Organization Active NPI

Falgoust Eye Medical and Surgical

  • Ophthalmology Physician
  • Lake Charles, LA
National Provider Identifier
1649285040
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD12137R Issued in LA
Legal business name
FALGOUST EYE MEDICAL AND SURGICAL
Practice address
1980 Tybee Lane
Lake Charles, LA 70605-2400
Phone
(337) 477-0963
Fax
(337) 477-1912
NPI assigned
Jul 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Authorized official

Name
Michelle M Falgoust
Title
Director of Operations
Phone
(337) 477-0963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X MD12137R LA Primary

Addresses

Primary practice location

1980 Tybee Lane
Lake Charles, LA 70605-2400

Mailing address

PO Box 4765
Lake Charles, LA 70606-4765
Phone (337) 477-0963

Other identifiers 2

IdentifierTypeStateIssuer
1695807MedicaidLA
435194099BOtherLABCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060330000537 LA Part B Supplier - Clinic/Group Practice 9739197880 Receives reassigned benefits from 4 practitioners
Practice locations: Lake Charles, LA

National Provider Directory

National Provider Directory

Locations

1920 W Sale Rd
Ste 6
Lake Charles, LA 70605
Phone (337) 477-0963

Practitioners & affiliated clinicians

Practitioners 4

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": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1649285040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4765",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706064765",
            "telephone_number": "337-477-0963",
            "fax_number": "337-477-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 TYBEE LANE",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706052400",
            "telephone_number": "337-477-0963",
            "fax_number": "337-477-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALGOUST EYE MEDICAL AND SURGICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "FALGOUST",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "337-477-0963"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "MD12137R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1695807",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "435194099B",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.