NPIMap

Individual provider Active NPI

Benjamin M Azevedo, M. D., M. P H

  • Internal Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1821434432
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
305391 Issued in LA
Practice address
1000 Walters St
Lake Charles, LA 70607-4647
Phone
(337) 480-8066
Fax
(337) 480-8061
NPI assigned
May 22, 2013
Last updated
Feb 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 305391 LA Primary

Addresses

Primary practice location

1000 Walters St
Lake Charles, LA 70607-4647

Mailing address

PO Box 122108 Dept 2108
Dallas, TX 75312-2108
Phone (337) 494-2772

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
I20170915001199 LA Practitioner - Internal Medicine 4284942012 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tulane University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LCMS Rehabilitation Institute of Southwest LouisianaGroup PAC ID 7012061930, 35 clinicians

Practice addresses (Care Compare)

1000 Walters St
Lake Charles, LA 70607-4647
Phone (337) 480-8066

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.41 of 100Reported as group
Improvement activities
40
Cost
70.62

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
LCMS Rehabilitation Institute of Southwest Louisiana CurrentSince Jul 31, 2017 Accepting new patients
LC Hospital Medicine Physicians, LLC Internal Medicine CurrentSince Jun 1, 2023 Accepting new patients
Southwest Louisiana Hospital Association Inc Past Accepting new patients

Locations

1000 Walters St
Lake Charles, LA 70607
Phone (337) 475-8687

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

1717 Oak Park Blvd
Fl 3
Lake Charles, LA 70601
Phone (337) 494-4900

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lake Charles Memorial HospitalLake Charles, LA, CCN 190060 Hospital Corporate Officer Jan 1, 2026
Lake Charles Memorial HospitalLake Charles, LA, CCN 19T060 Hospital Corporate Director Jan 1, 2023
Lake Charles Memorial HospitalLake Charles, LA, CCN 19S060 Hospital Corporate Officer Jan 1, 2023
Home Health Agency of Lake Charles Memorial HospitalLake Charles, LA, CCN 197005 Home health agency Corporate Officer Jan 1, 2023
Iowa Health CenterIowa, LA, CCN 193408 Rural health clinic Corporate Officer Jan 1, 2023

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 10

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": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1821434432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122108 DEPT 2108",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122108",
            "telephone_number": "337-494-2772",
            "fax_number": "337-494-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALTERS ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074647",
            "telephone_number": "337-480-8066",
            "fax_number": "337-480-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZEVEDO",
        "first_name": "BENJAMIN",
        "middle_name": "M",
        "credential": "M. D., M. P H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-22",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "305391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.