Active NPI
Andrew J Fercowicz
- Family Medicine Physician
- Lufkin, TX
National Provider Identifier
1245281971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- K0743
- Practice address
- 202 S John Redditt Dr
Lufkin, TX 75904-3112 - Phone
- (936) 639-1005
- Fax
- (936) 639-1006
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | K0743 | TX | Primary |
Addresses
Primary practice location
202 S John Redditt Dr
Lufkin, TX 75904-3112
Mailing address
202 S John Redditt Dr
Lufkin, TX 75904-3112
Phone (936) 639-1005
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 092111601 | Medicaid | TX |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baylor St. Luke'S Medical Group | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JIHBCA
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- The Woodlands, TX
- NPI 1740485879
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334707200000",
"number": "1245281971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 S JOHN REDDITT DR",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043112",
"telephone_number": "936-639-1005",
"fax_number": "936-639-1006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 S JOHN REDDITT DR",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043112",
"telephone_number": "936-639-1005",
"fax_number": "936-639-1006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERCOWICZ",
"first_name": "ANDREW",
"middle_name": "J",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2012-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "K0743",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "092111601",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lufkin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.