Individual provider Active NPI

Bryan Johannes Vekovius, M.D.

  • Specialist
  • Shreveport, LA
National Provider Identifier
1285674820
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
L023263 Issued in LA
Practice address
450 Ashley Ridge Blvd
Shreveport, LA 71106-7228
Phone
(318) 375-3733
Fax
(318) 675-3734
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuro-ophthalmology Physician 207WX0109X L023263 LA
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X L023263 LA
Specialist 174400000X L023263 LA Primary

Addresses

Primary practice location

450 Ashley Ridge Blvd
Shreveport, LA 71106-7228

Mailing address

450 Ashley Ridge Blvd
Shreveport, LA 71106-7228
Phone (318) 675-3733

Other identifiers 5

IdentifierTypeStateIssuer
154644202OtherTXTEXAS MEDICAID
170085727OtherLAGROUP NPI #
0238TUOtherTXBLUE CROSS BLUE SHIELD
1495867MedicaidLA
180044593OtherLARAILROAD MEDICARE

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
I20101208000707 LA Practitioner - Ophthalmology 7618930256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in Shreveport, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

450 Ashley Ridge Blvd
Shreveport, LA 71106-7228
Phone (318) 675-3733

450 Ashley Ridge Boulevard
Shreveport, LA 71106-7228

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10
Melanoma (skin cancer) excision26
Removal of skin lesions1-10
Removal or shaving of skin growth29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L023263LAMDNeuro-ophthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Vekovius M.D. LLC Ophthalmology CurrentSince Jul 1, 2002 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Ophthalmology CurrentSince Mar 21, 2018 Accepting new patients
Laser & Cataract Center of Shreveport LLC PastSince Aug 1, 2007 Accepting new patients

Locations

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

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

450 Ashley Ridge Blvd
Shreveport, LA 71106
Phone (318) 375-3733

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

1420 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0717

Interoperability endpoints

  • Direct secure messaging: bryanvekovius@drvekovius.direct.eyemdemr.com

Organizations & group practices 3

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1285674820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 ASHLEY RIDGE BLVD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067228",
            "telephone_number": "318-675-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 ASHLEY RIDGE BLVD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067228",
            "telephone_number": "318-375-3733",
            "fax_number": "318-675-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEKOVIUS",
        "first_name": "BRYAN",
        "middle_name": "JOHANNES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0109X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": "LA",
            "license": "L023263",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "LA",
            "license": "L023263",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "L023263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAID",
            "identifier": "154644202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI #",
            "identifier": "170085727",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0238TU",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1495867",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180044593",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.