DR. BRYAN WAYNE RANDOLPH D.P.M.
NPI 1649276007
Podiatrist in Shreveport, LA


Quality Rating: 0 out of 100 score

NPI Status: Active since June 21, 2005

Contact Information

1449 E BERT KOUN LOOP STE 101
SHREVEPORT, LA
ZIP 71105
Phone: (318) 681-4282

Get Directions Reviews

  • Individual
  • Male
  • Years of Experience 28
  • Podiatrist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About BRYAN RANDOLPH

This page provides the complete NPI Profile along with additional information for Bryan Randolph, a provider established in Shreveport, Louisiana with a medical specialization in Podiatrist and more than 28 years of experience. He graduated from Kent State University College Of Podiatric Medicine in 1998. The healthcare provider is registered in the NPI registry with number 1649276007 assigned on June 2005. The practitioner's primary taxonomy code is 213E00000X with license number DPM.PD290R (LA). The provider is registered as an individual and his NPI record was last updated June 2025.

NPI
1649276007
Provider Name
DR. BRYAN WAYNE RANDOLPH D.P.M.
Gender
Male
Entity Type
Individual
Location Address
1449 E BERT KOUN LOOP STE 101 SHREVEPORT, LA 71105
Location Phone
(318) 681-4282
Mailing Address
7821 YOUREE DR SHREVEPORT, LA 71105
Mailing Phone
(318) 213-3668
Mailing Fax
Medical School Name
KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduation Year
1998
Is Sole Proprietor?
No
Enumeration Date
06-21-2005
Last Update Date
06-17-2025
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A podiatrist like Bryan Randolph provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.

Location Map

Secondary Locations

  • 1505 E Bert Kouns Industrial Loop Ste 101
    Shreveport, LA 71105
    (318) 681-7480
  • 7821 Youree Dr
    Shreveport, LA 71105
    (318) 213-3668
  • 2703 Beene Blvd
    Bossier City, LA 71111
    (318) 681-4515

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Podiatrist

Taxonomy Code
213E00000X
Type
Podiatric Medicine & Surgery Service Providers
License No.
DPM.PD290R
License State
LA
Taxonomy Description
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1213E00000XPodiatric Medicine & Surgery Service Providers

Podiatrist

PD290R (LA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Complete Silver (QualChoice) - POS
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Blue Max 70/50 $6700 - PPO
  • Blue Max 90/70 $1500 - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $3300 - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan - PPO
  • Blue Saver 60/40 $6100 - PPO
  • Blue Saver 90/70 $3200 - PPO
  • CHRISTUS Bronze - HMO
  • CHRISTUS Bronze Essential - HMO
  • CHRISTUS Bronze Essential Plus - HMO
  • CHRISTUS Bronze Plus - HMO
  • CHRISTUS Catastrophic - HMO
  • CHRISTUS Gold - HMO
  • CHRISTUS Gold Essential - HMO
  • CHRISTUS Gold Essential Plus - HMO
  • CHRISTUS Gold Plus - HMO
  • CHRISTUS Silver - HMO
  • Blue Connect 80/60 $3200 (L) - POS
  • Blue Connect 80/60 $3200 (N) - POS
  • Blue Connect 80/60 $3200 (S) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan (L) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan (N) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan (S) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan (L) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan (N) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan (S) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan (L) - POS

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1436127MEDICAID (05)LA 

Medicare Participation & PECOS Enrollment Status

Bryan Randolph is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Bryan Randolph is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 8729116595

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20100514000793

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Medical/Surgical Supplies (DA023N)

    Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing (HCPCS:A6196)

    2 DME suppliers used 12 Medicare Claims 286 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6402)

    2 DME suppliers used 15 Medicare Claims 1140 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6446)

    2 DME suppliers used 14 Medicare Claims 1564 Services Paid

Orthotic Devices

  • DME-Orthotic Devices (DF003N)

    Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise (HCPCS:L4360)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less

This procedure involves applying a skin substitute graft to a wound that's 25.0 sq cm or less, located on areas such as the face, scalp, eyelids, mouth, neck, ears, around eyes, hands, feet, fingers, or toes. The graft aids in wound healing and tissue regeneration.

This service was performed 66 times for 12 patients

Epifix, per square centimeter

Epifix is an advanced wound care treatment, derived from human placental tissue. It helps to promote healing by providing a protective barrier and supplying growth factors. Each square centimeter refers to the size of the Epifix graft needed for your specific wound.

This service was performed 400 times for 12 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 91 times for 86 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 30 times for 15 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 573 times for 288 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 18 times for 15 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 1-10 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 140 times for 140 patients

Permanent removal fingernail or toenail

Permanent removal of a fingernail or toenail, also known as avulsion, is a procedure performed to treat nail infections or severe ingrown nails. The nail is carefully removed under local anesthesia. After removal, a chemical is applied to prevent nail regrowth, ensuring the issue does not recur.

