Gerardo Santos San Pedro, M.D.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

11657R Issued in LA

Practice address

2400 Hospital Dr Ste 340
Bossier City, LA 71111-2387

Phone

(318) 747-2277

Fax

(318) 747-2217

NPI assigned

Jul 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Critical Care (Intensivists)Also: Pulmonary Disease

Education

University of Arkansas College of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Bossier Pulmonary and Critical Care ClinicGroup PAC ID 3678673043, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gsanpedro@direct.wkhs.com

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.

• WK Bossier Pulmonary & Critical Care Clinic

  • Pulmonary Disease Physician
  • Bossier City, LA
  • NPI 1215149331

  Critical Care Medicine, LA

  Medicare reassignment Care Compare group NPD
• WKB Family Medicine Associates

  • Family Medicine Physician
  • Bossier City, LA
  • NPI 1972746097
  NPD (past)

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

• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579

  Hospital

  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691

  Hospital

  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539

  Hospital

  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1336166255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 HOSPITAL DR",
            "address_2": "STE 340",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112387",
            "telephone_number": "318-747-2277",
            "fax_number": "318-747-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HOSPITAL DR STE 340",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112387",
            "telephone_number": "318-747-2277",
            "fax_number": "318-747-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN PEDRO",
        "first_name": "GERARDO",
        "middle_name": "SANTOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "LA",
            "license": "11657R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1680877",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Safe Spaces Counseling and Wellness
• Lindsay Salter, M.S., CCC-SLP
• Sam'S East, Inc
• Mikayla Sampson
• Sams East Inc
• Marshall W Sanderlin, DPT
• Carl Sanders
• Jason David Sanders, CRNA
• Shekina Sanders
• Zack G Sanders, MD

• All providers in Bossier City, LA
• Critical Care Medicine (Internal Medicine) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.