Cornelius Bos, MD
Individual provider Active NPI Diagnostic Radiology Physician · Shreveport, LA
NPI 1821069378 · NPPES record last updated Feb 3, 2014
Key facts
- NPI
- 1821069378
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 09662R (LA)
- Practice address
- 2600 Greenwood Rd
Shreveport, LA 71103-3908 - Phone
- (318) 212-4550
- NPI assigned
- Jan 31, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- University of California, Geffen School of Medicine, 1969
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Red River Consultants Inc
Practice addresses (Care Compare)
2030 S River Rd
Melbourne Beach, FL 32951-2928
Phone (318) 212-4550
2600 Greenwood Rd
Shreveport, LA 71103-3908
Phone (318) 212-4550
Hospital & facility affiliations
- Willis Knighton Medical Center
- North Caddo Medical Center
- Christus Shreveport-Bossier Health System
- Minden Medical Center
- Springhill Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.94 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 73.13
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in LA, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100629000607 | LA | Practitioner - Diagnostic Radiology | 3173613692 | Reassigns benefits to 1 organization |
| I20170109001554 | FL | Practitioner - Diagnostic Radiology | 3173613692 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09662R | LA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Red River Consultants, Inc | Diagnostic Radiology | Current |
Accepting new patients |
Locations
8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000
2510 Bert Kouns Industrial Loop
Shreveport, LA 71118
Phone (318) 212-5000
2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 09662R | LA | Yes |
Addresses
Primary practice location
2600 Greenwood Rd
Shreveport, LA 71103-3908
Mailing address
PO Box 9600
Dept 09-033
Texarkana, TX 75505-9600
Phone (877) 243-8416
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1975371 | Medicaid | LA |
Other providers in Shreveport, LA
- Evelyn Bordovsky
- Allison Borel
- Patti F. Bornaman
- Alan John Borne
- Charlotte A Borst
- Joseph Houston Bosley
- Anand N Bosmia
- Brenda Kay Boston
- Dakota Boston
- Gloria Jean Boston
All providers in Shreveport, LA · Diagnostic Radiology Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.