SPENCER WAYNE PINION MD
NPI 1326346164
Family Medicine in Covington, LA

Active since March 02, 2011PECOS EnrolledAccepts Medicare Assignment
56 STARBRUSH CIR, COVINGTON, LA 70433(330) 364-4461 Get Directions Write a Review

NPPES record last updated: August 8, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 8, 2022, Aug 1, 2022 (2 updates tracked since 2022).

About Spencer Wayne Pinion Md NPPES

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

SPENCER WAYNE PINION MD (NPI 1326346164) is an individual family medicine provider in Covington, Louisiana, licensed in Louisiana (332740) and active in the NPI registry since March 2011. He is enrolled in Medicare PECOS, is affiliated with St Tammany Parish Hospital, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1326346164
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameSPENCER WAYNE PINIONCredential: MD
Location Address56 STARBRUSH CIRCovington, LA 70433-7208
Mailing Address56 Starbrush CirCovington, LA 70433-7208 · (985) 246-5670 · Fax (985) 246-5667
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateMarch 2, 2011
Last NPPES UpdateAugust 8, 20222 updates tracked since enumeration
NPPES CertifiedAugust 5, 2022
NPI 1326346164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses Licensed in LA · 332740 Licensed in OH · 35122354 Licensed in OH · TRAINING CERTIFICATE
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
56 STARBRUSH CIR, Covington, LA 70433

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

Spencer Wayne Pinion 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 ID2062641368
PECOS Enrollment IDI20220818002200
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 12

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 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.
391 services140 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.
60 services47 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
50 services50 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
48 services48 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.
32 services28 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
27 services18 patients

Hospital Affiliations CMS Care Compare 2

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

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

East Jefferson General Hospital

Acute Care Hospitals · Metairie, LA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number190176
Location4200 Houma BlvdMetairie, LA 70006 · Jefferson County
Emergency services Birthing friendly

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
$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.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers25 claims42 services$5.18 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
4 suppliers11 claims12 services$1.08 avg. paid by Medicare
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314
DME-Orthotic Devices · category DF000N
1 supplier11 claims11 services$24.36 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
1 supplier11 claims11 services$9.35 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
3 suppliers12 claims67 services$2.61 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 12

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

General Practice
56 STARBRUSH CIR
COVINGTON, LA 70433
Internal Medicine
56 STARBRUSH CIR
COVINGTON, LA 70433
Licensed Practical Nurse
56 STARBRUSH CIR
COVINGTON, LA 70433
Internal Medicine
56 STARBRUSH CIR
COVINGTON, LA 70433
Internal Medicine (Infectious Disease)
56 STARBRUSH CIR
COVINGTON, LA 70433
Nurse Practitioner (Family)
56 STARBRUSH CIR
COVINGTON, LA 70433
Physician Assistant (Medical)
56 STARBRUSH CIR
COVINGTON, LA 70433
Clinical Nurse Specialist (Adult Health)
56 STARBRUSH CIR
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 Spencer Pinion's NPI number?

The NPI number for Spencer Pinion is 1326346164. It was assigned to this individual provider in the NPPES registry on March 2, 2011.

Where is Spencer Pinion located?

Spencer Pinion practices at 56 Starbrush Cir, Covington, LA 70433. The listed phone number is (330) 364-4461.

What is Spencer Pinion's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Spencer Pinion enrolled in Medicare?

Yes. Spencer Pinion 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 Spencer Pinion accept?

Health plans from Blue Cross and Blue Shield of Louisiana, CareSource, HMO Louisiana and UnitedHealthcare list Spencer Pinion 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 Spencer Pinion affiliated with any hospitals?

According to CMS data, Spencer Pinion is affiliated with St Tammany Parish Hospital and East Jefferson General Hospital.

When was this NPI record last updated?

The NPPES record for Spencer Pinion was last updated on August 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.