Individual provider Active NPI

Martha E Stewart, MD

  • Dermatology Physician
  • Mandeville, LA
National Provider Identifier
1972535284
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
022941 Issued in LA
Practice address
4060 Lonesome Rd
Mandeville, LA 70448-7085
Phone
(985) 727-7701
Fax
(985) 727-7375
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 022941 LA Primary

Addresses

Primary practice location

4060 Lonesome Rd
Mandeville, LA 70448-7085

Mailing address

4060 Lonesome Rd
Mandeville, LA 70448-7085
Phone (985) 727-7701

Other identifiers 1

IdentifierTypeStateIssuer
1485951MedicaidLA

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
I20041001000019 LA Practitioner - Dermatology 5597734152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Tulane University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martha E Stewart MD LLCGroup PAC ID 3779552336, 2 clinicians

Practice addresses (Care Compare)

4060 Lonesome Rd
Mandeville, LA 70448-7085
Phone (985) 727-7701

Merit-based Incentive Payment System (MIPS)

Final score
99.18 of 100Reported as group
Quality
98.36
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions142
Skin biopsy97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022941LAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martha E Stewart MD LLC Dermatology CurrentSince Apr 1, 2002 Accepting new patients
Dermatology and Allergy Clinic of South Louisiana LTD Apmc Dermatology Past Accepting new patients
Abbeville General Hospital Past Accepting new patients

Locations

4060 Lonesome Rd
Mandeville, LA 70448
Phone (504) 483-3514

Interoperability endpoints

  • Direct secure messaging: mstewart1@marthastewart.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1972535284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 LONESOME RD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487085",
            "telephone_number": "985-727-7701",
            "fax_number": "985-727-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 LONESOME RD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487085",
            "telephone_number": "985-727-7701",
            "fax_number": "985-727-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MARTHA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "022941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1485951",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.