Individual provider Active NPI

Kevin J Callerame, MD

  • Neurology Physician
  • Baton Rouge, LA
National Provider Identifier
1245229459
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
020960 Issued in LA
Practice address
5427 Didesse Drive
Baton Rouge, LA 70808
Phone
(225) 215-2193
Fax
(225) 215-2194
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 020960 LA Primary

Addresses

Primary practice location

5427 Didesse Drive
Baton Rouge, LA 70808

Mailing address

2051 Silverside Dr
Ste 260
Baton Rouge, LA 70808-9005
Phone (225) 490-6301

Other identifiers 1

IdentifierTypeStateIssuer
1114359MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kcallerame12046@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epihosted.com/FHIRPoxy/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
I20100511000123 LA Practitioner - Neurology 3870557952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Tulane University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 953-7800

5247 Didesse Dr
Baton Rouge, LA 70808-9153
Phone (225) 765-2273

7777 Hennessy Blvd
Baton Rouge, LA 70808-4363

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Feb 23, 2015 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Feb 23, 2015 Accepting new patients
Radiology Associates LLC Past Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients
Our Lady of the Lake Inc Past Accepting new patients

Locations

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

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

2051 Silverside Dr
Ste 260
Baton Rouge, LA 70808
Phone (225) 490-6301

5247 Didesse Dr
Baton Rouge, LA 70808
Phone (225) 765-2273

Interoperability endpoints

  • Direct secure messaging: kcallerame12046@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 2

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1245229459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 SILVERSIDE DR",
            "address_2": "STE 260",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089005",
            "telephone_number": "225-490-6301",
            "fax_number": "225-765-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5427 DIDESSE DRIVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70808",
            "telephone_number": "225-215-2193",
            "fax_number": "225-215-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLERAME",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "020960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114359",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcallerame12046@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kcallerame12046@direct.casso.us.com",
            "address_1": "5427 Didesse Drive",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epihosted.com/FHIRPoxy/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": "5427 Didesse Drive",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.