Individual provider Active NPI

David Craig Pellegrin, M.D.

  • Gastroenterology Physician
  • Houma, LA
National Provider Identifier
1679662936
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
18280 Issued in LA
Practice address
8120 Main St
Suite 200
Houma, LA 70360-3403
Phone
(985) 851-5206
Fax
(985) 851-5224
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 18280 LA Primary

Addresses

Primary practice location

8120 Main St
Suite 200
Houma, LA 70360-3403

Mailing address

8120 Main St
Suite 200
Houma, LA 70360-3403
Phone (985) 851-5206

Other identifiers 1

IdentifierTypeStateIssuer
1399191MedicaidLA

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
I20110411000799 LA Practitioner - Gastroenterology 7416131792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8120 Main St
Suite 200
Houma, LA 70360-3403
Phone (985) 851-5206

Hospital & facility affiliations

  • Terrebonne General Medical Center - Parish Hospital, Houma, LA, CCN 190008
  • Thibodaux Regional Medical Center Hospital, Thibodaux, LA, CCN 190004
  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy229
Upper gastrointestinal (GI) endoscopy for acid reflux260

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18280LAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Center of the South, Apmc Gastroenterology CurrentSince Oct 1, 1992 Accepting new patients

Locations

8120 Main St
Ste 200
Houma, LA 70360
Phone (504) 851-5206

Interoperability endpoints

  • Direct secure messaging: pdavid407348@direct.ochsner.org

Organizations & group practices 1

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

Hospital & facility affiliations 3

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679662936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 MAIN ST",
            "address_2": "SUITE 200",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703603403",
            "telephone_number": "985-851-5206",
            "fax_number": "985-851-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 MAIN ST",
            "address_2": "SUITE 200",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703603403",
            "telephone_number": "985-851-5206",
            "fax_number": "985-851-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRIN",
        "first_name": "DAVID",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "LA",
            "license": "18280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1399191",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.