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CLAUDE WILLIAM GILBREATH M.D.
NPI 1356324594
Family Medicine in Hammond, LA

Active since November 22, 2005PECOS EnrolledAccepts Medicare Assignment
74.66/100
CMS Quality Rating
16052 DOCTORS BLVD, HAMMOND, LA 70403(985) 345-9606(985) 345-9616 Get Directions Write a Review

NPPES record last updated: August 6, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Claude William Gilbreath M.d. NPPES

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

CLAUDE WILLIAM GILBREATH M.D. (NPI 1356324594) is an individual family medicine provider in Hammond, Louisiana, licensed in Louisiana (10557R) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with North Oaks Medical Center, and is a graduate of Louisiana State University School Of Medicine In New Orleans (1993).

NPPES Registry Identity

NPI1356324594
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameCLAUDE WILLIAM GILBREATHCredential: M.D.
Location Address16052 DOCTORS BLVDHammond, LA 70403-1478
Mailing AddressPo Box 280Ponchatoula, LA 70454-0280 · (985) 345-9606 · Fax (985) 345-9616
Phone(985) 345-9606
Fax(985) 345-9616
Sole ProprietorNo
Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 1993
Enumeration DateNovember 22, 2005
Last NPPES UpdateAugust 6, 2008
✔ NPI 1356324594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in LA · 10557R
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.

16052 DOCTORS BLVD, Hammond, LA 70403
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Other Identifiers 6

OtherP00132265LA · Railroad Medicare
Medicare PIN5U808C822LA
Medicare UPINF92693LA
OtherP00174982LA · Rrm
Medicare ID-Type Unspecified5U808LA
Medicaid1659304LA

Accepted Insurance

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

Claude William Gilbreath 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 ID2567441462
PECOS Enrollment IDI20040715000065
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.

Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
888 services98 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.
407 services234 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.
386 services267 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.
307 services307 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
58 services58 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
38 services35 patients

Hospital Affiliations CMS Care Compare 3

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

North Oaks Medical Center

Acute Care Hospitals · Hammond, LA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number190015
Location15790 Paul Vega MD DriveHammond, LA 70403 · Tangipahoa 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

Cypress Pointe Surgical Hospital

Acute Care Hospitals · Hammond, LA
OwnershipPhysician
CMS Certification Number190303
Location42570 South Airport RdHammond, LA 70403 · Tangipahoa County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70403 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.

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.

74.66/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.77
Promoting Interoperability98
Improvement Activities40
Cost37.42

Referred Medical Equipment & Supplies CMS DME claims 12

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
8 suppliers27 claims42 services$6.06 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
4 suppliers23 claims23 services$88.53 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
3 suppliers16 claims45 services$30.15 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
3 suppliers11 claims66 services$20.46 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
4 suppliers13 claims13 services$59.37 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
5 suppliers24 claims24 services$19.18 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 3

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

JOHN A WALKER JR. M.D.
Family Medicine
16052 DOCTORS BLVD
HAMMOND, LA 70403
Tangipahoa Parish (985) 345-9606
MAGGIE SMITH NP
Nurse Practitioner (Family)
16052 DOCTORS BLVD
HAMMOND, LA 70403
Tangipahoa Parish (985) 345-9606
KACIE BLACKWELL APRN
Nurse Practitioner (Family)
16052 DOCTORS BLVD
HAMMOND, LA 70403
Tangipahoa Parish (985) 945-9606

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 Claude Gilbreath's NPI number?

The NPI number for Claude Gilbreath is 1356324594. It was assigned to this individual provider in the NPPES registry on November 22, 2005.

Where is Claude Gilbreath located?

Claude Gilbreath practices at 16052 Doctors Blvd, Hammond, LA 70403. The listed phone number is (985) 345-9606.

What is Claude Gilbreath's specialty?

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

Is Claude Gilbreath enrolled in Medicare?

Yes. Claude Gilbreath 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 Claude Gilbreath accept?

Health plans from Blue Cross and Blue Shield of Louisiana, HMO Louisiana and UnitedHealthcare list Claude Gilbreath 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 Claude Gilbreath affiliated with any hospitals?

According to CMS data, Claude Gilbreath is affiliated with North Oaks Medical Center, St Tammany Parish Hospital and Cypress Pointe Surgical Hospital.

When was this NPI record last updated?

The NPPES record for Claude Gilbreath was last updated on August 6, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.