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DR. DAVID CRAIG PELLEGRIN M.D.
NPI 1679662936
Internal Medicine - Gastroenterology in Houma, LA

Active since October 12, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
8120 MAIN ST, SUITE 200, HOUMA, LA 70360(985) 851-5206(985) 851-5224 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. David Craig Pellegrin M.d. NPPES

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

DR. DAVID CRAIG PELLEGRIN M.D. (NPI 1679662936) is an individual gastroenterology provider in Houma, Louisiana, licensed in Louisiana (18280) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Thibodaux Regional Medical Center, and is a graduate of Other (1985).

NPPES Registry Identity

NPI1679662936
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. DAVID CRAIG PELLEGRINCredential: M.D.
Location Address8120 MAIN ST, SUITE 200Houma, LA 70360-3403
Mailing Address8120 Main St, Suite 200Houma, LA 70360-3403 · (985) 851-5206 · Fax (985) 851-5224
Phone(985) 851-5206
Fax(985) 851-5224
Sole ProprietorNo
Medical School CMSOtherGraduated 1985
Enumeration DateOctober 12, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1679662936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in LA · 18280
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
8120 MAIN ST, Houma, LA 70360
Open in Google Maps ↗

Other Identifiers 3

Medicare UPINC73872LA
Medicaid1399191LA
Medicare ID-Type Unspecified548197163LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, HMO Louisiana.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. David Craig Pellegrin 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 ID7416131792
PECOS Enrollment IDI20110411000799
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 David Pellegrin reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Gastroenterology Center Of The South, Apmc
Same address
Gastroenterology
8120 MAIN ST, SUITE 200
Houma, LA 70360
  • Reassigned Medicare billing, Louisiana enrollment
NPI 1992723571 (985) 851-5206
Physician Practice Partners
0.1 mi
Internal Medicine
8166 MAIN ST
Houma, LA 70360
  • Reassigned Medicare billing, Louisiana enrollment
  • 168 clinicians in this Medicare group
NPI 1326598434 (985) 873-4751

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 13

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 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.
404 services310 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.
154 services139 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
153 services153 patients
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211
This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
138 services137 patients
Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235
This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.
119 services115 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
78 services78 patients

Hospital Affiliations CMS Care Compare 3

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

Thibodaux Regional Medical Center

Acute Care Hospitals · Thibodaux, LA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190004
Location602 N Acadia RoadThibodaux, LA 70301 · Lafourche County
Emergency services Birthing friendly

Terrebonne General Medical Center - Parish

Acute Care Hospitals · Houma, LA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number190008
Location8166 Main StreetHouma, LA 70360 · Terrebonne County
Emergency services Birthing friendly

Ochsner Medical Center Acute

Acute Care Hospitals · New Orleans, LA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190036
Location1516 Jefferson HwyNew Orleans, LA 70121 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70360 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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
22%778 patients2/55-star benchmark: 85%
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
79%24 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.
54%2,051 patients1/55-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%3,182 patients5/55-star benchmark: 99%
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.
72%1,326 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.
52%2,321 patients3/55-star benchmark: 97%
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…
21%1,441 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 453 patients
Patients tobacco: 99% · 453 patients
93%44 patients4/55-star benchmark: 98%
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…
97%2,321 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%2,321 patients1/55-star benchmark: 89%
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+: 0% · 725 patients
1%725 patients4/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
7%2,321 patients
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.

Other Providers at the Same Location NPPES 20

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

ERIN HALEY PENNISON M.D.
Obstetrics & Gynecology
8120 MAIN ST, SUITE 202
HOUMA, LA 70360
Terrebonne Parish (985) 223-8994
EMCO ANESTHETICS AND CONSULTING SERVICES, LLC
Anesthesiology
8120 MAIN ST, STE 202
HOUMA, LA 70360
Terrebonne Parish (985) 870-3629
COMPREHENSIVE CARE PLUS
Internal Medicine
8120 MAIN ST, SUITE 403
HOUMA, LA 70360
Terrebonne Parish (985) 868-3737
DR. FADI F ABOU-ISSA MD
Specialist
8120 MAIN ST, SUITE 301
HOUMA, LA 70360
Terrebonne Parish (985) 851-6680
OCHSNER CLINIC LLC
General Practice
8120 MAIN ST
HOUMA, LA 70360
Terrebonne Parish (504) 842-3900
PREMIER OBGYN SPECIALISTS, LLC
Obstetrics & Gynecology
8120 MAIN ST, SUITE 202
HOUMA, LA 70360
Terrebonne Parish (985) 223-8994
DR. KIMBERLEY JOYCE BARNER M.D.
Pediatrics (Adolescent Medicine)
8120 MAIN ST, SUITE 300
HOUMA, LA 70360
Terrebonne Parish (985) 872-2897
MS. DAWN ELIZABETH TOUPS LPC
Counselor
8120 MAIN ST, SUITE 405
HOUMA, LA 70360
Terrebonne Parish (985) 868-2756

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 David Pellegrin's NPI number?

The NPI number for David Pellegrin is 1679662936. It was assigned to this individual provider in the NPPES registry on October 12, 2006.

Where is David Pellegrin located?

David Pellegrin practices at 8120 Main St Suite 200, Houma, LA 70360. The listed phone number is (985) 851-5206.

What is David Pellegrin's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is David Pellegrin enrolled in Medicare?

Yes. David Pellegrin 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 David Pellegrin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), David Pellegrin reassigns Medicare benefits to 2 organizations: Gastroenterology Center Of The South, Apmc (Houma, LA) and Physician Practice Partners (Houma, 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 David Pellegrin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does David Pellegrin accept?

Health plans from Blue Cross and Blue Shield of Louisiana and HMO Louisiana list David Pellegrin 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 David Pellegrin affiliated with any hospitals?

According to CMS data, David Pellegrin is affiliated with Thibodaux Regional Medical Center, Terrebonne General Medical Center - Parish and Ochsner Medical Center Acute.

When was this NPI record last updated?

The NPPES record for David Pellegrin was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.