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DR. MICHAEL L HAWTHORNE M.D.
NPI 1235159252
Internal Medicine - Pulmonary Disease in Houma, LA

Active since July 20, 2006PECOS EnrolledAccepts Medicare Assignment
96.9/100
CMS Quality Rating
855 BELANGER ST, SUITE 208, HOUMA, LA 70360(985) 872-6210(985) 876-7743 Get Directions Write a Review

NPPES record last updated: April 13, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Michael L Hawthorne M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL L HAWTHORNE M.D. (NPI 1235159252) is an individual pulmonary disease provider in Houma, Louisiana, licensed in Louisiana (33315) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with West Jefferson Medical Center, and is a graduate of Louisiana State University School Of Medicine In Shreveport (1998).

NPPES Registry Identity

NPI1235159252
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. MICHAEL L HAWTHORNECredential: M.D.
Location Address855 BELANGER ST, SUITE 208Houma, LA 70360-4463
Mailing Address3525 Prytania St, Ste 526New Orleans, LA 70115-8127 · (985) 872-6210 · Fax (985) 876-7743
Phone(985) 872-6210
Fax(985) 876-7743
Sole ProprietorYes
Medical School CMSLouisiana State University School Of Medicine In ShreveportGraduated 1998
Enumeration DateJuly 20, 2006
Last NPPES UpdateApril 13, 2017
✔ NPI 1235159252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in LA · 33315
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
855 BELANGER ST, Houma, LA 70360
Open in Google Maps ↗

Other Identifiers 3

OtherP00385330LA · Railroad Medicare
Medicaid1571431LA
Medicare PIN4K116LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michael L Hawthorne M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537147681
PECOS Enrollment IDI20060504000769
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
75 services57 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
46 services26 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
42 services31 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
39 services16 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
29 services16 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
21 services21 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

West Jefferson Medical Center

Acute Care Hospitals · Marrero, LA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190039
Location1101 Medical Center BlvdMarrero, LA 70072 · Jefferson County
Emergency services Birthing friendly

Touro Infirmary

Acute Care Hospitals · New Orleans, LA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190046
Location1401 Foucher StreetNew Orleans, LA 70115 · Orleans County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70360 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.60 typical visit price
range $53.43 – $164.73
Typical copayment $31.15 (range $13.35 – $41.18)
Most-billed visit code 99204
Established Patient
$95.09 typical visit price
range $16.64 – $133.62
Typical copayment $23.77 (range $4.16 – $33.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

96.9/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality77.77
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 11

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers14 claims70 services$15.69 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
4 suppliers15 claims15 services$15.62 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
5 suppliers15 claims15 services$10.59 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
5 suppliers29 claims123 services$1.89 avg. paid by Medicare
Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$37.16 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
2 suppliers19 claims19 services$800.86 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GASTROENTEROLOGY INSTITUTE, INC.
Internal Medicine (Gastroenterology)
855 BELANGER ST, SUITE 205
HOUMA, LA 70360
Terrebonne Parish (985) 868-7773
ALL INDUSTRIAL MEDICAL SERVICES LLC
Nurse Practitioner (Family)
855 BELANGER ST, SUITE 207
HOUMA, LA 70360
Terrebonne Parish (985) 868-2302
DAVID A SISAM DO
Internal Medicine (Endocrinology, Diabetes & Metabolism)
855 BELANGER ST, SUITE 100
HOUMA, LA 70360
Terrebonne Parish (985) 876-5451
ALL ACCESS WALK IN CLINIC
Clinic/Center (Urgent Care)
855 BELANGER ST, SUITE 106
HOUMA, LA 70360
Terrebonne Parish (985) 709-0311
CHRISTINE ALBRECHT MD APMC
Obstetrics & Gynecology
855 BELANGER ST, SUITE 209
HOUMA, LA 70360
Terrebonne Parish (985) 873-0112
MRS. ANDRE GERVAIS GROS NP
Nurse Practitioner (Family)
855 BELANGER ST, SUITE 102
HOUMA, LA 70360
Terrebonne Parish (985) 873-0112
DR. GREGORY CHUKWUEMEKA MAIDOH M.D.
Internal Medicine (Nephrology)
855 BELANGER ST, SUITE 205
HOUMA, LA 70360
Terrebonne Parish (985) 876-9113
DR. RALPH JAMES BOURGEOIS M.D.
Internal Medicine (Pulmonary Disease)
855 BELANGER ST, SUITE 107
HOUMA, LA 70360
Terrebonne Parish (985) 581-0059

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Hawthorne's NPI number?

The NPI number for Michael Hawthorne is 1235159252. It was assigned to this individual provider in the NPPES registry on July 20, 2006.

Where is Michael Hawthorne located?

Michael Hawthorne practices at 855 Belanger St Suite 208, Houma, LA 70360. The listed phone number is (985) 872-6210.

What is Michael Hawthorne's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Michael Hawthorne enrolled in Medicare?

Yes. Michael Hawthorne is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michael Hawthorne accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter from Superior HealthPlan and Blue Cross and Blue Shield of Louisiana and 1 other insurer list Michael Hawthorne as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Michael Hawthorne affiliated with any hospitals?

According to CMS data, Michael Hawthorne is affiliated with West Jefferson Medical Center and Touro Infirmary.

When was this NPI record last updated?

The NPPES record for Michael Hawthorne was last updated on April 13, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.