Organization Active NPI

B&L Medical Services LLC

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1225579402
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
B&L MEDICAL SERVICES LLC
Practice address
1800 Irving PL
Shreveport, LA 71101-4608
Phone
(318) 425-4096
NPI assigned
Mar 20, 2017
Last updated
Mar 22, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Authorized official

Name
Brian Andrew Monaco, MDNPI 1578908851
Title
Member Manager
Phone
(631) 495-5683

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1800 Irving PL
Shreveport, LA 71101-4608

Mailing address

PO Box 64568
Phoenix, AZ 85082-4568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170501000573 LA Part B Supplier - Clinic/Group Practice 8527345545 Receives reassigned benefits from 1 practitioner
Practice locations: Shreveport, LA; Bossier City, LA

National Provider Directory

National Provider Directory

Locations

1500 Line Ave
Ste 206
Shreveport, LA 71101
Phone (318) 213-3800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1225579402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64568",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850824568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 IRVING PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014608",
            "telephone_number": "318-425-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B&L MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "MONACO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "631-495-5683",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.