Randall C Poche, M.D.

Individual provider Active NPI Family Medicine Physician · Lutcher, LA

NPI 1730255696 · NPPES record last updated Jun 13, 2017

Key facts

NPI
1730255696
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
LA16676 (LA)
Practice address
1645 Lutcher Ave
Lutcher, LA 70071-5150
Phone
(225) 869-3493
Fax
(225) 869-9333
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Medicare Care Compare profile

Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. James Parish Hosp Serv Dist (10 clinicians)

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • St James Parish Hospital Hospital · Lutcher, LA · CCN 191305
  • Ochsner Medical Center-Kenner Hospital · Kenner, LA · CCN 190274

Merit-based Incentive Payment System (MIPS)

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St. James Parish Hospital
Lutcher, LA · CCN 191305
Hospital Corporate Director Jul 21, 2021
St. James Parish Hosp Serv Dist
Lutcher, LA · CCN 19Z305
Hospital Corporate Director Jul 21, 2021

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100816000284 LA Practitioner - Family Practice 8527111723 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
016676LAMDPharmacist
LA16676LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St James Parish Hosp Serv Dist Current
since Jun 1, 2013
Accepting new patients
St. James Parish Hosp Serv Dist Family Medicine Current
since Jun 1, 2013
Accepting new patients
St. James Parish Hosp. Serv. Dist. Current
since Jun 1, 2013
Accepting new patients
St. James Parish Hosp Serv Dist Family Medicine Past Accepting new patients

Locations

1731 Lutcher Ave
Lutcher, LA 70071
Phone (225) 258-2040

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LA16676 LA Yes

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 identifiers

IdentifierTypeStateIssuer
1347655MedicaidLA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 13, 2017.

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497312000000",
    "number": "1730255696",
    "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",
            "fax_number": "225-869-9333"
        },
        {
            "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",
            "fax_number": "225-869-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POCHE",
        "first_name": "RANDALL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2017-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "LA16676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1347655",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutcher, LA

All providers in Lutcher, LA · Family Medicine Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.