Individual provider Active NPI

Braden Wenter McIntosh, MD

  • Emergency Medicine Physician
  • Baton Rouge, LA
National Provider Identifier
1427477173
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
305506 Issued in LA
Practice address
8300 Constantin Blvd
Baton Rouge, LA 70809-3489
Phone
(225) 374-1410
Fax
(225) 374-1616
NPI assigned
Apr 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 305506 LA Primary

Addresses

Primary practice location

8300 Constantin Blvd
Baton Rouge, LA 70809-3489

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0011

Other practice location 1

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-7163

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bmcintosh82204@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

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
I20170706000291 LA Practitioner - Emergency Medicine 0042589178 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Emergency Physician Associates, LLCGroup PAC ID 1759317092, 78 clinicians

Practice addresses (Care Compare)

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 765-8826

Hospital & facility affiliations

  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

Merit-based Incentive Payment System (MIPS)

Final score
88.35 of 100Reported as group
Quality
80.15
Promoting interoperability
100
Improvement activities
40
Cost
76.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
305506LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Emergency Physician Associates, LLC Emergency Medicine CurrentSince May 27, 2017 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Jan 13, 2020 Accepting new patients
Professional Emergency Medicine Management -- Lake Charles LLC Emergency Medicine CurrentSince Mar 15, 2018 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Jan 13, 2020 Accepting new patients

Locations

Dept AT952639
Atlanta, GA 31192

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

8300 Constantin Blvd
Baton Rouge, LA 70809
Phone (225) 374-1410

5000 Hennessy Blvd
Ste B
Baton Rouge, LA 70808

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

5439 Airline Hwy
Baton Rouge, LA 70805
Phone (225) 358-2280

8415 Goodwood Blvd
Ste 105
Baton Rouge, LA 70806
Phone (225) 765-4226

8300 Constantin Blvd
#3
Baton Rouge, LA 70809

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

5000 Odonavan Blvd
Walker, LA 70785
Phone (225) 214-4200

Interoperability endpoints

  • Direct secure messaging: bmcintosh82204@direct.casso.us.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 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": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1427477173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0011",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CONSTANTIN BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093489",
            "telephone_number": "225-374-1410",
            "fax_number": "225-374-1616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Hennessy Blvd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "70808",
            "country_code": "US",
            "telephone_number": "225-765-7163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "BRADEN",
        "middle_name": "WENTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "305506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bmcintosh82204@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bmcintosh82204@direct.casso.us.com",
            "address_1": "8300 Constantin Blvd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093489",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8300 Constantin Blvd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.