Organization Active NPI

Mohs Surgery Specialists, LLC

  • Plastic Surgery Physician
  • Baton Rouge, LA
National Provider Identifier
1871626903
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
MOHS SURGERY SPECIALISTS, LLC
Practice address
4950 Essen Lane
Suite 301
Baton Rouge, LA 70808
Phone
(225) 763-9611
Fax
(225) 763-9699
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Authorized official

Name
Dr. Stephen D Antrobus, M.D.NPI 1629116553
Title
Owner
Phone
(225) 763-9611

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

4950 Essen Lane
Suite 301
Baton Rouge, LA 70808

Mailing address

4950 Essen Lane
Suite 301
Baton Rouge, LA 70809
Phone (225) 763-9611

Other identifiers 1

IdentifierTypeStateIssuer
435829281BOtherLABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050203000856 LA Part B Supplier - Clinic/Group Practice 0345291670 Receives reassigned benefits from 2 practitioners
Practice locations: Baton Rouge, LA

National Provider Directory

National Provider Directory

Locations

4950 Essen Ln
Ste 301
Baton Rouge, LA 70809
Phone (225) 763-9611

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316995200000",
    "number": "1871626903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 ESSEN LANE",
            "address_2": "SUITE 301",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70809",
            "telephone_number": "225-763-9611",
            "fax_number": "225-763-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 ESSEN LANE",
            "address_2": "SUITE 301",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70808",
            "telephone_number": "225-763-9611",
            "fax_number": "225-763-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHS SURGERY SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2011-09-26",
        "status": "A",
        "authorized_official_last_name": "ANTROBUS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-763-9611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "435829281B",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.