Individual provider Active NPI

Teddy Carlo Alonso Arevalo Rodriguez, MD

  • Pulmonary Disease Physician
  • Shreveport, LA
National Provider Identifier
1295390169
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
347645 Issued in LA
Practice address
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 626-0000
NPI assigned
May 7, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 347645 LA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 347645 LA
Pulmonary Disease Physician 207RP1001X 347645 LA Primary

Addresses

Primary practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1541 Kings Hwy
Attn: Payor Credentialing
Shreveport, LA 71103-4228

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
I20250801000530 LA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 0244561504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098
  • Ochsner Lsu Health Monroe Hospital, Monroe, LA, CCN 190011
  • Ochsner Lsu Health Shreveport-St Mary Medical Cent Hospital, Shreveport, LA, CCN 190317

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Internal Medicine CurrentSince Aug 1, 2025 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

463 Ashley Ridge Blvd
Ste 100
Shreveport, LA 71106
Phone (318) 221-3585

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

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

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 3

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": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1295390169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "address_2": "ATTN: PAYOR CREDENTIALING",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AREVALO RODRIGUEZ",
        "first_name": "TEDDY",
        "middle_name": "CARLO ALONSO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-07",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "347645",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "LA",
            "license": "347645",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "LA",
            "license": "347645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.