MEDICARE: CHILDREN'S HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician
3	2080C0008X	Child Abuse Pediatrics Physician
4	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician
5	207ZP0213X	Pediatric Pathology Physician
6	2080P0208X	Pediatric Infectious Diseases Physician
7	2085N0700X	Neuroradiology Physician
8	2085P0229X	Pediatric Radiology Physician
9	2085R0202X	Diagnostic Radiology Physician
10	225100000X	Physical Therapist
11	207P00000X	Emergency Medicine Physician
12	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician
13	207RA0000X	Adolescent Medicine (Internal Medicine) Physician
14	207ZC0006X	Clinical Pathology Physician
15	174400000X	Specialist	256	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043230873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S HOSPITAL

Provider Business Mailing Address
First Line	:	200 HNEY CLAY AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118
Country	:	US
Telephone Number	:	504-896-9511
Fax Number	:	504-896-2772

Provider Business Practice Location Address
First Line	:	200 HENRY CLAY AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-5720
Country	:	US
Telephone Number	:	504-896-9511
Fax Number	:	504-896-2772

Authorized Official
Title or Position	:	CFO
Name	:	LUCIO FRAGOUSO
Credential	:
Telephone Number	:	504-899-9511

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	03/06/2025

Similar Medicare Providers

1821090713 — CHILDRENS HOSPITAL MEDICAL PRACTICE CORPORATION
Practice Location Address:

298 HENRY CLAY AVE
NEW ORLEANS, LA
70118-5720

Practice Phone: 504-896-9827
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1073505632 — THOMAS H CARSON M.D.
Practice Location Address:

200 HENRY CLAY AVE , CHILDREN'S HOSPITAL- DEPARTMENT OF PATHOLOGY
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70118-5720

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1104819366 — CHILDREN'S HOSPITAL
Practice Location Address:

200 HENRY CLAY AVE
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70118-5720

Practice Phone: 504-896-9511
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1316930365 — NEHA H MEHTA M.D.
Practice Location Address:

200 HENRY CLAY AVE , CARE CENTER
NEW ORLEANS, LA
70118-5720

Practice Phone: 504-896-9237
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1669467809 — FRANK JUDE BISSANT MD
Practice Location Address:

200 HENRY CLAY AVE
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70118-5720

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1801885892 — DR. LERON JEREMY FINGER MD
Practice Location Address:

200 HENRY CLAY AVE
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70118-5720

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Practice Fax: 504-896-9707

1447224860 — DR. JAY K KOLLS MD
Practice Location Address:

200 HENRY CLAY AVE
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70118-5720

Practice Phone: 504-988-0456
Practice Fax:

Directions to “CHILDREN'S HOSPITAL ” Practice Location

Language	Start Address	Practice Location

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