Individual provider Active NPI

Beau Hezwell Kalan, MD

  • General Practice Physician
  • New Orleans, LA
National Provider Identifier
1265964928
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
85967 Issued in SC
Practice address
1415 Tulane Ave
New Orleans, LA 70112-2600
Phone
(504) 988-5263
NPI assigned
Mar 31, 2017
Last updated
Jan 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 85967 SC
Student in an Organized Health Care Education/Training Program 390200000X LA
General Practice Physician 208D00000X 85967 SC Primary

Addresses

Primary practice location

1415 Tulane Ave
New Orleans, LA 70112-2600

Mailing address

14 Lockwood Dr Apt 5B
Charleston, SC 29401-1131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85967SCMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1265964928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LOCKWOOD DR APT 5B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 TULANE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122600",
            "telephone_number": "504-988-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALAN",
        "first_name": "BEAU",
        "middle_name": "HEZWELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-31",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "85967",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "SC",
            "license": "85967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.