Individual provider Active NPI

Mahlon Paul Poche Jr., MD

  • Emergency Medicine Physician
  • Metairie, LA
National Provider Identifier
1992772263
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.021487 Issued in LA
Practice address
3131 North I-10 Service Road East
Suite 308
Metairie, LA 70002-0000
Phone
(504) 833-7770
Fax
(504) 833-7796
NPI assigned
Mar 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.021487 LA Primary

Addresses

Primary practice location

3131 North I-10 Service Road East
Suite 308
Metairie, LA 70002-0000

Mailing address

3131 North I-10 Service Road East
Suite 308
Metairie, LA 70002-0000
Phone (504) 833-7770

Other practice location 1

1310 W 7th St
Kaplan, LA 70548-2910
Phone (337) 643-8300

Other identifiers 1

IdentifierTypeStateIssuer
1929239MedicaidLA

Other names 1

  • Dr. Mahlon Poche Other name

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
I20040811000822 LA Practitioner - Emergency MedicinePractitioner - Family Practice 2466424213 Reassigns benefits to 7 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0121LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Concord North Texas, PLLC Emergency Medicine CurrentSince Apr 1, 2020 Accepting new patients
South Central Physicians PLLC CurrentSince Jul 11, 2021 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Jul 11, 2021 Accepting new patients
Lafourche Parish Hospital Service District No.1 Emergency Medicine CurrentSince Apr 10, 2009 Accepting new patients
Thibodaux Emergency Physicians Group LLC Emergency Medicine CurrentSince Nov 12, 2016 Accepting new patients
Lafourche Parish Hospital Service District No.1 CurrentSince Apr 10, 2009 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Jul 11, 2021 Accepting new patients
Calcasieu Cameron Emergency Physician Group LLC Emergency Medicine CurrentSince Apr 1, 2015 Accepting new patients
Sheridan Emergency Physician Services, Inc Emergency Medicine Past Accepting new patients
C&M Medical Services-St Charles LLC Past Accepting new patients

Locations

323 W Walnut Ave
Bastrop, LA 71220
Phone (318) 283-3600

200 W 134th Pl
Cut Off, LA 70345
Phone (985) 325-9300

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

1700 EE Wallace Blvd N
Ferriday, LA 71334
Phone (318) 281-2448

165 Beech Springs Rd
Jonesboro, LA 71251
Phone (318) 259-4435

701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4270

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1141430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1992772263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 NORTH I-10 SERVICE ROAD EAST",
            "address_2": "SUITE 308",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700020000",
            "telephone_number": "504-833-7770",
            "fax_number": "504-833-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 NORTH I-10 SERVICE ROAD EAST",
            "address_2": "SUITE 308",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700020000",
            "telephone_number": "504-833-7770",
            "fax_number": "504-833-7796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Kaplan",
            "state": "LA",
            "postal_code": "705482910",
            "country_code": "US",
            "telephone_number": "337-643-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POCHE",
        "first_name": "MAHLON",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-04",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.021487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1929239",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAHLON",
            "last_name": "POCHE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.