This service was performed 30 times for 22 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

This service was performed 20 times for 14 patients

Removal of fingernails or toenails, 1-5 nails

This procedure involves the careful removal of 1-5 nails from fingers or toes. It's typically done to treat conditions like ingrown nails, fungal infections, or damaged nails. Local anesthesia is used for comfort, and the area heals over time with appropriate care.

This service was performed 42 times for 34 patients

Removal of fingernails or toenails, 6 or more nails

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

This service was performed 1,069 times for 443 patients

Removal of noncancer thickened skin growth, 1 growth

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

This service was performed 110 times for 79 patients

Removal of noncancer thickened skin growth, 2-4 growths

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

This service was performed 155 times for 89 patients

Removal of skin and tissue, 20.0 sq cm or less

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

This service was performed 29 times for 13 patients

Removal of skin and tissue, 20.0 sq cm or less

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

This service was performed 20 times for 13 patients

Removal of tissue from wound, 20.0 sq cm or less

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

This service was performed 52 times for 16 patients

Removal of tissue from wound, 20.0 sq cm or less

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

This service was performed 188 times for 56 patients

Trimming of fingernails or toenails

Trimming of fingernails or toenails is a simple procedure for maintaining hygiene and preventing nail-related issues. It involves cutting the nails straight across, then smoothing any sharp edges with a file. Regular nail care can help prevent infections and discomfort.

This service was performed 73 times for 48 patients

X-ray of foot, minimum of 3 views

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

This service was performed 184 times for 111 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.9 for a new patient copayment and $16.76 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 71105 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $83.6
  • Minimum New Patient Price $53.43
  • Maximum New Patient Price $164.73
  • Average New Patient Copayment $20.9
  • Minimum New Patient Copayment $13.35
  • Maximum New Patient Copayment $41.18

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.06
  • Minimum Established Patient Price $16.64
  • Maximum Established Patient Price $133.62
  • Average Established Patient Copayment $16.76
  • Minimum Established Patient Copayment $4.16
  • Maximum Established Patient Copayment $33.4

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 0, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 0 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 0

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 0

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Bryan Randolph is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
CHRISTUS ST FRANCES CABRINI HOSPITAL3330 MASONIC DRIVE
ALEXANDRIA, LA 71301
(318) 487-1122Acute Care Hospitals
CHRISTUS SHREVEPORT-BOSSIER HEALTH SYSTEM1453 E BERT KOUNS INDUSTRIAL LOOP
SHREVEPORT, LA 71105
(318) 681-5000Acute Care Hospitals
OCHSNER LSU HEALTH SHREVEPORT1541 KINGS HIGHWAY
SHREVEPORT, LA 71103
(318) 675-5000Acute Care Hospitals
WILLIS KNIGHTON MEDICAL CENTER2600 GREENWOOD ROAD
SHREVEPORT, LA 71103
(318) 212-4000Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1649276007
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2689471200
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 8 + 9 + 4 + 7 + 1 + 2 + 0 + 0 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 77

The NPI number 1649276007 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1649276007, enumerated in the NPI registry as an "individual" on June 21, 2005

The provider is located at 1449 E Bert Koun Loop Ste 101 Shreveport, La 71105 and the phone number is (318) 681-4282

The provider's speciality is Podiatrist with taxonomy code 213E00000X

The provider has more than 28 years of experience. He graduated from Kent State University College Of Podiatric Medicine in 1998.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

Medicare beneficiaries should expect a typical cost of $83.6 with an average copayment of $20.9 for new patient appointments. Established patients should expect a typical charge of $67.06 and an average copayment of 16.76. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less, Epifix, per square centimeter, Established patient office or other outpatient visit, 10-19 minutes, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Melanoma (skin cancer) excision, New patient office or other outpatient visit, 30-44 minutes, Permanent removal fingernail or toenail, Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and, Removal of fingernails or toenails, 1-5 nails, Removal of fingernails or toenails, 6 or more nails, Removal of noncancer thickened skin growth, 1 growth, Removal of noncancer thickened skin growth, 2-4 growths, Removal of skin and tissue, 20.0 sq cm or less, Removal of skin and tissue, 20.0 sq cm or less, Removal of tissue from wound, 20.0 sq cm or less, Removal of tissue from wound, 20.0 sq cm or less, Trimming of fingernails or toenails and X-ray of foot, minimum of 3 views.

The practitioner is affiliated to the following hospital(s): CHRISTUS ST FRANCES CABRINI HOSPITAL, CHRISTUS SHREVEPORT-BOSSIER HEALTH SYSTEM, OCHSNER LSU HEALTH SHREVEPORT and WILLIS KNIGHTON MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 21, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.