NPIMap

Individual provider Active NPI

Rade N. Pejic, M.D.

  • Family Medicine Physician
  • Metairie, LA
National Provider Identifier
1982683199
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15695R Issued in LA
Practice address
4228 Houma Blvd Ste 200
Metairie, LA 70006-3004
Phone
(504) 454-7878
Fax
(504) 883-3775
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A80689 CA
Family Medicine Physician 207Q00000X 15695R LA Primary

Addresses

Primary practice location

4228 Houma Blvd Ste 200
Metairie, LA 70006-3004

Mailing address

4200 Houma Blvd
Medical Staff Services
Metairie, LA 70006
Phone (504) 503-6781

Other identifiers 3

IdentifierTypeStateIssuer
15695ROtherLASTATE MEDICAL LICENSE
1464431MedicaidLA
A80689OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040910000013 LA Practitioner - Family Practice 9436125416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Administrators of the Tulane Educational FundGroup PAC ID 0446163760, 388 clinicians

Practice addresses (Care Compare)

200 Broadway St
Suite 230
New Orleans, LA 70118-3544
Phone (504) 988-9000

Hospital & facility affiliations

  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176
  • Touro Infirmary Hospital, New Orleans, LA, CCN 190046
  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
  • West Jefferson Medical Center Hospital, Marrero, LA, CCN 190039
  • University Medical Center New Orleans Hospital, New Orleans, LA, CCN 190005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A80689CAMDFamily Medicine Physician
15695RLAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metairie Physician Services Inc. Past Accepting new patients
Administrators of the Tulane Education Fund PastSince Jul 31, 2023 Accepting new patients
Nes Louisiana Inc Past Accepting new patients

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1982683199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70006",
            "telephone_number": "504-503-6781",
            "fax_number": "504-503-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 HOUMA BLVD STE 200",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700063004",
            "telephone_number": "504-454-7878",
            "fax_number": "504-883-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEJIC",
        "first_name": "RADE",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A80689",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "15695R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "15695R",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1464431",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A80689",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.