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DR. SHANTRESE KENETRA DUPART DO
NPI 1609434430
Family Medicine in New Orleans, LA

Active since June 05, 2019PECOS Enrolled
4710 S CARROLLTON AVE, NEW ORLEANS, LA 70119(504) 454-9020(504) 454-9031 Get Directions Write a Review

NPPES record last updated: August 31, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 31, 2023, Jun 5, 2019 (2 updates tracked since 2019).

About Dr. Shantrese Kenetra Dupart Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANTRESE KENETRA DUPART DO (NPI 1609434430) is an individual family medicine provider in New Orleans, Louisiana, licensed in Louisiana (338610) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS and is a graduate of Edward Via Col Of Osteo Medicine-virginia Campus (2019).

NPPES Registry Identity

NPI1609434430
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SHANTRESE KENETRA DUPARTCredential: DO
Location Address4710 S CARROLLTON AVENew Orleans, LA 70119-6027
Mailing Address4710 S Carrollton AveNew Orleans, LA 70119-6027 · (504) 454-9020 · Fax (504) 454-9031
Phone(504) 454-9020
Fax(504) 454-9031
Sole ProprietorNo
Medical School CMSEdward Via Col Of Osteo Medicine-virginia CampusGraduated 2019
Enumeration DateJune 5, 2019
Last NPPES UpdateAugust 31, 20232 updates tracked since enumeration
NPPES CertifiedAugust 31, 2023
✔ NPI 1609434430 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in LA · 338610
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4710 S CARROLLTON AVE, New Orleans, LA 70119
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shantrese Kenetra Dupart Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID749519312
PECOS Enrollment IDI20230915002616
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shantrese Dupart reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pmr La Holding, LLC
665 mi
Specialist
1395 NW 167TH ST
Miami Gardens, FL 33169
  • Reassigned Medicare billing, Louisiana enrollment
  • 33 clinicians in this Medicare group
NPI 1700333689 (305) 628-6117

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70119 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.76 typical visit price
range $55.50 – $170.30
Typical copayment $21.69 (range $13.87 – $42.57)
Most-billed visit code 99203
Established Patient
$98.35 typical visit price
range $17.42 – $138.03
Typical copayment $24.58 (range $4.35 – $34.50)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL S GREENBERG
Internal Medicine
4710 S CARROLLTON AVE
NEW ORLEANS, LA 70119
Orleans Parish (504) 454-9020
ABIGALE HEATHER DAWN KAVANAGH MD
Family Medicine
4710 S CARROLLTON AVE
NEW ORLEANS, LA 70119
Orleans Parish (504) 454-9020
AHSAKI GEORGE-SCHARPON FNP
Nurse Practitioner (Family)
4710 S CARROLLTON AVE
NEW ORLEANS, LA 70119
Orleans Parish (504) 454-9020
JAIRO LUIS TEJADA M.D
Internal Medicine
4710 S CARROLLTON AVE
NEW ORLEANS, LA 70119
Orleans Parish (504) 454-9020
KIRK LEE BONNER MD
Family Medicine
4710 S CARROLLTON AVE
NEW ORLEANS, LA 70119
Orleans Parish (504) 454-9020
DR. RENATA E MCGHEE DNP, FNP-C
Nurse Practitioner (Family)
4710 S CARROLLTON AVE
NEW ORLEANS, LA 70119
Orleans Parish (504) 454-9020
JOHN VINCENT MARTINO MD
Internal Medicine
4710 S CARROLLTON AVE
NEW ORLEANS, LA 70119
Orleans Parish (504) 454-9020
DR. ANDREW MORRIS M.D.
Family Medicine
4710 S CARROLLTON AVE
NEW ORLEANS, LA 70119
Orleans Parish (504) 454-9020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shantrese Dupart's NPI number?

The NPI number for Shantrese Dupart is 1609434430. It was assigned to this individual provider in the NPPES registry on June 5, 2019.

Where is Shantrese Dupart located?

Shantrese Dupart practices at 4710 S Carrollton Ave, New Orleans, LA 70119. The listed phone number is (504) 454-9020.

What is Shantrese Dupart's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shantrese Dupart enrolled in Medicare?

Yes. Shantrese Dupart is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shantrese Dupart's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shantrese Dupart reassigns Medicare benefits to Pmr La Holding, LLC (Miami Gardens, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shantrese Dupart's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shantrese Dupart was last updated on August 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.