1. Home
  2. Directory
  3. Louisiana
  4. Franklinton
  5. Internal Medicine
  6. NPI Profile

DR. LUIS M ALVARADO M.D.
NPI 1396793998
Internal Medicine in Franklinton, LA

Active since May 05, 2006PECOS EnrolledAccepts Medicare Assignment
21012 HIGHWAY 16, FRANKLINTON, LA 70438(985) 795-0500(985) 795-0600 Get Directions Write a Review

NPPES record last updated: June 18, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 18, 2024, Apr 23, 2020 (2 updates tracked since 2020).

About Dr. Luis M Alvarado M.d. NPPES

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

DR. LUIS M ALVARADO M.D. (NPI 1396793998) is an individual internal medicine provider in Franklinton, Louisiana, licensed in Louisiana (10439R) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with St Tammany Parish Hospital, and maintains a secondary practice location in Mandeville.

NPPES Registry Identity

NPI1396793998
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. LUIS M ALVARADOCredential: M.D.
Location Address21012 HIGHWAY 16Franklinton, LA 70438-3668
Mailing Address21012 Highway 16Franklinton, LA 70438-3668 · (985) 795-0500 · Fax (985) 795-0600
Phone(985) 795-0500
Fax(985) 795-0600
Sole ProprietorYes
Medical School CMSOtherGraduated 1990
Enumeration DateMay 5, 2006
Last NPPES UpdateJune 18, 20242 updates tracked since enumeration
NPPES CertifiedJune 18, 2024
✔ NPI 1396793998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in LA · 10439R
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
21012 HIGHWAY 16, Franklinton, LA 70438
Open in Google Maps ↗

Secondary Practice Location 1

Location 14244 Highway 22 Ste 9Mandeville, LA 70471-1263 · Phone (985) 795-0500 · Fax (985) 795-0600

Other Identifiers 1

Medicaid1994715LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.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

Dr. Luis M Alvarado 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 ID5991831620
PECOS Enrollment IDI20100331001116
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 Reassignments

2

Medicare enrollment records show Luis Alvarado reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Luis M Alvarado
Same address
Internal Medicine
21012 HIGHWAY 16
Franklinton, LA 70438
  • Reassigned Medicare billing, Louisiana enrollment
NPI 1154766913 (985) 795-0500
St. Tammany Parish Hospital Service District No 1
22 mi
General Acute Care Hospital
1202 S TYLER ST
Covington, LA 70433
  • Reassigned Medicare billing, Louisiana enrollment
  • 183 clinicians in this Medicare group
NPI 1598798597 (985) 898-4000

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 10

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
374 services176 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.
209 services68 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
130 services20 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
96 services14 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
77 services74 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
48 services47 patients

Hospital Affiliations CMS Care Compare 3

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

Our Lady Of The Angels Hospital

Acute Care Hospitals · Bogalusa, LA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190312
Location433 Plaza StreetBogalusa, LA 70427 · Washington County
Emergency services Birthing friendly

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 70438 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
$124.60 typical visit price
range $53.43 – $164.73
Typical copayment $31.15 (range $13.35 – $41.18)
Most-billed visit code 99204
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
86%37 patients4/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
55%75 patients3/55-star benchmark: 85%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
62%47 patients3/55-star benchmark: 98%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
81%47 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%209 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%6,894 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
0%245 patients1/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
96%129 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
41%138 patients2/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
83%173 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
45%62 patients3/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
6%148 patients1/55-star benchmark: 96%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
1%129 patients1/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 1% · 138 patients
1%138 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 7

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
9 suppliers34 claims64 services$5.85 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers13 claims13 services$1.08 avg. paid by Medicare
Hospital bed, fixed height, with any type side rails, with mattress E0250
DME-Hospital Beds · category DB000N
1 supplier21 claims21 services$35.29 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier15 claims15 services$21.18 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers20 claims20 services$7.77 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier15 claims15 services$118.74 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

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

LUIS M ALVARADO
Internal Medicine
21012 HIGHWAY 16
FRANKLINTON, LA 70438
Washington Parish (985) 795-0500

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 Luis Alvarado's NPI number?

The NPI number for Luis Alvarado is 1396793998. It was assigned to this individual provider in the NPPES registry on May 5, 2006.

Where is Luis Alvarado located?

Luis Alvarado practices at 21012 Highway 16, Franklinton, LA 70438. The listed phone number is (985) 795-0500.

What is Luis Alvarado's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Luis Alvarado enrolled in Medicare?

Yes. Luis Alvarado 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.

Which organizations bill Medicare for Luis Alvarado's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Luis Alvarado reassigns Medicare benefits to 2 organizations: Luis M Alvarado (Franklinton, LA) and St. Tammany Parish Hospital Service District No 1 (Covington, LA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Luis Alvarado's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Luis Alvarado accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and AmeriHealth Caritas Next and 3 other insurers list Luis Alvarado 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 Luis Alvarado affiliated with any hospitals?

According to CMS data, Luis Alvarado is affiliated with St Tammany Parish Hospital, Our Lady Of The Angels Hospital and Riverside Medical Center.

When was this NPI record last updated?

The NPPES record for Luis Alvarado was last updated on June 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.