Mamatha Katikaneni, MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD.206221 Issued in LA

Practice address

1541 Kings Hwy
Shreveport, LA 71103-4228

Phone

(318) 813-2528

NPI assigned

Jul 29, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

RheumatologyAlso: Internal Medicine

Education

Louisiana State University School of Medicine in Shreveport, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Larry K. Broadwell, M.D., a Medical CorporationGroup PAC ID 7113984402, 10 clinicians

Cornerstone Therapy and Balance Center, LLCGroup PAC ID 0345397899, 98 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BAJHBA

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.

• Rheumatology and Osteoporosis Specialists, AMC

  • Rheumatology Physician
  • Shreveport, LA
  • NPI 1689766271
  Medicare reassignment Care Compare group NPD
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222

  Internal Medicine

  Medicare reassignment NPD
• Cornerstone Therapy and Balance Center, LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Shreveport, LA
  • NPI 1659518041
  Care Compare group
• Rheumatology and Osteoporosis Specialists, AMC

  • Pharmacy
  • Shreveport, LA
  • NPI 1477343713
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation
• Christus Health Ark-la-Tex

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1902110109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "address_2": "ATTN: PAYOR CREDENTIALING",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-813-2528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Jordan St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711014518",
            "country_code": "US",
            "telephone_number": "318-221-0399",
            "fax_number": "318-221-1940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATIKANENI",
        "first_name": "MAMATHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-29",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.206221",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "LA",
            "license": "MD.206221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2127578",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arbab Burhan Uddin Kasi
• Marwan Kaskas, MD
• Kassie Angels Transportation
• Kathleen Porter NP and Willis-Knighton Medical Center
• Shweta Kathuria Arora, MD
• Pavan Katikaneni, MD
• Nrusheel Kattar
• Roohi Katyal, M.D.
• Sanford Rory Katz, M.D.
• David A Kaufman, M.D.

• Rheumatology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Rheumatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.