Individual provider Active NPI

Patt Christian Panuncillon, DO

  • Student in an Organized Health Care Education/Training Program
  • New Orleans, LA
National Provider Identifier
1972356442
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1401 Jefferson Highway
Academic Center, 1St Floor
New Orleans, LA 70121
Phone
(504) 842-3260
NPI assigned
Apr 8, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X LA Primary

Addresses

Primary practice location

1401 Jefferson Highway
Academic Center, 1St Floor
New Orleans, LA 70121

Mailing address

1401 Jefferson Highway
Academic Center, 1St Floor
New Orleans, LA 70121
Phone (504) 842-3260

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
I20240624001430 LA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5890238422

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1972356442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 JEFFERSON HIGHWAY",
            "address_2": "ACADEMIC CENTER, 1ST FLOOR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70121",
            "telephone_number": "504-842-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 JEFFERSON HIGHWAY",
            "address_2": "ACADEMIC CENTER, 1ST FLOOR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70121",
            "telephone_number": "504-842-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANUNCILLON",
        "first_name": "PATT CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.