Individual provider Active NPI

Kristen Lebleu Losavio, MD

  • Dermatology Physician
  • Baton Rouge, LA
National Provider Identifier
1225203904
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD.205348 Issued in LA
Practice address
5326 Odonovan Dr
Baton Rouge, LA 70808-4691
Phone
(225) 769-7546
Fax
(225) 769-0471
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD.205348 LA Primary

Addresses

Primary practice location

5326 Odonovan Dr
Baton Rouge, LA 70808-4691

Mailing address

5326 Odonovan Dr
Baton Rouge, LA 70808-4691
Phone (225) 769-7546

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
I20121010000108 LA Practitioner - Dermatology 3870742778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Clinic a Professional Medical CorporationGroup PAC ID 6103856661, 13 clinicians

Practice addresses (Care Compare)

5326 Odonovan Dr
Baton Rouge, LA 70808-4691
Phone (225) 769-7546

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Quality
84.54
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions617
Skin biopsy61

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Clinic a Professional Medical Corporation Dermatology CurrentSince Sep 1, 2016 Accepting new patients
Louisiana Dermatology Associates, LLC Dermatology PastSince Sep 1, 2025 Accepting new patients

Locations

5326 Odonovan Dr
Baton Rouge, LA 70808
Phone (225) 768-2850

5000 Odonavan Blvd
Ste 315
Walker, LA 70785
Phone (225) 769-7546

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1225203904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5326 ODONOVAN DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084691",
            "telephone_number": "225-769-7546",
            "fax_number": "225-769-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5326 ODONOVAN DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084691",
            "telephone_number": "225-769-7546",
            "fax_number": "225-769-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOSAVIO",
        "first_name": "KRISTEN",
        "middle_name": "LEBLEU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "MD.205348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.