine 9739232919 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020944LAMDInternal Medicine Physician
191947NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Jul 1, 2009 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Jul 1, 2009 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Jul 1, 2009 Accepting new patients
Administrators of the Tulane Education Fund PastSince Jul 31, 2023 Accepting new patients

Locations

71211 Highway 21
Ste B
Covington, LA 70433
Phone (985) 893-9922

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1430 Tulane Ave
#22
New Orleans, LA 70112

2003 Tulane Ave
New Orleans, LA 70112
Phone (504) 962-6110

1430 Tulane Ave
#8016
New Orleans, LA 70112
Phone (504) 988-1332

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

Organizations & group practices 4

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": "1241395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1942434147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE # 8016",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-988-7518",
            "fax_number": "504-988-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE # 8016",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-988-7518",
            "fax_number": "504-988-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNAUD",
        "first_name": "PETER",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-04",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "191947",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "020944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.