Active NPI
Rodolfo Mangubat Ramos Jr., MD
- Internal Medicine Physician
- Lake Charles, LA
National Provider Identifier
1861456501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 10998R
- Practice address
- 2025 Oak Park Blvd
Lake Charles, LA 70601-7827 - Phone
- (337) 478-2573
- Fax
- (337) 478-5296
- NPI assigned
- Apr 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 10998R | LA | Primary |
Addresses
Primary practice location
2025 Oak Park Blvd
Lake Charles, LA 70601-7827
Mailing address
2025 Oak Park Blvd
Lake Charles, LA 70601-7827
Phone (337) 478-2573
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10998R | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Charles Medical Services, Inc | Past | Accepting new patients | |
| Humphries Family Healthcare, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Primary Care Clinic/Center
- Lake Charles, LA
- NPI 1538244884
-
- Rural Health Clinic/Center
- Iowa, LA
- NPI 1134271497
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548288000000",
"number": "1861456501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 OAK PARK BLVD",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706017827",
"telephone_number": "337-478-2573",
"fax_number": "337-478-5296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 OAK PARK BLVD",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706017827",
"telephone_number": "337-478-2573",
"fax_number": "337-478-5296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAMOS",
"first_name": "RODOLFO",
"middle_name": "MANGUBAT",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2019-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "LA",
"license": "10998R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10998R",
"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 Jan 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.