Individual provider Active NPI

Luke Minao Baudoin, M.D.

  • Family Medicine Physician
  • Shreveport, LA
National Provider Identifier
1275507568
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21573 Issued in LA
Practice address
1501 Kings Hwy
Dept of Family Medicine
Shreveport, LA 71103-4228
Phone
(318) 675-5815
Fax
(318) 675-7950
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21573 LA Primary

Addresses

Primary practice location

1501 Kings Hwy
Dept of Family Medicine
Shreveport, LA 71103-4228

Mailing address

1501 Kings Hwy
Dept of Family Medicine
Shreveport, LA 71103-4228
Phone (318) 675-5815

Other identifiers 2

IdentifierTypeStateIssuer
1672998MedicaidLA
24320OtherLALA CDS

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
I20040903000441 LA Practitioner - Family Practice 8820064520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21573LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Family Medicine CurrentSince Feb 25, 2017 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

4481 Viking Dr
Bossier City, LA 71111
Phone (318) 626-2593

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1023 Provenance Pl
Ste 130
Shreveport, LA 71106
Phone (318) 626-0100

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

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

6670 Saint Vincent Ave
Shreveport, LA 71106
Phone (318) 626-0500

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.

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1275507568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "DEPT OF FAMILY MEDICINE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5815",
            "fax_number": "318-675-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "DEPT OF FAMILY MEDICINE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5815",
            "fax_number": "318-675-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUDOIN",
        "first_name": "LUKE",
        "middle_name": "MINAO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "21573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1672998",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA CDS",
            "identifier": "24320",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.