Mario H Lobao Goncalves, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

328121 Issued in LA

Practice address

1541 Kings Hwy
Shreveport, LA 71103-4228

Phone

(318) 626-0000

NPI assigned

Oct 10, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Dr. Mario H Lobao Professional name

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

Specialty

Sports MedicineAlso: Orthopedic Surgery

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lsu Health Sciences Center Shreveport Faculty Group PracticeGroup PAC ID 4082902721, 567 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Lsu Health Shreveport-St Mary Medical Cent Hospital, Shreveport, LA, CCN 190317
• Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098
• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
• Ochsner Lsu Health Monroe Hospital, Monroe, LA, CCN 190011
• Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Brfhh Shreveport LLC

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1912909912
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brfhh Monroe LLC

  • General Acute Care Hospital
  • Monroe, LA
  • NPI 1215939210
  Care Compare affiliation
• Christus Health Northern Louisiana

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1417950106
  Care Compare affiliation
• Ochsner Lsu Health Shreveport - St. Mary Medical Center, LLC

  • Women's Hospital
  • Shreveport, LA
  • NPI 1285253252
  Care Compare affiliation
• University Health Shreveport LLC

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1427536325
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1063922573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "address_2": "ATTN: PAYOR CREDENTIALING",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOBAO GONCALVES",
        "first_name": "MARIO",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-10",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "LA",
            "license": "328121",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "328121",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "LA",
            "license": "328121",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "LA",
            "license": "328121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIO",
            "last_name": "LOBAO",
            "middle_name": "H",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Kasi Lively
• William James Livigni, LMFT
• Charles Marion Lobrano III, MD
• Michael Todd Lobrano, PH.D.
• Edward Locascio, MD
• Judy Lynn Locati, M.D.
• Marcia Rose Locke Thompson, RN

• Sports Medicine (Orthopaedic Surgery) Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.