Individual provider Active NPI

Isaac A Odudu, MD

  • Pediatrics Physician
  • Mandeville, LA
National Provider Identifier
1780780528
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
13224R Issued in LA
Practice address
639 Lotus Dr N
Suite B
Mandeville, LA 70471-2926
Phone
(985) 626-6133
Fax
(985) 626-6136
NPI assigned
Sep 16, 2006
Last updated
Aug 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 13224R LA Primary

Addresses

Primary practice location

639 Lotus Dr N
Suite B
Mandeville, LA 70471-2926

Mailing address

208 Ridgewood Blvd
Alexandria, LA 71303-3320
Phone (318) 483-6571

Other identifiers 1

IdentifierTypeStateIssuer
1558346MedicaidLA

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
I20040712001597 LA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 5991783250 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Emergency Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kisatchie Emergency Group LLCGroup PAC ID 9537400270, 19 clinicians
Emergency Staffing Solutions IncGroup PAC ID 9830001650, 57 clinicians

Practice addresses (Care Compare)

1020 W Fertita Blvd
Leesville, LA 71446-4645
Phone (337) 239-5278

207 Jefferson St
Mansfield, LA 71052-2603
Phone (318) 872-0821

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.66 of 100Reported as group
Quality
26.46
Improvement activities
40
Cost
80.85

Merit-based Incentive Payment System (MIPS)

Final score
83.62 of 100Reported as group
Quality
70.88
Improvement activities
40
Cost
75.82

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Service District No 1 Parish of Avoyelles State of Louisiana CurrentSince Sep 27, 2011 Accepting new patients
Keystone Medical Services of Ferriday, Inc. CurrentSince Feb 1, 2024 Accepting new patients
Correct Care, Inc. CurrentSince Sep 16, 2013 Accepting new patients
Kisatchie Emergency Group, LLC CurrentSince Mar 20, 2019 Accepting new patients
Hospital Service District No 1 Parish of Avoyelles State of Louisiana Current Accepting new patients
Ess of Ferriday, LLC CurrentSince Jan 31, 2022 Accepting new patients
Emergency Staffing Solutions Inc CurrentSince Oct 1, 2006 Accepting new patients
Northern Louisiana Emergency Physicians LLP CurrentSince Jun 1, 2010 Accepting new patients
Northern Louisiana Emergency Physicians, LLP CurrentSince Jun 1, 2010 Accepting new patients
St Martin Emergency Group LLC CurrentSince Oct 5, 2018 Accepting new patients
C & M Medical Services, Inc. CurrentSince Jul 1, 1990 Accepting new patients
Hospital Service District No 1 Parish of Avoyelles State of la CurrentSince Sep 27, 2011 Accepting new patients
Ess Hospitalist LLC CurrentSince Apr 14, 2014 Accepting new patients
Concord North Texas, PLLC CurrentSince Dec 1, 2018 Accepting new patients
GPN-Leesville, LLC Past Accepting new patients
Ess Region II LLC Past Accepting new patients

Locations

323 W Walnut Ave
Bastrop, LA 71220
Phone (318) 283-3600

210 Champagne Blvd
Breaux Bridge, LA 70517
Phone (337) 332-2178

427 Evergreen St
Bunkie, LA 71322
Phone (318) 346-6681

229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225

301 Memorial Dr
Donaldsonvlle, LA 70346
Phone (225) 473-7931

1700 EE Wallace Blvd N
Ferriday, LA 71334
Phone (318) 281-2448

1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278

207 Jefferson St
Mansfield, LA 71052
Phone (318) 871-3109

240 Highland Dr
Many, LA 71449
Phone (318) 256-5691

3223 8th St
Metairie, LA 70002
Phone (504) 833-7770

2202 False River Dr
New Roads, LA 70760
Phone (225) 638-5702

6569 Highway 84
Ridgecrest, LA 71334
Phone 3187576551605

401 E Vaughn Ave
Ruston, LA 71270
Phone (318) 254-2100

900 Johnson St
Tallulah, LA 71282
Phone (318) 395-2241

2106 Loop Rd
Winnsboro, LA 71295
Phone (318) 282-8482

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 3

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1780780528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 RIDGEWOOD BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033320",
            "telephone_number": "318-483-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 LOTUS DR N",
            "address_2": "SUITE B",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704712926",
            "telephone_number": "985-626-6133",
            "fax_number": "985-626-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUDU",
        "first_name": "ISAAC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "13224R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558346",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.