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

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: August 02, 2026.

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
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

Other Identifiers 4

Medicaid1492647LA
Medicare PIN5E498N365LA
Medicare PIN5E498LA
Medicare UPING92013LA

Accepted 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

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.

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

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
Quality41.47
Promoting Interoperability0
Improvement Activities30
Cost19.1

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 14

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

Nurse Practitioner (Adult Health)
19343 SUNSHINE AVE
COVINGTON, LA 70433
Orthopaedic Surgery
19343 SUNSHINE AVE
COVINGTON, LA 70433
Specialist/Technologist (Athletic Trainer)
19343 SUNSHINE AVE
COVINGTON, LA 70433
Orthopaedic Surgery
19343 SUNSHINE AVE
COVINGTON, LA 70433
Orthopaedic Surgery
19343 SUNSHINE AVE
COVINGTON, LA 70433
Orthopaedic Surgery
19343 SUNSHINE AVE
COVINGTON, LA 70433
Orthopaedic Surgery
19343 SUNSHINE AVE
COVINGTON, LA 70433
Physician Assistant
19343 SUNSHINE AVE
COVINGTON, LA 70433

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 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.

Where is Herbert Plauche located?

Herbert Plauche practices at 19343 Sunshine Ave, Covington, LA 70433. The listed phone number is (985) 892-5117.

What is Herbert Plauche's specialty?

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

Is Herbert Plauche enrolled in Medicare?

Yes. Herbert Plauche 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 Herbert Plauche accept?

Health plans from Blue Cross and Blue Shield of Louisiana and HMO Louisiana list Herbert Plauche 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 Herbert Plauche affiliated with any hospitals?

According to CMS data, Herbert Plauche is affiliated with Ochsner Medical Center Acute, St Tammany Parish Hospital, Avala and Riverside Medical Center.

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.