Kevin Dibenedetto, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

017254 Issued in LA

Practice address

12525 Perkins Rd
Suite B
Baton Rouge, LA 70810-1907

Phone

(225) 819-8857

Fax

(225) 767-6822

NPI assigned

Jul 17, 2006

Last updated

Sep 15, 2021By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in LA, KS, GA3 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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdibenedetto8505@direct.casso.us.com

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.

• Convenient Care LLC

  dba Lake After Hours Perkins

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1164422630
  Medicare reassignment NPD
• Lake Charles Urgent Care

  • Urgent Care Clinic/Center
  • Lake Charles, LA
  • NPI 1306135892
  Medicare reassignment NPD
• Lake Urgent Care Ascension LLC

  dba Lake Urgent Care - Ascension

  • Urgent Care Clinic/Center
  • Prairieville, LA
  • NPI 1912243122
  Medicare reassignment NPD
• LCMC Urgent Care LLC

  • Urgent Care Clinic/Center
  • New Orleans, LA
  • NPI 1184162877
  Medicare reassignment NPD
• Lcuc Family Physicians Urgent Care LLC

  • Urgent Care Clinic/Center
  • Sulphur, LA
  • NPI 1932655784
  Medicare reassignment NPD
• Lourdes After Hours LLC

  • Urgent Care Clinic/Center
  • Lafayette, LA
  • NPI 1649297730
  Medicare reassignment NPD
• Total Urgent Care and Occupational Medicine

  • Urgent Care Clinic/Center
  • Cut Off, LA
  • NPI 1760871602
  Medicare reassignment NPD
• Uk St Francis Urgent Care

  • Urgent Care Clinic/Center
  • Topeka, KS
  • NPI 1457970782
  Medicare reassignment
• Convenient Care LLC

  dba Lake After Hours Hammond

  • Urgent Care Clinic/Center
  • Hammond, LA
  • NPI 1225119225
  NPD
• Convenient Care LLC

  dba Lake After Hours O'neal

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1821181801
  NPD
• Lake Urgent Care Ascension LLC

  • Urgent Care Clinic/Center
  • Saint Amant, LA
  • NPI 1487024618
  NPD
• Lourdes After Hours LLC

  • Urgent Care Clinic/Center
  • Carencro, LA
  • NPI 1669774923
  NPD

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1407874738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "SUITE 1004-154",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-214-9352",
            "fax_number": "225-214-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12525 PERKINS RD",
            "address_2": "SUITE B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101907",
            "telephone_number": "225-819-8857",
            "fax_number": "225-767-6822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "361 Commercial Dr",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314063659",
            "country_code": "US",
            "telephone_number": "912-355-6221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIBENEDETTO",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "017254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336408",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "930113224",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keriel Dial
• Micaela Diaz, LMSW
• Richie Rose Tulagan Diaz, MD
• Kristy Leigh Dibble, NP
• Kala D Dibenedetto, SLP
• Vincent Dicarlo II, DDS
• Juliette Dicharia
• Amanda Dick, M.A.CCC-SLP
• Eula B. Dickerson
• Evan Dickerson

• Family Medicine Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.