Active NPI
Don Alan Bravin, M.D.
- Ophthalmology Physician
- Lake Charles, LA
National Provider Identifier
1114909041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 12560R
- Practice address
- 1767 Imperial Blvd
Lake Charles, LA 70605-5362 - Phone
- (337) 478-3810
- Fax
- (337) 478-6360
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 12560R | LA | Primary |
Addresses
Primary practice location
1767 Imperial Blvd
Lake Charles, LA 70605-5362
Mailing address
1767 Imperial Blvd
Lake Charles, LA 70605-5362
Phone (337) 478-3810
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180033480 | Other | LA | RAILROAD MEDICARE |
| 720680677023 | Other | LA | CIGNA |
| 1537764 | Medicaid | LA | |
| 5013045 | Other | LA | AETNA |
| 567564020 | Other | LA | BLUECROSSBLUESHIELDLA |
Other names 1
- Dr. Don Alan Bravin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12560R | LA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589846400000",
"number": "1114909041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1767 IMPERIAL BLVD",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706055362",
"telephone_number": "337-478-3810",
"fax_number": "337-478-6360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1767 IMPERIAL BLVD",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706055362",
"telephone_number": "337-478-3810",
"fax_number": "337-478-6360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVIN",
"first_name": "DON",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2020-05-19",
"certification_date": "2020-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "LA",
"license": "12560R",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180033480",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "720680677023",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1537764",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5013045",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSSBLUESHIELDLA",
"identifier": "567564020",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DON",
"last_name": "BRAVIN",
"middle_name": "ALAN",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.