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DR. PEDRO N ROMAGUERA MD
NPI 1659303857
Internal Medicine in Metairie, LA

Active since July 07, 2006PECOS EnrolledAccepts Medicare Assignment
3901 HOUMA BLVD STE 501, METAIRIE, LA 70006(504) 779-3507(504) 779-3508 Get Directions Write a Review

NPPES record last updated: February 22, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 22, 2023, Aug 4, 2022, Nov 17, 2021 and 2 more (5 updates tracked since 2017).

About Dr. Pedro N Romaguera Md NPPES

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

DR. PEDRO N ROMAGUERA MD (NPI 1659303857) is an individual internal medicine provider in Metairie, Louisiana, licensed in Louisiana (MD.09148R) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with East Jefferson General Hospital, and is a graduate of Other (1989).

NPPES Registry Identity

NPI1659303857
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. PEDRO N ROMAGUERACredential: MD
Location Address3901 HOUMA BLVD STE 501Metairie, LA 70006-2927
Mailing Address3901 Houma Blvd Ste 501Metairie, LA 70006-2927 · (504) 779-3507 · Fax (504) 779-3508
Phone(504) 779-3507
Fax(504) 779-3508
Sole ProprietorYes
Medical School CMSOtherGraduated 1989
Enumeration DateJuly 7, 2006
Last NPPES UpdateFebruary 22, 20235 updates tracked since enumeration
NPPES CertifiedFebruary 22, 2023
✔ NPI 1659303857 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 · MD.09148R
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.
3901 HOUMA BLVD STE 501, Metairie, LA 70006
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Other Identifiers 1

Medicaid1932523LA

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 Magnolia Health and more.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

Dr. Pedro N Romaguera 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 ID6103801196
PECOS Enrollment IDI20040623000551
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 14

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 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.
252 services42 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.
110 services41 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.
85 services28 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
56 services32 patients
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
53 services26 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.
27 services27 patients

Hospital Affiliations CMS Care Compare

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

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 70006 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
$128.88 typical visit price
range $55.50 – $170.30
Typical copayment $32.22 (range $13.87 – $42.57)
Most-billed visit code 99204
Established Patient
$98.35 typical visit price
range $17.42 – $138.03
Typical copayment $24.58 (range $4.35 – $34.50)
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

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
11%269 patients1/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
7%107 patients1/55-star benchmark: 100%
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…
33%511 patients2/55-star benchmark: 97%
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 15

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

Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
2 suppliers14 claims700 services$0.21 avg. paid by Medicare
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196
DME-Medical/Surgical Supplies · category DA023N
2 suppliers11 claims376 services$7.13 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
2 suppliers33 claims1,016 services$4.06 avg. paid by Medicare
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4036
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims372 services$3.39 avg. paid by Medicare
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4149
Other-Enteral and Parenteral · category OB006N
1 supplier13 claims5,028 services$0.88 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier20 claims8,495 services$0.27 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.

NOVA HEALTH LLC
Chiropractor (Rehabilitation)
3901 HOUMA BLVD STE 501
METAIRIE, LA 70006
Jefferson Parish (504) 344-1047

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 Pedro Romaguera's NPI number?

The NPI number for Pedro Romaguera is 1659303857. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Where is Pedro Romaguera located?

Pedro Romaguera practices at 3901 Houma Blvd Ste 501, Metairie, LA 70006. The listed phone number is (504) 779-3507.

What is Pedro Romaguera's specialty?

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

Is Pedro Romaguera enrolled in Medicare?

Yes. Pedro Romaguera 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 Pedro Romaguera accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter from Superior HealthPlan and Blue Cross and Blue Shield of Louisiana and 2 other insurers list Pedro Romaguera 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 Pedro Romaguera affiliated with any hospitals?

According to CMS data, Pedro Romaguera is affiliated with East Jefferson General Hospital.

When was this NPI record last updated?

The NPPES record for Pedro Romaguera was last updated on February 22, 2023. 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.