Individual provider Active NPI

Michael Thomas Certa

  • Oral and Maxillofacial Surgery (Dentist)
  • New Orleans, LA
National Provider Identifier
1942762075
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
7736 Issued in LA
Practice address
1100 Florida Ave
New Orleans, LA 70119-2715
Phone
(504) 941-8212
NPI assigned
Apr 6, 2019
Last updated
Sep 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 11408 KY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 7736 LA Primary

Addresses

Primary practice location

1100 Florida Ave
New Orleans, LA 70119-2715

Mailing address

2100 Saint Thomas St Apt 303
New Orleans, LA 70130-4971
Phone (516) 263-7934

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
I20251121000549 LA Practitioner - Maxillofacial Surgery 9133456932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3000 34TH St
Metairie, LA 70001-2016

478 S Johnson St
New Orleans, LA 70112-2238

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11408KYMDOral and Maxillofacial Surgery (Dentist)
7736LAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Aug 25, 2025 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G Current Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Aug 25, 2025 Accepting new patients

Locations

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

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

Organizations & group practices 3

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": "1554508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1942762075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SAINT THOMAS ST APT 303",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701304971",
            "telephone_number": "516-263-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 FLORIDA AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701192715",
            "telephone_number": "504-941-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERTA",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-06",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "11408",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "7736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.