Individual provider Active NPI

Andrew John Zovath, D.O.

  • Family Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1720585359
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
312473 Issued in LA
Practice address
1525 Oak Park Blvd
Lake Charles, LA 70601-8849
Phone
(337) 494-6767
Fax
(337) 494-6750
NPI assigned
Apr 10, 2018
Last updated
Aug 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X S8409 TX
Family Medicine Physician 207Q00000X 312473 LA Primary

Addresses

Primary practice location

1525 Oak Park Blvd
Lake Charles, LA 70601-8849

Mailing address

1525 Oak Park Blvd
Lake Charles, LA 70601-8849
Phone (337) 494-6767

Other practice location 1

1604 Rock Prairie Rd
College Station, TX 77845-8343
Phone (979) 680-5474

Other identifiers 2

IdentifierTypeStateIssuer
Q00277466OtherTXRAILROAD MEDICARE PTAN
425653901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210519001989 TX Practitioner - Family Practice 4688923857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-3777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
312473LAMDFamily Medicine Physician
S8409TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Regional Health Center Family Medicine CurrentSince Jul 12, 2021 Accepting new patients
St Joseph Regional Health Center CurrentSince Jul 12, 2021 Accepting new patients
St Joseph Regional Health Center Past Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

Interoperability endpoints

  • Direct secure messaging: azovath468891@direct.stlukeshealth.org

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

Hospital & facility affiliations 2

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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1720585359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018849",
            "telephone_number": "337-494-6767",
            "fax_number": "337-494-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018849",
            "telephone_number": "337-494-6767",
            "fax_number": "337-494-6750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1604 Rock Prairie Rd",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778458343",
            "country_code": "US",
            "telephone_number": "979-680-5474",
            "fax_number": "979-680-5487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZOVATH",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S8409",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "312473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "Q00277466",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425653901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.