Individual provider Active NPI

Arthur E Liles, MD

  • Urology Physician
  • Monroe, LA
National Provider Identifier
1619903572
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
013314 Issued in LA
Practice address
2516 Broadmoor Blvd
Monroe, LA 71201-2988
Phone
(318) 387-9420
Fax
(318) 323-8216
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 013314 LA Primary

Addresses

Primary practice location

2516 Broadmoor Blvd
Monroe, LA 71201-2988

Mailing address

130 Desiard St
Suite 355
Monroe, LA 71201-7319
Phone (318) 807-7875

Other identifiers 1

IdentifierTypeStateIssuer
1314480MedicaidLA

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
I20060915000459 LA Practitioner - Urology 8628031267 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013314LAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Health Group, LLC CurrentSince Dec 1, 2013 Accepting new patients
Affinity Health Group, LLC Urology CurrentSince Dec 1, 2013 Accepting new patients
St. Francis Medical Center, Inc. PastSince Jan 1, 2011 Accepting new patients

Locations

130 Desiard St
Ste 355
Monroe, LA 71201
Phone (318) 807-7875

2408 Broadmoor Blvd
Ste 2
Monroe, LA 71201
Phone (318) 807-0525

2516 Broadmoor Blvd
Monroe, LA 71201
Phone (318) 322-1161

711 Saint John St
Monroe, LA 71201
Phone (318) 387-9420

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1619903572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DESIARD ST",
            "address_2": "SUITE 355",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017319",
            "telephone_number": "318-807-7875",
            "fax_number": "318-812-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 BROADMOOR BLVD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012988",
            "telephone_number": "318-387-9420",
            "fax_number": "318-323-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILES",
        "first_name": "ARTHUR",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "LA",
            "license": "013314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1314480",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.