NPIMap

Individual provider Active NPI

Peyman Roohani, MD

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1285632745
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.131353R Issued in LA
Practice address
1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone
(318) 773-4903
Fax
(318) 747-9994
NPI assigned
Jul 8, 2005
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13153R LA
Internal Medicine Physician 207R00000X MD.131353R LA Primary

Addresses

Primary practice location

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800

Mailing address

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone (318) 773-4903

Other identifiers 1

IdentifierTypeStateIssuer
1559997MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050713000041 LA Practitioner - Internal Medicine 8325074172 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Louisiana Physicians LLCGroup PAC ID 2365885944, 44 clinicians

Practice addresses (Care Compare)

2531 Viking Dr
Bossier City, LA 71111-2103
Phone (318) 681-7000

9111 Linwood Ave
Shreveport, LA 71106-6509
Phone (318) 688-0961

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13153RLAMDInternal Medicine Physician
MD.131353RLAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Louisiana Physicians, LLC Internal Medicine CurrentSince Feb 1, 2024 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Integrity Health Provider Internal Medicine CurrentSince Oct 2, 2023 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Oct 15, 2022 Accepting new patients
Garden Park Nursing & Rehabilitation Center, LLC Past Accepting new patients
Lifecare Hospitals LLC Past Accepting new patients
Internal Medical Associates of Doctors Hospital Internal Medicine Past Accepting new patients

Locations

2531 Viking Dr
Bossier City, LA 71111
Phone (318) 681-7000

4200 Nelson Rd
Lake Charles, LA 70605
Phone (318) 474-6370

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

2000 Canal St
#C
New Orleans, LA 70112

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

9111 Linwood Ave
Shreveport, LA 71106
Phone (318) 688-0961

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1285632745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711056800",
            "telephone_number": "318-773-4903",
            "fax_number": "318-747-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711056800",
            "telephone_number": "318-773-4903",
            "fax_number": "318-747-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOHANI",
        "first_name": "PEYMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "13153R",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.131353R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1559997",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.