Dominique J. Beaudry, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

312596 Issued in LA

Practice address

1541 Kings Hwy
Shreveport, LA 71103-4228

Phone

(318) 626-0000

NPI assigned

Nov 8, 2007

Last updated

Aug 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX, LA2 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

Specialty

Internal MedicineAlso: Interventional Cardiology

Education

University of Texas Medical School at Houston, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lsu Health Sciences Center Shreveport Faculty Group PracticeGroup PAC ID 4082902721, 567 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Lsu Health Monroe Hospital, Monroe, LA, CCN 190011
• Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098
• Morehouse General Hospital Hospital, Bastrop, LA, CCN 190116
• Union General Hospital Hospital, Farmerville, LA, CCN 191301
• Reeves Memorial Medical Center Hospital, Bernice, LA, CCN 191326

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Brfhh Monroe LLC

  dba Ochsner LSU Health Monroe

  • Internal Medicine Physician
  • Monroe, LA
  • NPI 1811324882
  Medicare reassignment NPD
• Dominique J Beaudry MD PA

  • Interventional Cardiology Physician
  • Beaumont, TX
  • NPI 1467616201

  Cardiovascular Disease

  NPD (past) Authorized official
• Brfhh Monroe LLC

  dba University Health Conway

  • Psychiatric Hospital Unit
  • Monroe, LA
  • NPI 1255761151
  NPD
• Clinic for Cardiovascular Care

  dba Lone Star Heart and vascular center

  • Cardiovascular Disease Physician
  • Tomball, TX
  • NPI 1457462194
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brfhh Monroe LLC

  dba Ochsner LSU Health Monroe

  • General Acute Care Hospital
  • Monroe, LA
  • NPI 1215939210
  Care Compare affiliation
• Morehouse General Hospital

  • General Acute Care Hospital
  • Bastrop, LA
  • NPI 1003898313
  Care Compare affiliation
• Union General Hospital

  • Critical Access Hospital
  • Farmerville, LA
  • NPI 1881678704
  Care Compare affiliation
• University Health Shreveport LLC

  dba Ochsner LSU Health Shreveport

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1427536325
  Care Compare affiliation
• Ward 3 4 & 10 Hospital Service District of Parish of Union

  dba Reeves Memorial Medical Center

  • Critical Access Hospital
  • Bernice, LA
  • NPI 1023018835
  Care Compare affiliation

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1437339223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W KIRBY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033822",
            "telephone_number": "318-626-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8300 Floyd Curl Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293931",
            "country_code": "US",
            "telephone_number": "210-450-4888",
            "fax_number": "210-450-6018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAUDRY",
        "first_name": "DOMINIQUE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "312596",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "312596",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "M9151",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "M9151",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "LA",
            "license": "312596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197375206",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197375201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197375205",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "197375207",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael J. Beal, MD
• Calvin Beaner Sr.
• Patrice A Beaner
• Carrie L. Bearden, MD
• Kenneth Elgin Beatty
• Kathryn Elizabeth Beauregard-Southerland, D.D.S.
• Beautifli, LLC.
• David Lee Beaver, MD
• Kelly Louise Beavers, APRN, FNP-C
• Becerra Wellness LLC

• Interventional Cardiology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Interventional Cardiology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.