Benjamin J Palombo, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD.204031 Issued in LA

Practice address

4806 Weaver Rd
Lake Charles, LA 70605-5100

Phone

(888) 443-7236

Fax

(337) 602-4904

NPI assigned

May 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Calcasieu Urgent Care LLC

  • Urgent Care Clinic/Center
  • Lake Charles, LA
  • NPI 1467715490
  Medicare reassignment NPD
• Calcasieu Urgent Care, LLC

  • Rural Health Clinic/Center
  • Breaux Bridge, LA
  • NPI 1194482398
  NPD

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1932310620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4806 WEAVER RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055100",
            "telephone_number": "337-296-4139",
            "fax_number": "888-443-7236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4806 WEAVER RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055100",
            "telephone_number": "888-443-7236",
            "fax_number": "337-602-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMBO",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.204031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02950",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pain Stop Clinic, LLC
• Ryan Keogh Palermo, PA-C
• Palliative Care at Heart, LLC
• Christine Camille Palma, DPM
• Anthony J Palombo, D.C.
• Brooke Palombo, BCBA
• David Palombo
• Pantheon ABA, LLC
• Paradigm Shift Behavioral Health & Wellness Center LLC
• Paradise Optical & Gifts

• Family Medicine Physician in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.