Individual provider Active NPI

Manuel James Lozada III, D.O.

  • Anesthesiology Physician
  • Lafayette, LA
National Provider Identifier
1306283205
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
TEM-COV19-29474 Issued in IL
Practice address
4600 Ambassador Caffery Pkwy
Lafayette, LA 70508-6902
Phone
(337) 470-5500
NPI assigned
May 31, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 325166 LA
Anesthesiology Physician 207L00000X T4205 TX
Anesthesiology Physician 207L00000X BP10047099 TX
Anesthesiology Physician 207L00000X DO3435 TN
Anesthesiology Physician 207L00000X TEM-COV19-29474 IL Primary

Addresses

Primary practice location

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508-6902

Mailing address

3045 Marina Bay Dr Apt 11108
League City, TX 77573-2779
Phone (814) 659-5481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211202000309 IL Practitioner - Anesthesiology 4981953957 Reassigns benefits to 1 organization
I20220511001170 CO Practitioner - Anesthesiology 4981953957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEM-COV19-29474ILMDAnesthesiology Physician
DO3435TNMDAnesthesiology Physician
BP10047099TXMDAnesthesiology Physician
T4205TXMDAnesthesiology Physician
3435TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Anesthesiology Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Midwest Anesthesia Providers S.C Anesthesiology CurrentSince Oct 1, 2021 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

58 Club Manor Dr
Pueblo, CO 81008
Phone (719) 584-4045

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

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 7

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": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1306283205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 MARINA BAY DR APT 11108",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775732779",
            "telephone_number": "814-659-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086902",
            "telephone_number": "337-470-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOZADA",
        "first_name": "MANUEL",
        "middle_name": "JAMES",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-31",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "325166",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "T4205",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "BP10047099",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "DO3435",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "TEM-COV19-29474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.