Individual provider Active NPI

Richard M O'Donovan, M.D.

  • Nephrology Physician
  • Monroe, LA
National Provider Identifier
1467422949
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
08579R Issued in LA
Practice address
711 Wood St
Ste a
Monroe, LA 71201-7549
Phone
(318) 323-8847
Fax
(318) 327-3410
NPI assigned
Jan 25, 2006
Last updated
Dec 3, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 08579R LA Primary

Addresses

Primary practice location

711 Wood St
Ste a
Monroe, LA 71201-7549

Mailing address

711 Wood St
Ste a
Monroe, LA 71201-7549
Phone (318) 323-8847

Other identifiers 1

IdentifierTypeStateIssuer
1907090MedicaidLA

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
I20100120000184 LA Practitioner - Nephrology 6709839202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Louisiana Kidney Specialists,LLCGroup PAC ID 5799748182, 8 clinicians

Practice addresses (Care Compare)

711 Wood St
Suite a
Monroe, LA 71201-7549

711 Wood St a
Monroe, LA 71201-7549
Phone (318) 323-8847

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.26 of 100Reported as individual
Quality
64.78
Improvement activities
40
Cost
51.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
08579RLAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Louisiana Kidney Specialists,LLC Nephrology CurrentSince Sep 1, 1998 Accepting new patients

Locations

711 Wood St
Ste A
Monroe, LA 71201
Phone (318) 323-8847

Interoperability endpoints

  • Direct secure messaging: rodonovan16342@direct.casso.us.com

Organizations & group practices 1

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 9

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1467422949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 WOOD ST",
            "address_2": "STE A",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017549",
            "telephone_number": "318-323-8847",
            "fax_number": "318-327-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 WOOD ST",
            "address_2": "STE A",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017549",
            "telephone_number": "318-323-8847",
            "fax_number": "318-327-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONOVAN",
        "first_name": "RICHARD",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "08579R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1907090",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.