NPIMap

Individual provider Active NPI

Matthew W. Hanudel, MD

  • Emergency Medicine Physician
  • Shreveport, LA
National Provider Identifier
1942643358
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.207294 Issued in LA
Practice address
1501 Kings Hwy
Dept. of EMS
Shreveport, LA 71103-4228
Phone
(318) 675-6632
NPI assigned
Apr 16, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.207294 LA Primary

Addresses

Primary practice location

1501 Kings Hwy
Dept. of EMS
Shreveport, LA 71103-4228

Mailing address

1501 Kings Hwy
Dept. of EMS
Shreveport, LA 71103-4228
Phone (318) 675-6632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150730011411 LA Practitioner - Emergency Medicine 5496069759 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Calcasieu Emergency Group LLCGroup PAC ID 4183651425, 25 clinicians
Calcasieu Cameron Emergency Physician Group LLCGroup PAC ID 3476871815, 7 clinicians

Practice addresses (Care Compare)

4200 Nelson Rd
Lake Charles, LA 70605-4118
Phone (337) 436-2511

701 E Cypress St Emergency Dept
Sulphur, LA 70663-5053
Phone (337) 527-7034

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Correct Care, Inc. Emergency Medicine CurrentSince Aug 10, 2015 Accepting new patients
Professional Emergency Medicine Management -- Lake Charles LLC Emergency Medicine CurrentSince Jan 10, 2017 Accepting new patients
Webster Emergency Group LLC Emergency Medicine CurrentSince Aug 28, 2015 Accepting new patients
Sound Physicians Emergency Medicine of Louisiana Inc Emergency Medicine CurrentSince Mar 16, 2018 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Emergency Medicine CurrentSince Feb 26, 2017 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC CurrentSince Mar 16, 2018 Accepting new patients
Calcasieu Cameron Emergency Physician Group LLC Emergency Medicine CurrentSince Jul 15, 2024 Accepting new patients
Christus Health Southwestern Louisiana Past Accepting new patients

Locations

2351 Viking Dr
Bossier City, LA 71111
Phone (318) 681-4500

229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225

301 Memorial Dr
Donaldsonvlle, LA 70346
Phone (225) 473-7931

4200 Nelson Rd
Lake Charles, LA 70605
Phone (318) 474-6370

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

1 Medical Plaza Pl
Minden, LA 71055
Phone (318) 371-4042

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

6841 Fern Ave
Ste 100
Shreveport, LA 71105
Phone (318) 626-4200

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

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

701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4270

Organizations & group practices 9

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1942643358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "DEPT. OF EMS",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "DEPT. OF EMS",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANUDEL",
        "first_name": "MATTHEW",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.207294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.