Mario Kakazu, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD.05311R Issued in LA

Practice address

2552 Williams Blvd
Kenner, LA 70062-5538

Phone

(504) 463-3002

NPI assigned

Jan 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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 Service District No. 2

  • Critical Access Hospital
  • Breaux Bridge, LA
  • NPI 1548263262
  NPD (past)
• Nes Louisiana Inc

  • Emergency Medicine Physician
  • Franklinton, LA
  • NPI 1407161250
  NPD (past)

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1366421562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2490",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700732490",
            "telephone_number": "504-762-8909",
            "fax_number": "504-328-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 WILLIAMS BLVD",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700625538",
            "telephone_number": "504-463-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKAZU",
        "first_name": "MARIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "05311R",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "LA",
            "license": "MD.05311R",
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1317128",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "G6438",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Marie Jumonville, RD, LDN
• Brook Juneau
• K.E. Vogel, M.D., AMC
• Davidra Kaba, APRN, PMHNP-CNP
• Saba Ali Kagani, PHARMD
• Sanjay Kamboj, M.D.
• Bhindhyaa Kaur, MD
• Christal Keller, PHARMD
• Kelly Optometry, a Professional Corporation
• Dakeitha Kelly

• Physical Medicine & Rehabilitation Physician in Kenner, LA
• Providers in Kenner, LA by specialty
• Physical Medicine & Rehabilitation Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.