NPIMap

Individual provider Active NPI

Stephen Randolph Vick, M.D.

  • Urology Physician
  • Baton Rouge, LA
National Provider Identifier
1689634099
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
022020 Issued in LA
Practice address
7777 Hennessy Blvd
Suite 2004
Baton Rouge, LA 70808-4300
Phone
(225) 769-2500
Fax
(225) 769-9424
NPI assigned
Mar 28, 2006
Last updated
Mar 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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 022020 LA Primary

Addresses

Primary practice location

7777 Hennessy Blvd
Suite 2004
Baton Rouge, LA 70808-4300

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0011

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
I20101214001280 LA Practitioner - Urology 8224045778 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Louisiana State University School of Medicine in Shreveport, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baton Rouge Urology Group ApmcGroup PAC ID 1850499161, 9 clinicians

Practice addresses (Care Compare)

7777 Hennessy Blvd
Suite 2004
Baton Rouge, LA 70808-4370
Phone (225) 769-2500

7777 Hennessy Blvd
Suite 302
Baton Rouge, LA 70808-4365
Phone (225) 358-4853

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Prostate resection15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022020LAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Mar 8, 2021 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Mar 8, 2021 Accepting new patients
Baton Rouge Urology Group Apmc Urology CurrentSince Jul 1, 2002 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients
Our Lady of the Lake Hospital Inc. Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

7777 Hennessy Blvd
Ste 2004
Baton Rouge, LA 70808
Phone (225) 769-2500

7777 Hennessy Blvd
Ste 302
Baton Rouge, LA 70808
Phone (225) 374-0500

Interoperability endpoints

  • FHIR API: https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: svick14813@direct.casso.us.com

Organizations & group practices 5

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1689634099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0011",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "SUITE 2004",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-769-2500",
            "fax_number": "225-769-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICK",
        "first_name": "STEPHEN",
        "middle_name": "RANDOLPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "LA",
            "license": "022020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.