Organization Active NPI

Robert L. Hovancsek, D.P.M. PS

  • Podiatrist
  • Aberdeen, WA
National Provider Identifier
1396928263
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO00000531 Issued in OH
Legal business name
ROBERT L. HOVANCSEK, D.P.M. PS
Practice address
2218 Simpson Ave
Aberdeen, WA 98520-3514
Phone
(360) 533-4344
Fax
(360) 533-4755
NPI assigned
Dec 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Authorized official

Name
Mr. Robert Louis Hovancsek, DPMNPI 1508868167
Title
Owner/President
Phone
(360) 533-4344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X PO00000531 OH Primary

Addresses

Primary practice location

2218 Simpson Ave
Aberdeen, WA 98520-3514

Mailing address

2218 Simpson Ave
Aberdeen, WA 98520-3514
Phone (360) 533-4344

Other identifiers 3

IdentifierTypeStateIssuer
51866OtherWALABOR & INDUSTRIES
H07445OtherWAREGENCE BLUE SHIELD
1089119MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081002000231 WA Part B Supplier - Clinic/Group Practice 5092883199 Receives reassigned benefits from 1 practitioner
Practice locations: Aberdeen, WA

National Provider Directory

National Provider Directory

Locations

2218 Simpson Ave
Aberdeen, WA 98520
Phone (206) 533-4344

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1396928263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 SIMPSON AVE",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985203514",
            "telephone_number": "360-533-4344",
            "fax_number": "360-533-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2218 SIMPSON AVE",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985203514",
            "telephone_number": "360-533-4344",
            "fax_number": "360-533-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT L. HOVANCSEK, D.P.M. PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "HOVANCSEK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "360-533-4344",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "PO00000531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "51866",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "H07445",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1089119",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.