MG Desalvo MD&GM Gremillion Mdamc

Primary specialty

SpecialistTaxonomy code 174400000X

License

207Y00000X Issued in LA

Legal business name

MG DESALVO MD&GM GREMILLION MDAMC

Practice address

3645 Houma Blvd
Metairie, LA 70006-4229

Phone

(504) 885-4677

Fax

(504) 888-0549

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Cynthia M. Petta

Title

Office Manage

Phone

(504) 885-4677

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michael G. DeSalvo, MD, A Med. Corp Former legal business name

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael G Desalvo, MD

  • Otolaryngology Physician
  • Metairie, LA
  • NPI 1477504397
  Medicare reassignment Care Compare group NPD
• Alexis Renee Desalvo, PA

  • Physician Assistant
  • Metairie, LA
  • NPI 1699518555
  Medicare reassignment Care Compare group
• Grayson Matthew Gremillion

  • Student in an Organized Health Care Education/Training Program
  • New Orleans, LA
  • NPI 1962701854
  Medicare reassignment Care Compare group
• Madison Claire North, PA

  • Medical Physician Assistant
  • New Orleans, LA
  • NPI 1033720941
  Medicare reassignment Care Compare group
• Joseph J Creely Jr., MD

  • Otolaryngology Physician
  • Metairie, LA
  • NPI 1922044171
  Medicare reassignment NPD
• Gerald W Vocke, M.D.

  • Specialist
  • Metairie, LA
  • NPI 1871597633
  Medicare reassignment NPD

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609372800000",
    "number": "1972623049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700064229",
            "telephone_number": "504-885-4677",
            "fax_number": "504-888-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700064229",
            "telephone_number": "504-885-4677",
            "fax_number": "504-888-0549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MG DESALVO MD&GM GREMILLION MDAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A",
        "authorized_official_last_name": "PETTA",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGE",
        "authorized_official_telephone_number": "504-885-4677",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "207Y00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1149179",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael G. DeSalvo, MD, A Med. Corp",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Douglas Meyer
• Jennifer Lynne Meyer, M.D.
• Angelina Meyers
• William M Meyers Jr., M.D.
• McKala Meziere
• Mga Gastrointestinal Diagnostic & Therapeutic-Metairie (MGA Gastrointestinal Diagnostic and Therapeutic Center - Metairie)
• MHM Occupational Medicine, LLC
• MHM Urgent Care Slidell, LLC
• Jaime Michel, MD
• Kelly Michel, MD

• Specialist in Metairie, LA
• Providers in Metairie, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.