Organization Active NPI

Munoz Consulting LLC

  • Internal Medicine Physician
  • Bossier City, LA
National Provider Identifier
1164035770
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MUNOZ CONSULTING LLC
Practice address
4900 Medical Dr
Bossier City, LA 71112-4521
Phone
(318) 747-9500
NPI assigned
Aug 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Authorized official

Name
Derek Munoz, MDNPI 1063876068
Title
Member Manager
Phone
(409) 728-6583

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4900 Medical Dr
Bossier City, LA 71112-4521

Mailing address

200 N Bryant Ave Ste 10
Edmond, OK 73034-6273
Phone (318) 424-5449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201204000142 LA Part B Supplier - Clinic/Group Practice 0446661961 Receives reassigned benefits from 1 practitioner
Practice locations: Bossier City, LA; Shreveport, LA

National Provider Directory

National Provider Directory

Locations

1111 Line Ave
Ste 350
Shreveport, LA 71101

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1164035770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N BRYANT AVE STE 10",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346273",
            "telephone_number": "318-424-5449",
            "fax_number": "855-230-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MEDICAL DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711124521",
            "telephone_number": "318-747-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNOZ CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-25",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "409-728-6583",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.