NPIMap

Individual provider Active NPI

Ted Armstrong Kovacev, MD

  • Surgery Physician
  • Lake Jackson, TX
National Provider Identifier
1568614402
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
Q0779 Issued in TX
Practice address
104 Circle Way St Ste a
Lake Jackson, TX 77566-5200
Phone
(979) 721-7007
Fax
(979) 721-4254
NPI assigned
Oct 22, 2008
Last updated
May 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01070428A IN
Surgery Physician 208600000X Q0779 TX Primary

Addresses

Primary practice location

104 Circle Way St Ste a
Lake Jackson, TX 77566-5200

Mailing address

104 Circle Way St Ste a
Lake Jackson, TX 77566-5200
Phone (979) 721-7007

Other names 1

  • Ted Kovacev Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20141112000665 TX Practitioner - General Surgery 7214199587 Reassigns benefits to 2 organizations
Practice locations: Lake Jackson, TX

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

104 Circle Way St
Suite a
Lake Jackson, TX 77566-5200
Phone (979) 721-7007

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy84
Hernia repair - groin (open)15
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux36
Melanoma (skin cancer) excision1-10
Removal of tissue50
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q0779TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arlington Physician Services PA Surgery CurrentSince Jun 12, 2016 Accepting new patients
Dr Ted Kovacev MD PA Surgery CurrentSince Sep 11, 2019 Accepting new patients
Hancock Regional Hospital Surgery Past Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients
Hancock Physician Network, LLC Surgery Past Accepting new patients

Locations

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

104 Circle Way St
Ste A
Lake Jackson, TX 77566
Phone (979) 721-7007

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJBHCD/Endpoint/CJBHCD
  • Direct secure messaging: ted.kovacev.1@17497.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1568614402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CIRCLE WAY ST STE A",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665200",
            "telephone_number": "979-721-7007",
            "fax_number": "979-721-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CIRCLE WAY ST STE A",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665200",
            "telephone_number": "979-721-7007",
            "fax_number": "979-721-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACEV",
        "first_name": "TED",
        "middle_name": "ARMSTRONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01070428A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "Q0779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TED",
            "last_name": "KOVACEV",
            "credential": "MD PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lake Jackson, TX

Sources for this page

Verify at the official NPI Registry.