NPIMap

Individual provider Active NPI

John Kalieb Pourciau, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Lake Charles, LA
National Provider Identifier
1053589580
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
DPM200016 Issued in LA
Practice address
1747 Imperial Blvd
Lake Charles, LA 70605-5362
Phone
(337) 721-7236
Fax
(337) 721-7237
NPI assigned
Feb 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X DPM200016 LA Primary

Addresses

Primary practice location

1747 Imperial Blvd
Lake Charles, LA 70605-5362

Mailing address

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 433-8400

Other identifiers 1

IdentifierTypeStateIssuer
1198501MedicaidLA

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
I20080916000259 LA Practitioner - Podiatry 2860569902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Orthopaedics and Spine LLCGroup PAC ID 1557797206, 32 clinicians

Practice addresses (Care Compare)

1747 Imperial Blvd
Lake Charles, LA 70605-5362
Phone (337) 721-7236

Hospital & facility affiliations

  • Christus Homecare St Patrick Home health agency, Lake Charles, LA, CCN 197015
  • Lake Charles Memorial Hospital Hospital, Lake Charles, LA, CCN 190060
  • Christus Ochsner St Patrick Hospital Hospital, Lake Charles, LA, CCN 190027

Merit-based Incentive Payment System (MIPS)

Final score
64.65 of 100Reported as individual
Quality
37.44
Promoting interoperability
90
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue117
Removal of nail tissue86
Removal or shaving of skin growth11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DPM200016LAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopaedics and Spine LLC Foot & Ankle Surgery CurrentSince Mar 2, 2020 Accepting new patients
Center for Orthopaedics and Spine LLC Foot & Ankle Surgery CurrentSince Mar 2, 2020 Accepting new patients
Imperial Health LLP Past Accepting new patients

Locations

1355 Sam Houston Jones Pkwy
Ste 340
Lake Charles, LA 70611
Phone (337) 721-7236

501 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 312-8258

1747 Imperial Blvd
Lake Charles, LA 70605
Phone (337) 721-7236

Interoperability endpoints

  • Direct secure messaging: jpourciau@direct.centerforortho.com

Organizations & group practices 3

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1053589580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015724",
            "telephone_number": "337-433-8400",
            "fax_number": "337-312-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 IMPERIAL BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055362",
            "telephone_number": "337-721-7236",
            "fax_number": "337-721-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURCIAU",
        "first_name": "JOHN",
        "middle_name": "KALIEB",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "LA",
            "license": "DPM200016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1198501",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.