NPIMap

Individual provider Active NPI

Jagan Beedupalli, M.D.

  • Cardiovascular Disease Physician
  • Shreveport, LA
National Provider Identifier
1497956601
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD.202094 Issued in LA
Practice address
2727 Hearne Ave
Suite 301
Shreveport, LA 71103-3917
Phone
(318) 631-6400
Fax
(318) 631-0300
NPI assigned
May 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 202094 LA
Cardiovascular Disease Physician 207RC0000X MD.202094 LA Primary

Addresses

Primary practice location

2727 Hearne Ave
Suite 301
Shreveport, LA 71103-3917

Mailing address

1202 Louisiana Ave
Shreveport, LA 71101-3910
Phone (318) 212-8951

Other practice location 1

2300 Hospital Dr Ste 450
Bossier City, LA 71111-2195
Phone (318) 752-2328

Other identifiers 2

IdentifierTypeStateIssuer
298405YH54OtherLAMEDICARE PTAN
1092771MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080916000343 LA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Peripheral Vascular Disease 4789751843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Peripheral Vascular Disease
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springhill Medical Services, Inc.Group PAC ID 6002728912, 19 clinicians
WKMC Cardiovascular ConsultantsGroup PAC ID 0941420061, 34 clinicians

Practice addresses (Care Compare)

2001 Doctors Dr
Springhill, LA 71075-4526
Phone (318) 539-1000

2727 Hearne Ave
Suite 301
Shreveport, LA 71103-3918
Phone (318) 631-6400

Hospital & facility affiliations

  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
  • Springhill Medical Center Hospital, Springhill, LA, CCN 190088
  • Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041
  • Natchitoches Regional Medical Center Hospital, Natchitoches, LA, CCN 190007
  • Claiborne Memorial Medical Center Hospital, Homer, LA, CCN 190114

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting23
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202094LAMDInternal Medicine Physician
MD.202094LAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WKMC Cardiovascular Consultants Cardiovascular Disease CurrentSince Mar 1, 2017 Accepting new patients
Springhill Medical Services, Inc. CurrentSince May 29, 2019 Accepting new patients
Springhill Medical Services, Inc. Internal Medicine CurrentSince May 29, 2019 Accepting new patients

Locations

2300 Hospital Dr
Ste 450
Bossier City, LA 71111
Phone (318) 425-4096

2400 Hospital Dr
Ste 350
Bossier City, LA 71111
Phone (318) 212-7902

104 Morris Cir
Homer, LA 71040
Phone (318) 927-1110

102 S Monroe St
Minden, LA 71055
Phone (318) 377-3425

1029 Keyser Ave
Ste M
Natchitoches, LA 71457

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

8001 Youree Dr
Ste 740
Shreveport, LA 71115
Phone (318) 212-3830

2727 Hearne Ave
Ste 301
Shreveport, LA 71103

2001 Doctors Dr
Springhill, LA 71075
Phone (318) 539-1000

401 11th St NE
Springhill, LA 71075
Phone (318) 539-1700

1003 S Spruce St
Vivian, LA 71082
Phone (318) 375-3239

10320 Little Patuxent Pkwy
Ste 23302
Columbia, MD 21044

Organizations & group practices 8

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1497956601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-212-8951",
            "fax_number": "318-212-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 HEARNE AVE",
            "address_2": "SUITE 301",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033917",
            "telephone_number": "318-631-6400",
            "fax_number": "318-631-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Hospital Dr Ste 450",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "711112195",
            "country_code": "US",
            "telephone_number": "318-752-2328",
            "fax_number": "318-746-0160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEEDUPALLI",
        "first_name": "JAGAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "202094",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "MD.202094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "298405YH54",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1092771",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.