Individual provider Active NPI

Dylan Edward Poche, MD

  • Family Medicine Physician
  • Lutcher, LA
National Provider Identifier
1093219867
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
323165 Issued in LA
Practice address
1645 Lutcher Ave
Lutcher, LA 70071-5150
Phone
(225) 869-3493
NPI assigned
Mar 19, 2018
Last updated
Jan 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 323165 LA
Family Medicine Physician 207Q00000X 323165 LA Primary

Addresses

Primary practice location

1645 Lutcher Ave
Lutcher, LA 70071-5150

Mailing address

1645 Lutcher Ave
Lutcher, LA 70071-5150
Phone (225) 869-3493

Other practice location 1

2390 W Congress St
Lafayette, LA 70506-4205
Phone (337) 261-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201124000806 LA Practitioner - Family Practice 6507277514 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. James Parish Hosp Serv DistGroup PAC ID 3476459850, shared by 5 NPIs, 10 clinicians

Practice addresses (Care Compare)

1645 Lutcher Ave
Lutcher, LA 70071-5150
Phone (225) 258-5901

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.29 of 100Reported as group
Quality
64.64
Promoting interoperability
99
Improvement activities
40
Cost
73.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
323165LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vermilion Emergency Group LLC Emergency Medicine CurrentSince Oct 5, 2020 Accepting new patients
St James Parish Hosp Serv Dist CurrentSince Aug 9, 2021 Accepting new patients
St. James Parish Hosp. Serv. Dist. CurrentSince Aug 9, 2021 Accepting new patients
St. James Parish Hosp Serv Dist Family Medicine CurrentSince Aug 30, 2021 Accepting new patients
C & M Medical Services, Inc. CurrentSince Aug 1, 2021 Accepting new patients
St. James Parish Hosp Serv Dist Emergency Medicine Past Accepting new patients

Locations

301 Walnut St
Amite, LA 70422
Phone (985) 748-7141

1310 W 7th St
Kaplan, LA 70548
Phone (318) 643-8300

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

1645 Lutcher Ave
Lutcher, LA 70071
Phone (225) 258-5901

2202 False River Dr
New Roads, LA 70760
Phone (225) 638-5702

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1093219867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 LUTCHER AVE",
            "city": "LUTCHER",
            "state": "LA",
            "postal_code": "700715150",
            "telephone_number": "225-869-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 LUTCHER AVE",
            "city": "LUTCHER",
            "state": "LA",
            "postal_code": "700715150",
            "telephone_number": "225-869-3493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2390 W Congress St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705064205",
            "country_code": "US",
            "telephone_number": "337-261-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POCHE",
        "first_name": "DYLAN",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "323165",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "323165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutcher, LA

Sources for this page

Verify at the official NPI Registry.