NPIMap

Individual provider Active NPI

Eric Charles Fontenot, M.D.

  • Gastroenterology Physician
  • Lake Charles, LA
National Provider Identifier
1083931646
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD.206793 Issued in LA
Practice address
2770 3Rd Ave Ste 345
Lake Charles, LA 70601-8994
Phone
(337) 494-4785
Fax
(337) 494-4786
NPI assigned
Apr 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD.206793 LA Primary

Addresses

Primary practice location

2770 3Rd Ave Ste 345
Lake Charles, LA 70601-8994

Mailing address

PO Box 122623 Dept 2623
Dallas, TX 75312-0001
Phone (337) 494-2921

Other practice location 1

1890 W Gauthier Rd
Lake Charles, LA 70605-7179
Phone (337) 494-4785

Other practice location 2

555 Dr Michael Debakey Dr Ste 101
Lake Charles, LA 70601-5700
Phone (337) 439-0762

Other identifiers 2

IdentifierTypeStateIssuer
MD.206793OtherLASTATE LICENSE
2361325MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dhc@mmg.imed.phimailbox.com Health Information Exchange (HIE)

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
I20170726003485 LA Practitioner - GastroenterologyPractitioner - Internal Medicine 6901045541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Health Center of SwlaGroup PAC ID 3072782713, 9 clinicians

Practice addresses (Care Compare)

1701 Oak Park Blvd
Lake Charles, LA 70601-8911
Phone (337) 494-4785

2770 3Rd Ave
Suite 345
Lake Charles, LA 70601-8994
Phone (337) 494-4785

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy120
Upper gastrointestinal (GI) endoscopy for acid reflux237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.206793LAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Health Center of Swla Gastroenterology CurrentSince Jan 1, 2021 Accepting new patients
Southwest Louisiana Hospital Association Inc Gastroenterology CurrentSince Oct 30, 2022 Accepting new patients
Southwest Louisiana Hospital Association Inc Past Accepting new patients

Locations

2770 3rd Ave
Ste 345
Lake Charles, LA 70601
Phone (337) 494-4785

2615 Enterprise Blvd
Ste B
Lake Charles, LA 70601
Phone (337) 480-8900

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1083931646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122623 DEPT 2623",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753120001",
            "telephone_number": "337-494-2921",
            "fax_number": "337-494-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 3RD AVE STE 345",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018994",
            "telephone_number": "337-494-4785",
            "fax_number": "337-494-4786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1890 W Gauthier Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706057179",
            "country_code": "US",
            "telephone_number": "337-494-4785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 Dr Michael Debakey Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706015700",
            "country_code": "US",
            "telephone_number": "337-439-0762",
            "fax_number": "337-439-9253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "ERIC",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-22",
        "last_updated": "2022-04-27",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "LA",
            "license": "MD.206793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD.206793",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2361325",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dhc@mmg.imed.phimailbox.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2615 Enterprise Blvd Ste B",
            "city": "Lake Charles",
            "state": "LA",
            "country_code": "US",
            "postal_code": "706017686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.