Gary Bernard Mazzanti, M.D.

Primary specialty

Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X

License

MD020779 Issued in LA

Practice address

701 Jordan St
Suite a
Shreveport, LA 71101-4660

Phone

(318) 221-6700

Fax

(318) 221-6701

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Undersea and Hyperbaric MedicineAlso: Family Practice

Education

University of Mississippi School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1174629299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 JORDAN ST",
            "address_2": "SUITE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014660",
            "telephone_number": "318-221-6700",
            "fax_number": "318-221-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 JORDAN ST",
            "address_2": "SUITE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014660",
            "telephone_number": "318-221-6700",
            "fax_number": "318-221-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZANTI",
        "first_name": "GARY",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "LA",
            "license": "MD020779",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD020779",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1399256",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Undersea and Hyperbaric Medicine (Emergency Medicine) Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Undersea and Hyperbaric Medicine (Emergency Medicine) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.