Individual provider Active NPI

Sarah E. Glorioso, M.D.

  • Dermatology Physician
  • Bossier City, LA
National Provider Identifier
1093916140
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD.201108 Issued in LA
Practice address
2300 Hospital Dr.
Suite 400
Bossier City, LA 71111-2180
Phone
(318) 212-7800
Fax
(318) 212-7802
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD.201108 LA Primary

Addresses

Primary practice location

2300 Hospital Dr.
Suite 400
Bossier City, LA 71111-2180

Mailing address

2300 Hospital Dr.
Suite 400
Bossier City, LA 71111-2180
Phone (318) 212-7800

Other identifiers 1

IdentifierTypeStateIssuer
21683MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

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
I20090815000010 LA Practitioner - Dermatology 0345394086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Dermatology ClinicGroup PAC ID 5092814434, 4 clinicians

Practice addresses (Care Compare)

2300 Hospital Dr
Suite 400
Bossier City, LA 71111-2180
Phone (318) 212-7800

Hospital & facility affiliations

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
Melanoma (skin cancer) excision249
Removal of skin lesions3334
Removal or shaving of skin growth26
Skin biopsy604

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.201108LAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Dermatology Clinic Dermatology CurrentSince Jul 6, 2009 Accepting new patients

Locations

2300 Hospital Dr
Ste 400
Bossier City, LA 71111
Phone (318) 212-7800

1811 E Bert Kouns Industrial Loop
Ste 160
Shreveport, LA 71105
Phone (318) 212-3223

7941 Youree Dr
Shreveport, LA 71105
Phone (318) 797-7941

Interoperability endpoints

  • Direct secure messaging: sglorioso@direct.wkhs.com

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 4

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1093916140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR.",
            "address_2": "SUITE 400",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112180",
            "telephone_number": "318-212-7800",
            "fax_number": "318-212-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR.",
            "address_2": "SUITE 400",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112180",
            "telephone_number": "318-212-7800",
            "fax_number": "318-212-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLORIOSO",
        "first_name": "SARAH",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "MD.201108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21683",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

Verify at the official NPI Registry.