Individual provider Active NPI

Michael John Sampognaro, M.D.

  • Internal Medicine Physician
  • Monroe, LA
National Provider Identifier
1194752865
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
017752 Issued in LA
Practice address
1 Bancroft CR
Monroe, LA 71201-5101
Phone
(318) 966-8400
Fax
(318) 966-8401
NPI assigned
Jun 27, 2006
Last updated
Sep 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 017752 LA Primary

Addresses

Primary practice location

1 Bancroft CR
Monroe, LA 71201-5101

Mailing address

5959 S Sherwood Forest Blvd Ste 355
Baton Rouge, LA 70816-6038
Phone (318) 966-8400

Other practice location 1

309 Jackson St
Monroe, LA 71201-7407
Phone (318) 966-4000

Other identifiers 1

IdentifierTypeStateIssuer
1368946MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address msampognaro16429@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ 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
I20070802000311 LA Practitioner - Internal Medicine 1951492180 Reassigns benefits to 4 organizations
Practice locations: Monroe, LA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monroe Surgical Hospital, LLCGroup PAC ID 5294725297, 6 clinicians
St Francis Medical Group LLCGroup PAC ID 5092970624, 176 clinicians

Practice addresses (Care Compare)

2408 Broadmoor Blvd
Monroe, LA 71201-2963

2408 Broadmoor Blvd
Monroe, LA 71201-2994
Phone (318) 410-0002

309 Jackson St
Monroe, LA 71201-7407
Phone (318) 966-4541

312 Grammont St
Monroe, LA 71201-7403

517 Catalpa St
Monroe, LA 71201-7426
Phone (318) 966-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.3 of 100Reported as group
Quality
78.23
Promoting interoperability
100
Improvement activities
40
Cost
69.42

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as apm
Quality
60.04
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017752LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Health Group, LLC CurrentSince Jul 1, 2014 Accepting new patients
St Francis Medical Group LLC Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Monroe Surgical Hospital, LLC CurrentSince Jun 5, 2002 Accepting new patients
St Francis Medical Center, Inc CurrentSince Jan 1, 1994 Accepting new patients
St. Francis Medical Center, Inc. CurrentSince Jan 1, 1994 Accepting new patients
Affinity Health Group, LLC CurrentSince Jul 1, 2014 Accepting new patients
Monroe Surgical Hospital, LLC CurrentSince Jun 5, 2002 Accepting new patients
St Francis Medical Center, Inc Past Accepting new patients
St Francis Specialty Hospital,Inc Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

5959 S Sherwood Forest Blvd
Ste 355
Baton Rouge, LA 70816

1 Bancroft Cir
Monroe, LA 71201
Phone (318) 361-0995

130 Desiard St
Ste 355
Monroe, LA 71201
Phone (318) 807-7875

2408 Broadmoor Blvd
Monroe, LA 71201
Phone (318) 410-0002

2408 Broadmoor Blvd
Ste 2
Monroe, LA 71201
Phone (318) 807-0525

309 Jackson St
Monroe, LA 71201
Phone (318) 966-4000

3421 Medical Park Dr
Monroe, LA 71203
Phone (318) 327-4686

517 Catalpa St
Monroe, LA 71201
Phone (318) 966-6500

920 Oliver Rd
Ste B
Monroe, LA 71201
Phone (318) 327-6201

Interoperability endpoints

  • Direct secure messaging: msampognaro16429@direct.casso.us.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1194752865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD STE 355",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "318-966-8400",
            "fax_number": "225-765-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BANCROFT CR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015101",
            "telephone_number": "318-966-8400",
            "fax_number": "318-966-8401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712017407",
            "country_code": "US",
            "telephone_number": "318-966-4000",
            "fax_number": "318-966-7359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPOGNARO",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "017752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1368946",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msampognaro16429@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "msampognaro16429@direct.casso.us.com",
            "address_1": "309 Jackson St",
            "city": "Monroe",
            "state": "LA",
            "country_code": "US",
            "postal_code": "712017407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "309 Jackson St",
            "city": "Monroe",
            "state": "LA",
            "country_code": "US",
            "postal_code": "712017407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.