Individual provider Active NPI

Michael Gerard D'Antonio, M.D.

  • Diagnostic Radiology Physician
  • Marrero, LA
National Provider Identifier
1992754097
Registry record updated Jan 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
020573 Issued in LA
Practice address
1111 Medical Center Blvd
Ste. N-108
Marrero, LA 70072-3151
Phone
(504) 349-1461
Fax
(504) 349-1461
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 020573 LA Primary

Addresses

Primary practice location

1111 Medical Center Blvd
Ste. N-108
Marrero, LA 70072-3151

Mailing address

PO Box 1339
Marrero, LA 70073-1339
Phone (504) 349-1461

Other identifiers 2

IdentifierTypeStateIssuer
05054550MedicaidMS
1681521MedicaidLA

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
I20060323000566 LA Practitioner - Diagnostic Radiology 9133137763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Louisiana State University School of Medicine in New Orleans, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson Radiology Associates, Inc.Group PAC ID 0143289363, 14 clinicians

Practice addresses (Care Compare)

1101 Medical Ctr Blvd
Marrero, LA 70072-3191
Phone (504) 349-1461

Hospital & facility affiliations

  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176
  • West Jefferson Medical Center Hospital, Marrero, LA, CCN 190039
  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
  • New Orleans East Hospital Hospital, New Orleans, LA, CCN 190313

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020573LAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WJH Physician Services CurrentSince Mar 1, 2021 Accepting new patients
West Jefferson MRI, LLC CurrentSince Apr 3, 2006 Accepting new patients
West Jefferson MRI, LLC CurrentSince Apr 3, 2006 Accepting new patients
Jefferson Radiology Associates, Inc Diagnostic Radiology CurrentSince Apr 3, 2006 Accepting new patients

Locations

4513 Westbank Expy
Marrero, LA 70072
Phone (504) 349-6360

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

4525 Westbank Expy
Ste B
Marrero, LA 70072
Phone (504) 349-6570

1111 Medical Center Blvd
Ste N108
Marrero, LA 70072
Phone (504) 349-1461

1111 Medical Center Blvd
Ste S250
Marrero, LA 70072
Phone (504) 347-5511

1111 Medical Center Blvd
Ste N110
Marrero, LA 70072
Phone (504) 349-6191

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

2121 Ridgelake Dr
Metairie, LA 70001
Phone (504) 349-1461

5620 Read Blvd
New Orleans, LA 70127
Phone (504) 241-2664

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 8

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295222400000",
    "number": "1992754097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1339",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700731339",
            "telephone_number": "504-349-1461",
            "fax_number": "504-349-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "STE. N-108",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-1461",
            "fax_number": "504-349-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANTONIO",
        "first_name": "MICHAEL",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2011-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "020573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05054550",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1681521",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.