NPIMap

Organization Active NPI

Bankai Physicians LLC

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1982145157
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BANKAI PHYSICIANS LLC
Practice address
1111 Line Ave
Shreveport, LA 71101-3841
Phone
(318) 716-4770
Fax
(318) 716-4791
NPI assigned
Mar 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Authorized official

Name
Adam Mossallati, MDNPI 1447517974
Title
Owner
Phone
(304) 203-5754

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X

Addresses

Primary practice location

1111 Line Ave
Shreveport, LA 71101-3841

Mailing address

PO Box 1684
Shreveport, LA 71165-1684
Phone (318) 424-6004

Other practice location 1

1800 Irving Pl
Shreveport, LA 71101-4608
Phone (318) 425-4096

Other practice location 2

2525 Viking Dr
Bossier City, LA 71111-2103
Phone (318) 841-2525

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170601002208 LA Part B Supplier - Clinic/Group Practice 5294002846 Receives reassigned benefits from 2 practitioners
Practice locations: Bossier City, LA; Minden, LA; Shreveport, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1982145157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1684",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711651684",
            "telephone_number": "318-424-6004",
            "fax_number": "866-276-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013841",
            "telephone_number": "318-716-4770",
            "fax_number": "318-716-4791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Irving Pl",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711014608",
            "country_code": "US",
            "telephone_number": "318-425-4096",
            "fax_number": "318-425-8438",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2525 Viking Dr",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "711112103",
            "country_code": "US",
            "telephone_number": "318-841-2525",
            "fax_number": "318-425-8438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BANKAI PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-18",
        "status": "A",
        "authorized_official_last_name": "MOSSALLATI",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-203-5754",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.