NPIMap

Individual provider Active NPI

Charles Victor Bayouth, M.D.

  • Surgery Physician
  • Lubbock, TX
National Provider Identifier
1952304354
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
K5255 Issued in TX
Practice address
3509 22ND St
Lubbock, TX 79410-1307
Phone
(806) 799-7928
Fax
(806) 788-8500
NPI assigned
May 31, 2005
Last updated
Nov 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X K5255 TX Primary

Addresses

Primary practice location

3509 22ND St
Lubbock, TX 79410-1307

Mailing address

3509 22ND St
Lubbock, TX 79410-1307
Phone (806) 799-7928

Other identifiers 1

IdentifierTypeStateIssuer
150430003MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charlesbayouth@swatsallp.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050311000351 TX Practitioner - General Surgery 2769436781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical Branch at Galveston, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swat Surgical Associates LLPGroup PAC ID 1355371832, 13 clinicians

Practice addresses (Care Compare)

3509 22ND St
Lubbock, TX 79410-1307
Phone (806) 799-7928

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Apr 1, 2021 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Surgery CurrentSince Apr 1, 2021 Accepting new patients
Swat Surgical Associates, L.L.P. Surgery CurrentSince Sep 1, 2003 Accepting new patients
Covenant Medical Group Surgery Past Accepting new patients
Covenant Medical Group Past Accepting new patients
Covenant Medical Center Past Accepting new patients

Locations

3509 22nd St
Lubbock, TX 79410
Phone (806) 799-7928

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

3611 22nd Pl
Lubbock, TX 79410
Phone (803) 771-2222

4102 24th St
Ste 304
Lubbock, TX 79410
Phone (806) 725-2360

1700 Cogdell Blvd
Snyder, TX 79549
Phone (325) 573-6374

Interoperability endpoints

  • Direct secure messaging: charlesbayouth@swatsallp.allscriptsdirect.net

Organizations & group practices 7

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 5

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1952304354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 22ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101307",
            "telephone_number": "806-799-7928",
            "fax_number": "806-788-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 22ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101307",
            "telephone_number": "806-799-7928",
            "fax_number": "806-788-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYOUTH",
        "first_name": "CHARLES",
        "middle_name": "VICTOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "K5255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150430003",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlesbayouth@swatsallp.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "3509 22nd St",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794101307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.