Centerwell Senior Primary Care (La) PC
NPI 1760005136ActiveOrganization· Internal Medicine· Bossier City, LA
Internal Medicine in Bossier City, Louisiana, registered in NPPES in May 2020, part of Centerwell Senior Primary Care (La) PC. The authorized official on file is Angie Martinez, Senior Credentialing Professional. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1760005136 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Centerwell Senior Primary Care (La) PC |
| NPI issued | May 20, 2020 |
| Last updated in NPPES | Nov 7, 2022 |
| Certified by provider | Nov 7, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
| Family Medicine | 207Q00000X | — | — |
| General Practice | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (LA) |
|---|
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