Individual provider Active NPI

Bader Alotaibi, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Shreveport, LA
National Provider Identifier
1003295791
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
337761 Issued in LA
Practice address
2727 Hearne Ave Ste 301
Shreveport, LA 71103-3918
Phone
(318) 631-6400
NPI assigned
May 27, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 337761 LA
Clinical Cardiac Electrophysiology Physician 207RC0001X 337761 LA Primary

Addresses

Primary practice location

2727 Hearne Ave Ste 301
Shreveport, LA 71103-3918

Mailing address

2727 Hearne Ave Ste 301
Shreveport, LA 71103-3918
Phone (318) 631-6400

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
I20231204003583 LA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4688063860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WKMC Cardiovascular ConsultantsGroup PAC ID 0941420061, 34 clinicians

Practice addresses (Care Compare)

2727 Hearne Ave
Suite 301
Shreveport, LA 71103-3918
Phone (318) 631-6400

Hospital & facility affiliations

  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
  • North Caddo Medical Center Hospital, Vivian, LA, CCN 191304

Merit-based Incentive Payment System (MIPS)

Final score
91.53 of 100Reported as apm
Quality
81.42
Promoting interoperability
94.6
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair37
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WKMC Cardiovascular Consultants Cardiovascular Disease CurrentSince Oct 1, 2023 Accepting new patients

Locations

102 S Monroe St
Minden, LA 71055
Phone (318) 377-3425

2727 Hearne Ave
Ste 301
Shreveport, LA 71103

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

Organizations & group practices 1

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 5

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": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1003295791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 HEARNE AVE STE 301",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033918",
            "telephone_number": "318-631-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 HEARNE AVE STE 301",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033918",
            "telephone_number": "318-631-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALOTAIBI",
        "first_name": "BADER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2023-10-23",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "337761",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "LA",
            "license": "337761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.