Individual provider Active NPI

Kanika Sood, MD

  • Family Medicine Physician
  • Quincy, MA
National Provider Identifier
1871055731
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1024290 Issued in MA
Practice address
1193 Sea St
Quincy, MA 02169-3544
Phone
(617) 471-8683
NPI assigned
Apr 1, 2019
Last updated
Aug 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 320412 LA
Family Medicine Physician 207Q00000X 1024290 MA Primary

Addresses

Primary practice location

1193 Sea St
Quincy, MA 02169-3544

Mailing address

1512 W Kirby PL
Shreveport, LA 71103-3822
Phone (318) 626-0287

Other practice location 1

4864 Jackson Street
Family Medicine
Monroe, LA 71202
Phone (318) 330-7164

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
I20220919001728 LA Practitioner - Family Practice 7618207101 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1024290MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Family Medicine CurrentSince Sep 1, 2022 Accepting new patients

Locations

1625 Louisville Ave
Monroe, LA 71201
Phone (318) 330-7000

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: kanika.sood.1@4368.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1871055731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W KIRBY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033822",
            "telephone_number": "318-626-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193 SEA ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021693544",
            "telephone_number": "617-471-8683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4864 Jackson Street",
            "address_2": "Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "71202",
            "country_code": "US",
            "telephone_number": "318-330-7164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOOD",
        "first_name": "KANIKA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "320412",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "1024290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.