NPIMap

Individual provider Active NPI

Carlos M Choucino, MD

  • Infectious Disease Physician
  • Lake Charles, LA
National Provider Identifier
1386604338
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
11215R Issued in LA
Practice address
1000 Walters St
Lake Charles, LA 70607-4647
Phone
(337) 475-8100
Fax
(337) 475-8416
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 11215R LA Primary

Addresses

Primary practice location

1000 Walters St
Lake Charles, LA 70607-4647

Mailing address

PO Box 122165 Dept 2165
Dallas, TX 75312-2165
Phone (337) 494-2772

Other identifiers 2

IdentifierTypeStateIssuer
F33789OtherLAUPN
1663395MedicaidLA

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
I20070604000078 LA Practitioner - Infectious DiseasePractitioner - Internal Medicine 7810095676 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
LCMS Rehabilitation Institute of Southwest LouisianaGroup PAC ID 7012061930, 35 clinicians
Southwest Louisiana AIDS CouncilGroup PAC ID 5890086078, 5 clinicians

Practice addresses (Care Compare)

1000 Walters St
Lake Charles, LA 70607-4647
Phone (337) 480-8066

1715 Common St
Lake Charles, LA 70601-6135
Phone (337) 439-5861

Hospital & facility affiliations

  • Lake Charles Memorial Hospital Hospital, Lake Charles, LA, CCN 190060
  • West Calcasieu Cameron Hospital Hospital, Sulphur, LA, CCN 190013

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Charles Medical Services Orthopedics Associates LLC CurrentSince Feb 27, 2022 Accepting new patients
LCMS Rehabilitation Institute of Southwest Louisiana Infectious Disease CurrentSince Jul 30, 2014 Accepting new patients
Sanctuary Louisiana, LLC Current Accepting new patients
Southwest Louisiana AIDS Council CurrentSince Nov 1, 2024 Accepting new patients
Comprehensive Care Center PC Past Accepting new patients

Locations

1000 Walters St
Lake Charles, LA 70607
Phone (337) 475-8687

1717 Oak Park Blvd
Fl 3
Lake Charles, LA 70601
Phone (337) 494-4900

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

425 Kingsley St
Lake Charles, LA 70601
Phone (337) 439-5861

2829 4th Ave
Ste 150
Lake Charles, LA 70601
Phone (337) 477-7091

1715 Common St
Lake Charles, LA 70601
Phone (337) 439-1386

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Harbor Hospice of Lake Charles, LPLake Charles, LA, CCN 191625 Hospice 5% Or Greater Direct Ownership Interest
General Partnership Interest		 Oct 1, 2006
Oct 1, 2006

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 10

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1386604338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122165 DEPT 2165",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122165",
            "telephone_number": "337-494-2772",
            "fax_number": "337-494-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALTERS ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074647",
            "telephone_number": "337-475-8100",
            "fax_number": "337-475-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUCINO",
        "first_name": "CARLOS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "LA",
            "license": "11215R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPN",
            "identifier": "F33789",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1663395",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.