MALCOLM MICHAEL DUPLANTIS JR PT
NPI 1285831271
Physical Therapist in Gonzales, LA

NPI Status: Active since July 02, 2007

Contact Information

211 E WORTHY ST
BLDG IV
GONZALES, LA
ZIP 70737
Phone: (225) 644-7044
Fax: (225) 644-4414

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  • Individual
  • Male
  • Years of Experience 26
  • Physical Therapist
  • Accepts Insurance
  • Accepts Medicare Approved Payment

About MALCOLM DUPLANTIS JR

This page provides the complete NPI Profile along with additional information for Malcolm Duplantis Jr, a provider established in Gonzales, Louisiana with a medical specialization in Physical Therapist and more than 26 years of experience. The healthcare provider is registered in the NPI registry with number 1285831271 assigned on July 2007. The practitioner's primary taxonomy code is 225100000X with license number 04755 (LA). The provider is registered as an individual and his NPI record was last updated 14 years ago.

NPI
1285831271
Provider Name
MALCOLM MICHAEL DUPLANTIS JR PT
Gender
Male
Entity Type
Individual
Location Address
211 E WORTHY ST BLDG IV GONZALES, LA 70737
Location Phone
(225) 644-7044
Location Fax
(225) 644-4414
Mailing Address
9541 MARGAUX DR BATON ROUGE, LA 70817
Mailing Phone
(985) 630-1656
Mailing Fax
(225) 644-4414
Medical School Name
OTHER
Graduation Year
2000
Is Sole Proprietor?
No
Enumeration Date
07-02-2007
Last Update Date
08-08-2012
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Therapist

Taxonomy Code
225100000X
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.
04755
License State
LA
Taxonomy Description
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1171W00000XOther Service Providers

Contractor

04755 (LA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
  • AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
  • AmeriHealth Caritas Next Gold Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Essential + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Signature + No Referrals - HMO
  • Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible - PPO
  • Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits - PPO
  • Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits - PPO
  • Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible - PPO
  • Blue Max Copay (PCP) 60/40 $6000 Standardized - PPO
  • Blue Max Copay (PCP) 75/55 $2000 Standardized - PPO
  • Blue Saver 60/40 $6100 - PPO
  • Blue Saver 90/70 $3400 - PPO
  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (L) - POS
  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (N) - POS
  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (S) - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (H) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (L) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (N) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (S) HSA Eligible - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (L) - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (N) - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (S) - POS

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
5C811OTHER (01)LAMEDICARD GROUP PTAN
721460193OTHER (01)LATAX ID PT AND HAND CENTER
4B693C811OTHER (01)LAMEDICARE GROUP MEMBER PTAN
$$$$$$$$$DOTHER (01)LABCBS PROV NUMBER
$$$$$$$$$AMEDICARE PIN (08)LA 

Medicare Participation & PECOS Enrollment Status

Malcolm Duplantis Jr is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • PECOS PAC ID: 6709854482

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20040921000239

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care

Electrical stimulation is a therapy method where mild electrical pulses are used to treat pain or stimulate muscles in certain areas. It's not for wound care but is part of a broader therapy plan. It's safe, non-invasive, and can help improve overall health.

This service was performed 143 times for 13 patients

Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes

This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.

This service was performed 287 times for 19 patients

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes

This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.

This service was performed 584 times for 23 patients

Therapy procedure using functional activities

A therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.

This service was performed 311 times for 18 patients

Therapy procedure using manual technique, each 15 minutes

This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.

This service was performed 359 times for 19 patients

Training for self-care or home management, each 15 minutes

This service involves training sessions, each lasting 15 minutes, focused on teaching you essential self-care or home management skills. You'll learn techniques to manage your health condition at home, promoting independence and enhancing your quality of life.

This service was performed 22 times for 13 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.9 for a new patient copayment and $16.76 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 70737 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $83.6
  • Minimum New Patient Price $53.43
  • Maximum New Patient Price $164.73
  • Average New Patient Copayment $20.9
  • Minimum New Patient Copayment $13.35
  • Maximum New Patient Copayment $41.18

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.06
  • Minimum Established Patient Price $16.64
  • Maximum Established Patient Price $133.62
  • Average Established Patient Copayment $16.76
  • Minimum Established Patient Copayment $4.16
  • Maximum Established Patient Copayment $33.4

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1285831271, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
5
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
3
Unchanged
Pos 7
1
Doubled → 2
Pos 8
2
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 8 → 16 → 7 1 → 2 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 6 + 5 + 1 + 6 + 3 + 2 + 2 + 1 + 4 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1285831271.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Occupational Therapist (Hand)
211 E WORTHY ST, BUILDING IV
GONZALES, LA 70737
Physical Therapist
211 E WORTHY ST, BUILDING 4
GONZALES, LA 70737
Physical Therapist (Neurology)
211 E WORTHY ST
GONZALES, LA 70737

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285831271, enumerated as an "individual" on July 02, 2007.

The provider is located at 211 E WORTHY ST BLDG IV GONZALES, LA 70737 and the phone number is (225) 644-7044.

Physical Therapist with taxonomy code 225100000X.

The provider might be accepting Accepts: AmeriHealth Caritas Next, Blue Cross and Blue. Please consult your insurance carrier or call the provider to verify.