DR. JAMES SMERIGLIO O.D. NPI 1003011636

Optometrist in Hunt Valley, MD

NPI 1003011636 Individual Male Years of Experience 33 Optometrist PECOS Enrolled Accepts Medicare Approved Payment

NPI Profile for DR. JAMES SMERIGLIO O.D.

James Smeriglio is a provider established in Hunt Valley, Maryland and his medical specialization is optometrist with more than 33 years of experience. He graduated from Pennsylvania College Of Optometry in 1990. The NPI number of James Smeriglio is 1003011636 and was assigned on June 2007. The practitioner's primary taxonomy code is 152W00000X with license number TA1092 (MD). The provider is registered as an individual and his NPI record was last updated one year ago.

James Smeriglio is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

James Smeriglio is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The typical physician office visit costs for Medicare beneficiaries in this area are: $36.36 for a new patient copayment and $19.8 for an established patient copayment.

NPI

1003011636

Provider NameDR. JAMES SMERIGLIO O.D.
Provider Location Address118 SHAWAN RD STE S HUNT VALLEY, MD 21030
Provider Mailing Address1950 OLD GALLOWS RD STE 520 VIENNA, VA 22182
GenderMale
NPI Entity TypeIndividual
Medical School NamePENNSYLVANIA COLLEGE OF OPTOMETRY
Graduation Year1990
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-14-2007
Last Update Date02-16-2021


Primary Taxonomy

Taxonomy Code152W00000X
ClassificationOptometrist
TypeEye and Vision Services Providers
License No.TA1092
License StateMD
Taxonomy DescriptionDoctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Business Address

DR. JAMES SMERIGLIO O.D.
118 SHAWAN RD STE S
HUNT VALLEY, MD
ZIP 21030
Phone: (410) 584-8224
Fax: (410) 584-8225

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Mailing Address

DR. JAMES SMERIGLIO O.D.
1950 OLD GALLOWS RD STE 520
VIENNA, VA
ZIP 22182
Phone: (703) 847-8899
Fax: (571) 223-6780



PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID2163673096
PECOS Enrollment IDI20121127000120
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesNo

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 21030 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$63.64 $191.95 $145.45
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.91 $47.98 $36.36
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$19.91 $156.57 $79.21
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.97 $39.14 $19.8

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003011636
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200301266
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 2 + 6 + 6 + 24 = 44
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 44 = 66

The NPI number 1003011636 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. James Smeriglio O.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.