Individual provider Active NPI

Sanford Rory Katz, M.D.

  • Radiation Oncology Physician
  • Shreveport, LA
National Provider Identifier
1215943642
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
12437R Issued in LA
Practice address
2600 Kings Hwy
Shreveport, LA 71103-3950
Phone
(318) 212-4639
Fax
(318) 212-8305
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 12437R LA
Radiation Oncology Physician 2085R0001X 12437R LA Primary

Addresses

Primary practice location

2600 Kings Hwy
Shreveport, LA 71103-3950

Mailing address

PO Box 30015
Shreveport, LA 71130-0015
Phone (318) 212-4639

Other identifiers 1

IdentifierTypeStateIssuer
1429902MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ 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
I20040918000188 LA Practitioner - Radiation Oncology 8426023987 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Maryland School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Radiation Oncology ServicesGroup PAC ID 2365752409, 4 clinicians
Radiation Oncology Services ApmcGroup PAC ID 9436124997, 4 clinicians

Practice addresses (Care Compare)

2600 Kings Hwy
Shreveport, LA 71103-3950
Phone (318) 212-4639

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12437RLAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Radiation Oncology Services Radiation Oncology CurrentSince Oct 1, 2015 Accepting new patients
Radiation Oncology Services Apmc Radiation Oncology CurrentSince Apr 1, 2004 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

2600 Kings Hwy
Shreveport, LA 71103
Phone (318) 212-4639

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

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

Organizations & group practices 3

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 5

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1215943642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30015",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711300015",
            "telephone_number": "318-212-4639",
            "fax_number": "318-212-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033950",
            "telephone_number": "318-212-4639",
            "fax_number": "318-212-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "SANFORD",
        "middle_name": "RORY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "12437R",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "LA",
            "license": "12437R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1429902",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.