Individual provider Active NPI

Wilson B Baber, MD

  • Ophthalmology Physician
  • Shreveport, LA
National Provider Identifier
1386649788
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
021943 Issued in LA
Practice address
1455 E Bert Koun Loop Ste 207
Shreveport, LA 71105-5634
Phone
(318) 221-3403
Fax
(318) 221-6744
NPI assigned
Jun 14, 2005
Last updated
Feb 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 021943 LA Primary

Addresses

Primary practice location

1455 E Bert Koun Loop Ste 207
Shreveport, LA 71105-5634

Mailing address

PO Box 44309
Shreveport, LA 71134-4309
Phone (318) 221-3403

Other identifiers 1

IdentifierTypeStateIssuer
1681954MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060314000134 LA Practitioner - Ophthalmology 1052328267 Reassigns benefits to 1 organization
I20080729000580 TX Practitioner - Ophthalmology 1052328267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in Shreveport, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1455 E Bert Koun Loop
Suite 207
Shreveport, LA 71105-5634
Phone (318) 221-3403

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021943LAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson B. Baber MD LLC Ophthalmology CurrentSince Feb 15, 2003 Accepting new patients
Cherokee Emergency Medicine Associates PA Past Accepting new patients
Charles E Lyon, MD, Apmc Ophthalmology PastSince Jul 1, 1999 Accepting new patients

Locations

1455 E Bert Kouns Ind Loop
Ste 207
Shreveport, LA 71105
Phone (318) 221-3403

734 N Ashley Ridge Loop
Shreveport, LA 71106
Phone (318) 681-7911

2828 4th St
Ste 100
Longview, TX 75605
Phone (903) 248-2300

Interoperability endpoints

  • Direct secure messaging: wbaber875050@direct.ochsner.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1386649788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44309",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711344309",
            "telephone_number": "318-221-3403",
            "fax_number": "318-221-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E BERT KOUN LOOP STE 207",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055634",
            "telephone_number": "318-221-3403",
            "fax_number": "318-221-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABER",
        "first_name": "WILSON",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "021943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1681954",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.