Individual provider Active NPI

Peter H. Seidenberg, MD

  • Sports Medicine (Family Medicine) Physician
  • Shreveport, LA
National Provider Identifier
1114960432
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
322503 Issued in LA
Practice address
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 626-0000
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 322503 LA
Sports Medicine (Family Medicine) Physician 207QS0010X 322503 LA Primary

Addresses

Primary practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1512 W Kirby PL
Shreveport, LA 71103-3822
Phone (318) 626-0287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070719000283 PA Practitioner - Family PracticePractitioner - Orthopedic SurgeryPractitioner - Sports Medicine 6103895271 Reassigns benefits to 1 organization
I20200610002825 LA Practitioner - Sports MedicinePractitioner - Family Practice 6103895271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Pennsylvania State University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000

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
  • Ochsner Lsu Health Monroe Hospital, Monroe, LA, CCN 190011

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Family Medicine CurrentSince May 21, 2020 Accepting new patients
King Medical Care, Inc. CurrentSince Jul 2, 2007 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Jul 14, 2012 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Sports Medicine CurrentSince Jul 14, 2012 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

4481 Viking Dr
Bossier City, LA 71111
Phone (318) 626-2593

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

950 Olive St
Shreveport, LA 71104
Phone (318) 221-1581

1023 Provenance Pl
Ste 130
Shreveport, LA 71106
Phone (318) 626-0100

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

6670 Saint Vincent Ave
Shreveport, LA 71106
Phone (318) 626-0500

3151 Columbia Blvd
Ste 100
Bloomsburg, PA 17815
Phone (570) 784-0500

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

3100 Schoolhouse Rd
Middletown, PA 17057
Phone (717) 948-5180

1850 E Park Ave
State College, PA 16803
Phone (814) 234-6750

143 Hospital Dr
Ste 112
State College, PA 16803
Phone (814) 865-3566

Organizations & group practices 5

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 3

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1114960432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W KIRBY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033822",
            "telephone_number": "318-626-0287"
        },
        {
            "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": "SEIDENBERG",
        "first_name": "PETER",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "322503",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "LA",
            "license": "322503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.