Individual provider Active NPI

Chaitanya Amrutkar, M.D.

  • Neurology Physician
  • Shreveport, LA
National Provider Identifier
1629451638
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
323745 Issued in LA
Practice address
1811 E Bert Koun Loop Ste 120
Shreveport, LA 71105-5741
Phone
(318) 212-2720
Fax
(318) 212-2718
NPI assigned
Jul 8, 2015
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 323745 LA Primary

Addresses

Primary practice location

1811 E Bert Koun Loop Ste 120
Shreveport, LA 71105-5741

Mailing address

1811 E Bert Koun Loop Ste 120
Shreveport, LA 71105-5741
Phone (318) 212-2720

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: 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
I20200925000517 LA Practitioner - Neurology 6406143064 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
WK Pierremont Neurology ClinicGroup PAC ID 4082033287, 6 clinicians

Practice addresses (Care Compare)

1811 E Bert Kouns Industrial Loop
Suite 120
Shreveport, LA 71105-5741

1811 E Bert Kouns Industrial Loop
Suite 200
Shreveport, LA 71105-5766
Phone (318) 212-2720

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.53 of 100Reported as apm
Quality
81.42
Promoting interoperability
94.6
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
323745LAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Neurology Consultants CurrentSince Jul 31, 2020 Accepting new patients
WK Pierremont Neurology Clinic Neurology CurrentSince Oct 1, 2020 Accepting new patients

Locations

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

1811 E Bert Kouns Industrial Loop
Ste 120
Shreveport, LA 71105
Phone (318) 212-2720

1811 E Bert Kouns Industrial Loop
Ste 200
Shreveport, LA 71105
Phone (318) 212-2720

Interoperability endpoints

  • Direct secure messaging: camrutkar@direct.wkhs.com

Organizations & group practices 2

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 4

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": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1629451638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUN LOOP STE 120",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055741",
            "telephone_number": "318-212-2720",
            "fax_number": "318-212-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUN LOOP STE 120",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055741",
            "telephone_number": "318-212-2720",
            "fax_number": "318-212-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMRUTKAR",
        "first_name": "CHAITANYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-08",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "323745",
            "primary": true
        }
    ],
    "identifiers": [],
    "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.