NPIMap

Individual provider Active NPI

John Otto Lovretich, M.D.

  • Diagnostic Radiology Physician
  • Baton Rouge, LA
National Provider Identifier
1639259153
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
019094 Issued in LA
Practice address
100 Womans Way
Baton Rouge, LA 70817-5100
Phone
(225) 924-8264
Fax
(225) 924-8242
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 019094 LA Primary

Addresses

Primary practice location

100 Womans Way
Baton Rouge, LA 70817-5100

Mailing address

8230 Summa Ave Ste C
Baton Rouge, LA 70809-3465
Phone (225) 757-0552

Other identifiers 1

IdentifierTypeStateIssuer
1910732MedicaidLA

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
I20101019001645 LA Practitioner - Diagnostic Radiology 0547396335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Louisiana State University School of Medicine in New Orleans, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates LLCGroup PAC ID 8628041464, 83 clinicians

Practice addresses (Care Compare)

100 Womans Way
Baton Rouge, LA 70817-5100
Phone (225) 924-8267

Hospital & facility affiliations

  • Womans Hospital Hospital, Baton Rouge, LA, CCN 190128
  • Christus Ochsner St Patrick Hospital Hospital, Lake Charles, LA, CCN 190027
  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064
  • Christus Ochsner Lake Area Hospital Hospital, Lake Charles, LA, CCN 190201
  • Lane Regional Medical Center Hospital, Zachary, LA, CCN 190020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019094LAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates LLC Diagnostic Radiology CurrentSince Mar 1, 2012 Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients
Radsouth Imaging, LLP Diagnostic Radiology Past Accepting new patients

Locations

100 Womans Way
Baton Rouge, LA 70817
Phone (225) 293-2324

8230 Summa Ave
Ste C
Baton Rouge, LA 70809

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

1100 N 18th St
Ste 100
Monroe, LA 71201
Phone (318) 361-9900

900 Johnson St
Tallulah, LA 71282
Phone (318) 395-2241

Organizations & group practices 3

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1639259153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8230 SUMMA AVE STE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093465",
            "telephone_number": "225-757-0552",
            "fax_number": "225-763-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOMANS WAY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708175100",
            "telephone_number": "225-924-8264",
            "fax_number": "225-924-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVRETICH",
        "first_name": "JOHN",
        "middle_name": "OTTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "019094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1910732",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.