Active NPI
Eugene P Cicardo III, MD
- Anesthesiology Physician
- Charleston, SC
National Provider Identifier
1467945337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 330702
- Practice address
- 169 Ashley Ave RM 202
Charleston, SC 29425-8905 - Phone
- (843) 792-2437
- NPI assigned
- Jun 14, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | LL52646 | SC | |
| Anesthesiology Physician | 207L00000X | 330702 | LA | Primary |
Addresses
Primary practice location
169 Ashley Ave RM 202
Charleston, SC 29425-8905
Mailing address
1444 Peterman Dr
Alexandria, LA 71301-3432
Phone (318) 442-5399
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1444 Peterman Dr
Alexandria, LA 71301-3432
Phone (318) 442-5399
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL52646 | SC | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Louisiana Anesthesia Consultants, Apmc | Anesthesiology | Current | Accepting new patients |
| Opelousas General Health System | Current | Accepting new patients | |
| Opelousas General Health System | Current | Accepting new patients |
Locations
3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917
1444 Peterman Dr
Alexandria, LA 71301
Phone (318) 442-5399
3975 I 49 S Service Rd
Ste 200
Opelousas, LA 70570
Phone (337) 594-0750
3975 I 49 S Service Rd
Ste 105
Opelousas, LA 70570
Phone (337) 597-0750
Organizations & group practices 4
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.
-
- Anesthesiology Physician
- Alexandria, LA
- NPI 1205888914
-
- Family Medicine Physician
- Opelousas, LA
- NPI 1295098747
-
- Surgery Physician
- Opelousas, LA
- NPI 1053317016
-
- Surgery Physician
- Opelousas, LA
- NPI 1275794679
Hospital & facility affiliations 19
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Student Health Clinic/Center
- Pineville, LA
- NPI 1023139458
Hospital
-
- Student Health Clinic/Center
- Pineville, LA
- NPI 1093836421
Hospital
-
- Student Health Clinic/Center
- Provencal, LA
- NPI 1164687307
Hospital
-
- Student Health Clinic/Center
- Natchitoches, LA
- NPI 1356462782
Hospital
-
- Student Health Clinic/Center
- Marthaville, LA
- NPI 1609031962
Hospital
-
- General Acute Care Hospital
- Alexandria, LA
- NPI 1639160799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662076800000",
"number": "1467945337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1444 PETERMAN DR",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713013432",
"telephone_number": "318-442-5399",
"fax_number": "318-442-1586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE RM 202",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258905",
"telephone_number": "843-792-2437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CICARDO",
"first_name": "EUGENE",
"middle_name": "P",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-14",
"last_updated": "2022-09-02",
"certification_date": "2022-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "SC",
"license": "LL52646",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "LA",
"license": "330702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.