Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kenneth Charles Civello Jr., MD, MPH

Individual provider Cardiovascular Disease Physician · NPI 1699745562

Dr. Kenneth Charles Civello Jr., MD, MPH is a Cardiovascular Disease (Cardiology) in Baton Rouge, Louisiana. Graduated from Louisiana State University School of Medicine in New Orleans in 2000, 26 years ago. Practices with Our Lady of the Lake Physician Group LLC, a 635-clinician group and accepts Medicare assignment. Licensed in Louisiana and Ohio.

Years since qualifying
26
Trained at
Louisiana State University School of Medicine in New Orleans
Licensed in
LA, OH
In the registry since
2006
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MPH — Master of Public Health
A graduate degree in population health.

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Practice location Address checks out

7777 Hennessy Blvd Ste 1000
Baton Rouge, LA 70808-4300
Phone: (225) 767-3900
Fax: (225) 766-2226
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Cardiac Electrophysiology Physician (primary) Taxonomy 207RC0001X · Licence 201354 (LA)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 201354 (LA)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 35084798 (OH)
Clinical Cardiac Electrophysiology Physician Taxonomy 207RC0001X · Licence 35084798 (OH)

Record details

NPI number1699745562
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , MPH
Sole proprietorNo
NPI enumeratedJanuary 24, 2006
Last updated in NPPESFebruary 11, 2021
Certification dateFebruary 11, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCARDIOVASCULAR DISEASE (CARDIOLOGY)
Also practisesCARDIAC ELECTROPHYSIOLOGY
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated 2000 (26 years in practice)
Group practice Our Lady Of The Lake Physician Group Llc — 635 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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