Individual provider Active NPI

William B Liles, M.D.

  • Surgery Physician
  • Monroe, LA
National Provider Identifier
1710197033
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
202468 Issued in LA
Practice address
312 Grammont Street
Suite 303
Monroe, LA 71201
Phone
(318) 398-2984
Fax
(318) 398-2413
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 202468 LA Primary

Addresses

Primary practice location

312 Grammont Street
Suite 303
Monroe, LA 71201

Mailing address

312 Grammont Street
Suite 303
Monroe, LA 71201
Phone (318) 398-2984

Other identifiers 1

IdentifierTypeStateIssuer
1079294MedicaidLA

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
I20130306000350 LA Practitioner - General Surgery 1052566585 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Louisiana State University School of Medicine in New Orleans, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Surgery Clinic of Northeast Louisiana, LLCGroup PAC ID 6901159102, 4 clinicians

Practice addresses (Care Compare)

312 Grammont St
Suite 303
Monroe, LA 71201-7403
Phone (318) 398-2984

Hospital & facility affiliations

  • Fmol Health St Francis Hospital, Monroe, LA, CCN 190125
  • Richardson Medical Center Hospital, Rayville, LA, CCN 190151

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)16
Mastectomy1-10
Varicose vein removal166
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Surgery Clinic of Northeast Louisiana LLC Surgery CurrentSince Aug 2, 2018 Accepting new patients
Affinity Health Group, LLC Surgery CurrentSince Nov 1, 2013 Accepting new patients
Brfhh Monroe LLC CurrentSince Feb 23, 2018 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Surgery CurrentSince Jul 1, 2021 Accepting new patients
Affinity Health Group, LLC CurrentSince Nov 1, 2013 Accepting new patients
Brfhh Monroe LLC CurrentSince Feb 23, 2018 Accepting new patients
St Francis Medical Center, Inc Past Accepting new patients
Walter M Sartor MD AMC Surgery Past Accepting new patients
P & S Surgery Center LLC PastSince Apr 1, 2013 Accepting new patients

Locations

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

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

312 Grammont St
Ste 303
Monroe, LA 71201
Phone (318) 322-9882

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

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: wliles16290@direct.casso.us.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Fmol Health| St. FrancisMonroe, LA, CCN 190125 Hospital Corporate Officer Jan 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1710197033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 GRAMMONT STREET",
            "address_2": "SUITE 303",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71201",
            "telephone_number": "318-398-2984",
            "fax_number": "318-398-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 GRAMMONT STREET",
            "address_2": "SUITE 303",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71201",
            "telephone_number": "318-398-2984",
            "fax_number": "318-398-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILES",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "202468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1079294",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.