HERBERT R PLAUCHE MD
NPI 1275599557
Orthopaedic Surgery in Covington, LA

Q: What is Herbert Plauche's NPI number?

The NPI number for Herbert Plauche is 1275599557. It was assigned to this individual provider in the NPPES registry on April 25, 2006.

Q: What is Herbert Plauche's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Herbert Plauche was last updated on June 29, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.

Active since April 25, 2006PECOS EnrolledAccepts Medicare Assignment

29.42/100

CMS Quality Rating

19343 SUNSHINE AVE, COVINGTON, LA 70433(985) 892-5117(985) 892-5128 Get Directions Write a Review

NPPES record last updated: June 29, 2009. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Herbert R Plauche Md NPPES

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

HERBERT R PLAUCHE MD (NPI 1275599557) is an individual orthopaedic surgery provider in Covington, Louisiana, licensed in Louisiana (022170) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Ochsner Medical Center Acute, and is a graduate of Louisiana State University School Of Medicine In New Orleans (1994).

NPPES Registry Identity

NPI1275599557

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameHERBERT R PLAUCHECredential: MD

Location Address19343 SUNSHINE AVECovington, LA 70433-8834

Mailing Address19343 Sunshine AveCovington, LA 70433-8834 · (985) 892-5117 · Fax (985) 892-5128

Phone(985) 892-5117

Fax(985) 892-5128

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 1994

Enumeration DateApril 25, 2006

Last NPPES UpdateJune 29, 2009

✔ NPI 1275599557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in LA · 022170

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

19343 SUNSHINE AVE, Covington, LA 70433

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Other Identifiers 4

Medicaid1492647LA

Medicare PIN5E498N365LA

Medicare PIN5E498LA

Medicare UPING92013LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, HMO Louisiana.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Herbert R Plauche Md 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 ID8527050442

PECOS Enrollment IDI20040331001568

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.

Medicare Billing Reassignment

Medicare enrollment records show Herbert Plauche reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lmg LLC

33 mi

Orthopaedic Surgery

1615 METAIRIE RD
Metairie, LA 70005

Reassigned Medicare billing, Louisiana enrollment
48 clinicians in this Medicare group

NPI 1871919936 (504) 897-6351

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 23

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.

Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg J7322

Hymovis is a treatment involving the injection of a substance called hyaluronan into a joint. This substance, naturally found in the body, helps lubricate and cushion your joints. The treatment can help reduce joint pain and improve mobility.

1,176 services18 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.

657 services337 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

389 services230 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

305 services227 patients

X-ray of both knees while standing 73565

An X-ray of both knees while standing is a diagnostic procedure that captures images of your knee joints. You'll stand in front of an X-ray machine, and it will take pictures showing the bones and tissues in your knees. This helps doctors identify any abnormalities or injuries.

257 services225 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

143 services143 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

138 services104 patients

X-ray of shoulder blade 73010

An X-ray of the shoulder blade is a quick, painless test that produces images of the bones in your shoulder area. It helps identify fractures, infections, or other abnormalities. You'll need to stay still while a machine sends a small amount of radiation through your shoulder to capture the image.

137 services103 patients

Injection, methylprednisolone acetate, 80 mg J1040

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

104 services77 patients

X-ray of hip, 1 view 73501

An X-ray of the hip, 1 view, is a quick, painless test where a small amount of radiation is used to produce images of the hip joint. This helps in diagnosing conditions like arthritis or fractures. You'll be positioned so that the X-ray machine can capture the best image of your hip.

90 services73 patients

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.

73 services52 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

44 services32 patients

Aspiration and/or injection of fluid from small joint 20600

This procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.

37 services26 patients

X-ray of lower and sacral spine, minimum of 4 views 72110

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

28 services27 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

28 services28 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

25 services21 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

25 services15 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

24 services13 patients

Aspiration and/or injection of fluid from medium joint 20605

This procedure involves a needle being inserted into a medium-sized joint, such as a knee or shoulder, to remove (aspirate) excess fluid. Sometimes, medication may also be injected into the joint to reduce inflammation and pain.

20 services16 patients

Injection, methylprednisolone acetate, 20 mg J1020

Methylprednisolone acetate is a medication given via injection to reduce inflammation and pain. It's often used to treat conditions like arthritis, allergic reactions, and certain skin diseases. The 20 mg dose is tailored to your specific needs.

17 services17 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

15 services15 patients

X-ray of upper spine, 4-5 views 72050

An X-ray of the upper spine with 4-5 views is a non-invasive imaging test. It uses radiation to capture detailed images of the bones and structures in your neck and upper back. This procedure helps identify issues like fractures, infections, or deformities.

14 services14 patients

X-ray of elbow, minimum of 3 views 73080

An elbow X-ray with a minimum of 3 views is a non-invasive imaging test. It helps visualize the bones of the elbow from different angles. This aids in diagnosing conditions like fractures or arthritis. The procedure is quick, painless, and usually takes around 15 minutes.

14 services13 patients

Hospital Affiliations CMS Care Compare 4

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

Ochsner Medical Center Acute

Acute Care Hospitals · New Orleans, LA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190036

Location1516 Jefferson HwyNew Orleans, LA 70121 · Jefferson County

Emergency services Birthing friendly

St Tammany Parish Hospital

Acute Care Hospitals · Covington, LA

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number190045

Location1202 S Tyler StreetCovington, LA 70433 · St. Tammany County

Emergency services Birthing friendly

Avala

Acute Care Hospitals · Covington, LA

OwnershipPhysician

CMS Certification Number190267

Location67252 Industry LaneCovington, LA 70433 · St. Tammany County

Riverside Medical Center

Critical Access Hospitals · Franklinton, LA

OwnershipGovernment - Hospital District or Authority

CMS Certification Number191313

Location1900 South Main StFranklinton, LA 70438 · Washington County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70433 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

$83.60 typical visit price

range $53.43 – $164.73

Typical copayment $20.90 (range $13.35 – $41.18)

Most-billed visit code 99203

Established Patient

$67.06 typical visit price

range $16.64 – $133.62

Typical copayment $16.76 (range $4.16 – $33.40)

Most-billed visit code 99213

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.

29.42/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

41.47

Promoting Interoperability

Improvement Activities

Cost

19.1

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report

41%422 patients2/55-star benchmark: 87%

Documentation of Current Medications in the Medical Record

99%2,986 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%917 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

24%1,768 patients1/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

0%2,878 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 0% · 979 patients

0%979 patients

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 964 patients

Patients totalRate: 2% · 965 patients

2%965 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

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

Walker, heavy duty, wheeled, rigid or folding, any type E0149

DME-Other DME · category DE000N

1 supplier13 claims13 services$10.53 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 13

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

JESSICA T CARLSON NP

Nurse Practitioner (Adult Health)