Individual provider Active NPI

Pramod Savarapu

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1669959979
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
328670 Issued in LA
Practice address
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 626-0000
Fax
(318) 629-4833
NPI assigned
Jul 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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 4301116185 MI
Internal Medicine Physician 207R00000X 328670 LA Primary

Addresses

Primary practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1512 W Kirby PL
Shreveport, LA 71103-3822

Other practice location 1

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-5656

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
I20211004000436 LA Practitioner - Internal Medicine 1759630080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4864 Jackson St
Monroe, LA 71202-6400
Phone (318) 330-7167

Hospital & facility affiliations

  • Ochsner Lsu Health Monroe Hospital, Monroe, LA, CCN 190011
  • Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
328670LAMDInternal Medicine Physician
4301116185MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Internal Medicine CurrentSince Sep 17, 2021 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients
Brfhh Monroe LLC Past Accepting new patients

Locations

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

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.

Hospital & facility affiliations 2

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": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1669959979",
    "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"
        },
        {
            "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",
            "fax_number": "318-629-4833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 S Ballenger Hwy",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485323638",
            "country_code": "US",
            "telephone_number": "810-342-5656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAVARAPU",
        "first_name": "PRAMOD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-20",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301116185",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "328670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.