ANDREA G ESPINOZA M.D.
NPI 1700839495
Internal Medicine - Pulmonary Disease in Houma, LA

Active since May 17, 2006PECOS EnrolledAccepts Medicare Assignment
88.05/100
CMS Quality Rating
1990 INDUSTRIAL BLVD, HOUMA, LA 70363(985) 868-9300(985) 851-0053 Get Directions Write a Review

NPPES record last updated: October 4, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Andrea G Espinoza M.d. NPPES

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

ANDREA G ESPINOZA M.D. (NPI 1700839495) is an individual pulmonary disease provider in Houma, Louisiana, licensed in Louisiana (024932) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with East Jefferson General Hospital, and is a graduate of Louisiana State University School Of Medicine In New Orleans (2000).

NPPES Registry Identity

NPI1700839495
Entity TypeIndividualFemale
Primary Taxonomy207RP1001X
Provider Legal NameANDREA G ESPINOZACredential: M.D.
Location Address1990 INDUSTRIAL BLVDHouma, LA 70363-7055
Mailing Address1990 Industrial BlvdHouma, LA 70363 · (985) 868-9300 · Fax (985) 851-0053
Fax(985) 851-0053
Sole ProprietorNo
Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 2000
Enumeration DateMay 17, 2006
Last NPPES UpdateOctober 4, 2012
NPI 1700839495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in LA · 024932
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
1990 INDUSTRIAL BLVD, Houma, LA 70363

Other Identifiers 3

Medicare PIN4K1597627LA
Medicare UPIN4K159LA
Medicaid1420867LA

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

Andrea G Espinoza 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 ID1153334990
PECOS Enrollment IDI20060724000094
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 4

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.
58 services29 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
20 services16 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.
14 services12 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
11 services11 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 70363 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.

88.05/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.6
Promoting Interoperability100
Improvement Activities40
Cost58.23

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.

Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
5 suppliers28 claims28 services$83.31 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers28 claims82 services$34.36 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
5 suppliers21 claims21 services$18.71 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
3 suppliers36 claims36 services$14.06 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers35 claims206 services$2.22 avg. paid by Medicare
Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046
DME-Other DME · category DE001N
3 suppliers17 claims17 services$12.32 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 20

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

Pathology (Anatomic Pathology & Clinical Pathology)
1990 INDUSTRIAL BLVD
HOUMA, LA 70363
Family Medicine (Sports Medicine)
1990 INDUSTRIAL BLVD
HOUMA, LA 70363
Emergency Medicine
1990 INDUSTRIAL BLVD
HOUMA, LA 70363
Radiology (Diagnostic Radiology)
1990 INDUSTRIAL BLVD
HOUMA, LA 70363
Nurse Practitioner (Family)
1990 INDUSTRIAL BLVD
HOUMA, LA 70363
Nurse Practitioner (Family)
1990 INDUSTRIAL BLVD
HOUMA, LA 70363
Internal Medicine (Gastroenterology)
1990 INDUSTRIAL BLVD
HOUMA, LA 70363
Nurse Practitioner (Acute Care)
1990 INDUSTRIAL BLVD
HOUMA, LA 70363

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 Andrea Espinoza's NPI number?

The NPI number for Andrea Espinoza is 1700839495. It was assigned to this individual provider in the NPPES registry on May 17, 2006.

Where is Andrea Espinoza located?

Andrea Espinoza practices at 1990 Industrial Blvd, Houma, LA 70363. The listed phone number is (985) 868-9300.

What is Andrea Espinoza's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Andrea Espinoza enrolled in Medicare?

Yes. Andrea Espinoza 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 Andrea Espinoza accept?

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

According to CMS data, Andrea Espinoza is affiliated with East Jefferson General Hospital.

When was this NPI record last updated?

The NPPES record for Andrea Espinoza was last updated on October 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.