Individual provider Active NPI

Marcus L. Pittman III, M.D.

  • Family Medicine Physician
  • Covington, LA
National Provider Identifier
1609924919
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
014891 Issued in LA
Practice address
307 S Jefferson Ave
Covington, LA 70433-3135
Phone
(985) 892-3661
Fax
(985) 892-3372
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 014891 LA
General Practice Physician 208D00000X 014891 LA
Family Medicine Physician 207Q00000X 014891 LA Primary

Addresses

Primary practice location

307 S Jefferson Ave
Covington, LA 70433-3135

Mailing address

307 S Jefferson Ave
Covington, LA 70433-3135
Phone (985) 892-3661

Other practice location 1

2807 S Columbia St
Bogalusa, LA 70427-7915
Phone (985) 307-1600

Other names 1

  • Dr. Marc Pittman III Other name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110920000737 LA Practitioner - Family PracticePractitioner - Emergency Medicine 0042481277 Practice locations: Covington, LA

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

307 S Jefferson Ave
Covington, LA 70433-3135
Phone (985) 892-3661

Hospital & facility affiliations

  • St Tammany Parish Hospital Hospital, Covington, LA, CCN 190045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014891LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marc Pittman, III, MD, LLC General Practice PastSince Mar 22, 2020 Accepting new patients

Organizations & group practices 1

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 3

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1609924919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S JEFFERSON AVE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704333135",
            "telephone_number": "985-892-3661",
            "fax_number": "985-892-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S JEFFERSON AVE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704333135",
            "telephone_number": "985-892-3661",
            "fax_number": "985-892-3372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2807 S Columbia St",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704277915",
            "country_code": "US",
            "telephone_number": "985-307-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "MARCUS",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "014891",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "014891",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "014891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARC",
            "last_name": "PITTMAN",
            "prefix": "DR.",
            "suffix": "III",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.