Individual provider Active NPI

Alberto A Simoncini, MD

  • Diagnostic Radiology Physician
  • Shreveport, LA
National Provider Identifier
1871689307
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
201091 Issued in LA
Practice address
1501 Kings Hwy
Department of Radiology
Shreveport, LA 71130
Phone
(318) 675-5000
Fax
(318) 675-5666
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 201091 LA Primary

Addresses

Primary practice location

1501 Kings Hwy
Department of Radiology
Shreveport, LA 71130

Mailing address

1512 W Kirby PL
Shreveport, LA 71103-3822
Phone (318) 675-7636

Other identifiers 2

IdentifierTypeStateIssuer
1582999MedicaidLA
4K253F600OtherLAMEDICARE - PTAN

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
I20061106000210 LA Practitioner - Diagnostic Radiology 5092712083 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-4881

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

Hospital & facility affiliations

  • Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098
  • Ochsner Lsu Health Shreveport-St Mary Medical Cent Hospital, Shreveport, LA, CCN 190317
  • Ochsner Lsu Health Monroe Hospital, Monroe, LA, CCN 190011
  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
  • Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201091LAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Apr 19, 2017 Accepting new patients
Shriners Hospitals for Children CurrentSince Sep 6, 2017 Accepting new patients
Shriners Hospitals for Children CurrentSince Sep 6, 2017 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

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

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

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

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

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

1501 Kings Hwy
Rm 1201
Shreveport, LA 71103
Phone (318) 675-4881

3100 Samford Ave
Shreveport, LA 71103
Phone (318) 222-5704

Organizations & group practices 5

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 8

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1871689307",
    "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": "318-675-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71130",
            "telephone_number": "318-675-5000",
            "fax_number": "318-675-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONCINI",
        "first_name": "ALBERTO",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "201091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1582999",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - PTAN",
            "identifier": "4K253F600",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.