Individual provider Active NPI

Brian Joseph Lindenmayer, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Gonzales, LA
National Provider Identifier
1790983807
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
203963 Issued in LA
Practice address
2647 S Saint Elizabeth Blvd
Gonzales, LA 70737-5021
Phone
(225) 647-8511
Fax
(225) 644-5213
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 203963 LA Primary

Addresses

Primary practice location

2647 S Saint Elizabeth Blvd
Gonzales, LA 70737-5021

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2120620MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other
Direct Messaging Address blindenmayer2375@direct.casso.us.com Direct

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
I20100831000995 LA Practitioner - Family PracticePractitioner - Other (Physician) 4587701735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

2647 S Saint Elizabeth Blvd
Suite 219
Gonzales, LA 70737-5020
Phone (225) 765-5500

Hospital & facility affiliations

  • Amedisys Hospice Hospice, Baton Rouge, LA, CCN 191607
  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203963LAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Mar 1, 2019 Accepting new patients
Lake Urgent Care Ascension LLC CurrentSince Mar 19, 2013 Accepting new patients
Our Lady of the Lake Physician Group LLC Family Medicine CurrentSince Mar 1, 2019 Accepting new patients
Lake Urgent Care Ascension LLC CurrentSince Mar 19, 2013 Accepting new patients
Ascension Surgical Associates, LLC Past Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients

Locations

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

2647 S Saint Elizabeth Blvd
Ste 125
Gonzales, LA 70737
Phone (225) 647-9675

2647 S Saint Elizabeth Blvd
Ste 312
Gonzales, LA 70737

1702 N Burnside Ave
#B
Gonzales, LA 70737
Phone (225) 647-8319

2647 S Saint Elizabeth Blvd
Ste 100
Gonzales, LA 70737
Phone (225) 743-2707

2647 S Saint Elizabeth Blvd
Ste 219
Gonzales, LA 70737
Phone (225) 765-5864

14350 Highway 73
Prairieville, LA 70769
Phone (225) 313-3930

Interoperability endpoints

  • Direct secure messaging: blindenmayer2375@direct.casso.us.com

Organizations & group practices 7

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1790983807",
    "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": "2647 S SAINT ELIZABETH BLVD",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707375021",
            "telephone_number": "225-647-8511",
            "fax_number": "225-644-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDENMAYER",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "LA",
            "license": "203963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2120620",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIRURL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2647 S Saint Elizabeth Blvd",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707375021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "blindenmayer2375@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "blindenmayer2375@direct.casso.us.com",
            "address_1": "2647 S Saint Elizabeth Blvd",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707375021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

Verify at the official NPI Registry.