Individual provider Active NPI

Jack William Ploen

  • Certified Registered Nurse Anesthetist
  • Metairie, LA
National Provider Identifier
1922886258
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
201297 Issued in LA
Practice address
1517 Huron Ave
Metairie, LA 70005-1237
Phone
(985) 707-2829
NPI assigned
Sep 18, 2023
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 201297 LA Primary

Addresses

Primary practice location

1517 Huron Ave
Metairie, LA 70005-1237

Mailing address

1517 Huron Ave
Metairie, LA 70005-1237
Phone (985) 707-2829

Other practice location 1

15790 Paul Vega Md Dr
Hammond, LA 70403-1436
Phone (985) 230-2198

Other identifiers 1

IdentifierTypeStateIssuer
201297OtherLALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260618004469 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375015423 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Oaks Medical Center LLCGroup PAC ID 2466629522, shared by 7 NPIs, 317 clinicians

Practice addresses (Care Compare)

15790 Paul Vega MD Dr
Hammond, LA 70403-1434

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1922886258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 HURON AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700051237",
            "telephone_number": "985-707-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 HURON AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700051237",
            "telephone_number": "985-707-2829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15790 Paul Vega Md Dr",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "LA",
            "postal_code": "704031436",
            "country_code": "US",
            "telephone_number": "985-230-2198",
            "fax_number": "985-230-2159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLOEN",
        "first_name": "JACK",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "201297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "201297",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.