NPIMap

Individual provider Active NPI

Pavani Ellipeddi, M.D.

  • Medical Oncology Physician
  • Baton Rouge, LA
National Provider Identifier
1194905737
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
305195 Issued in LA
Practice address
7777 Hennessy Blvd Ste 6000
Baton Rouge, LA 70808-4366
Phone
(225) 757-0343
Fax
(225) 757-8354
NPI assigned
Nov 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 04-35740 KS
Hospitalist Physician 208M00000X 30365 AL
Medical Oncology Physician 207RX0202X 305195 LA Primary

Addresses

Primary practice location

7777 Hennessy Blvd Ste 6000
Baton Rouge, LA 70808-4366

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 757-0343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170518001844 LA Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Hematology 1850585480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7777 Hennessy Blvd
Suite 6000
Baton Rouge, LA 70808-4366
Phone (225) 757-0343

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-35740KSMDInternal Medicine Physician
30365ALMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Aug 1, 2024 Accepting new patients
Our Lady of the Lake Physician Group LLC Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
American Oncology Partners, P.a. Hematology Past Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients
Cadenza Health, P.C. Hospitalist PastSince Mar 26, 2023 Accepting new patients

Locations

500 Rue de la Vie St
Ste 430
Baton Rouge, LA 70817
Phone (225) 214-6700

7777 Hennessy Blvd
Ste 6000
Baton Rouge, LA 70808
Phone (225) 765-8648

5439 Airline Hwy
Baton Rouge, LA 70805
Phone (225) 358-2280

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

2647 S Saint Elizabeth Blvd
Ste 312
Gonzales, LA 70737

5000 Odonavan Blvd
Ste 404
Walker, LA 70785
Phone (225) 369-8100

Interoperability endpoints

  • Direct secure messaging: pellipeddi589335@direct.casso.us.com

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 8

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": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1194905737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-757-0343",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 6000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084366",
            "telephone_number": "225-757-0343",
            "fax_number": "225-757-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIPEDDI",
        "first_name": "PAVANI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-12",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-35740",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AL",
            "license": "30365",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "LA",
            "license": "305195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.