MONIQUE KERRY-JO FAGAN MD
NPI 1679258156
Student in an Organized Health Care Education/Training Program in New Orleans, LA

Q: What is Monique Fagan's NPI number?

The NPI number for Monique Fagan is 1679258156. It was assigned to this individual provider in the NPPES registry on June 21, 2023.

Q: What is Monique Fagan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Monique Fagan was last updated on June 21, 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.

Active since June 21, 2023PECOS Enrolled

1430 TULANE AVE # 8050, NEW ORLEANS, LA 70112(504) 988-7809(504) 988-3971 Get Directions Write a Review

NPPES record last updated: June 21, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Monique Kerry-jo Fagan Md NPPES

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

MONIQUE KERRY-JO FAGAN MD (NPI 1679258156) is an individual student in an organized health care education/training program in New Orleans, Louisiana, licensed in Louisiana (337293) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679258156

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameMONIQUE KERRY-JO FAGANCredential: MD

Location Address1430 TULANE AVE # 8050New Orleans, LA 70112-2632

Mailing Address1430 Tulane Ave # 8050New Orleans, LA 70112-2632 · (504) 988-7809 · Fax (504) 988-3971

Phone(504) 988-7809

Fax(504) 988-3971

Sole ProprietorYes

Enumeration DateJune 21, 2023

NPPES CertifiedJune 21, 2023

✔ NPI 1679258156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in LA · 337293

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1430 TULANE AVE # 8050, New Orleans, LA 70112

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Monique Kerry-jo Fagan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

DR. VISHNUPRIYA KUCHANA MD

Student in an Organized Health Care Education/Training Program