Individual provider Active NPI

Matthew Scott Menard, MD

  • Psychiatry Physician
  • Shreveport, LA
National Provider Identifier
1407148992
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
311908 Issued in LA
Practice address
1501 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 675-5053
NPI assigned
May 3, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 311908 LA Primary

Addresses

Primary practice location

1501 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5053

Other identifiers 1

IdentifierTypeStateIssuer
311908OtherLALSBME

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
I20190703000927 LA Practitioner - Psychiatry 9032403753 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Louisiana State University School of Medicine in Shreveport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Center for Psychiatric SupportGroup PAC ID 6406972645, 8 clinicians
Volunteers of America of North LouisianaGroup PAC ID 4486958071, 2 clinicians

Practice addresses (Care Compare)

1111 Line Ave
Shreveport, LA 71101-3841
Phone (318) 716-4610

2920 Knight St
Suite 155
Shreveport, LA 71105-2412
Phone (318) 429-6938

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311908LAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Center for Psychiatric Support Psychiatry CurrentSince Aug 5, 2020 Accepting new patients
Volunteers of America of North Louisiana CurrentSince Apr 20, 2023 Accepting new patients
Willis Knighton Medical Center, Inc. Past Accepting new patients
Willis Knighton Medical Center, Inc. Past Accepting new patients

Locations

2920 Knight St
Ste 155
Shreveport, LA 71105
Phone (318) 213-1804

1111 Line Ave
Fl 3
Shreveport, LA 71101
Phone (318) 212-8424

2920 Knight St
Bldg 1
Shreveport, LA 71105
Phone (318) 213-1871

354 Jordan St
Shreveport, LA 71101

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

1111 Line Ave
#3
Shreveport, LA 71101

Interoperability endpoints

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

Organizations & group practices 4

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 4

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": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1407148992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENARD",
        "first_name": "MATTHEW",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-03",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "311908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LSBME",
            "identifier": "311908",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.