DR. WILLIAM P. GRABENSTEIN M.D.
NPI 1003013160
Family Medicine in Clarksville, TN

NPI Status: Active since June 29, 2007

Contact Information

1822 MEMORIAL DR
CLARKSVILLE, TN
ZIP 37043
Phone: (931) 552-8012
Fax: (931) 551-3118

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  • Individual
  • Male
  • Years of Experience 39
  • Family Medicine
  • PECOS Enrolled
  • May Accept Medicare Approved Payment

About WILLIAM GRABENSTEIN

William Grabenstein is a primary care provider established in Clarksville, Tennessee and his medical specialization is Family Medicine with more than 39 years of experience. He graduated from University Of Tennessee, Hsc, College Of Medicine in 1985. The healthcare provider is registered in the NPI registry with number 1003013160 assigned on June 2007. The practitioner's primary taxonomy code is 207Q00000X with license number MD017935 (TN). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1003013160
Provider Name
DR. WILLIAM P. GRABENSTEIN M.D.
Gender
Male
Entity Type
Individual
Location Address
1822 MEMORIAL DR CLARKSVILLE, TN 37043
Location Phone
(931) 552-8012
Location Fax
(931) 551-3118
Mailing Address
1822 MEMORIAL DR CLARKSVILLE, TN 37043
Mailing Phone
(931) 552-8012
Mailing Fax
(931) 551-3118
Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year
1985
Is Sole Proprietor?
Yes
Enumeration Date
06-29-2007
Last Update Date
07-29-2015
Code Navigator

A primary care provider (PCP) like William Grabenstein sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

William Grabenstein is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
MD017935
License State
TN
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

The NPI profile data suggests this provider may be accepting health plans from these insurance companies or healthcare programs:

  • Blue Cross Blue Shield
  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
4102307OTHER (01)TNBLUE CROSS BLUE SHIELD
3728817MEDICAID (05)TN 
0003031899MEDICARE NSC (07)TN 
3728817OTHER (01)TNMEDICARE PTAN
A99546MEDICARE UPIN (02)TN 

PECOS Enrollment and Medicare Participation Status

William Grabenstein 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), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6103863931

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20050419001400

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Maybe

    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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 37043 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.32
  • Minimum New Patient Price $54.58
  • Maximum New Patient Price $167.19
  • Average New Patient Copayment $21.08
  • Minimum New Patient Copayment $13.64
  • Maximum New Patient Copayment $41.79

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $97.84
  • Minimum Established Patient Price $16.86
  • Maximum Established Patient Price $136.82
  • Average Established Patient Copayment $24.46
  • Minimum Established Patient Copayment $4.21
  • Maximum Established Patient Copayment $34.2

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

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 210

    Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)

  • 116

    Administration of influenza virus vaccine (HCPCS:G0008)

  • 50

    Urinalysis, manual test (HCPCS:81002)

  • 35

    Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)

  • 30

    Destruction of skin growth (HCPCS:17000)

  • 18

    Removal of impact ear wax, one ear (HCPCS:69210)

  • 17

    Destruction of 2-14 skin growths (HCPCS:17003)

  • 17

    Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. William Grabenstein is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
TENNOVA HEALTHCARE-CLARKSVILLE651 DUNLOP LANE
CLARKSVILLE, TN 37040
(931) 502-1000Acute Care Hospitals
SAINT THOMAS WEST HOSPITAL4220 HARDING RD, PO BOX 380
NASHVILLE, TN 37205
(615) 222-2111Acute Care Hospitals

Reviews for DR. WILLIAM P. GRABENSTEIN M.D.

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NPI Validation Check Digit Calculation


The following table explains the step by step 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.
1003013160
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003016112
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 6 + 1 + 1 + 2 + 24 = 40
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1003013160 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1457558512MRS. TONYA C. KRANTZ PA-C
Individual
Physician Assistant1822 MEMORIAL DR
CLARKSVILLE, TN 37043
(931) 552-8012

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003013160, enumerated in the NPI registry as an "individual" on June 29, 2007

The provider is located at 1822 Memorial Dr Clarksville, Tn 37043 and the phone number is (931) 552-8012

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 39 years of experience. He graduated from University Of Tennessee, Hsc, College Of Medicine in 1985.

The provider might be accepting Blue Cross Blue Shield, Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of April 12, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $84.32 with an average copayment of $21.08 for new patient appointments. Established patients should expect a typical charge of $97.84 and an average copayment of 24.46. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Injection beneath the skin or into muscle for therapy, diagnosis, or prevention, Administration of influenza virus vaccine, Urinalysis, manual test, Injection, triamcinolone acetonide, not otherwise specified, 10 mg, Destruction of skin growth, Removal of impact ear wax, one ear, Destruction of 2-14 skin growths and Aspiration and/or injection of large joint or joint capsule.

The practitioner is affiliated to the following hospital(s): TENNOVA HEALTHCARE-CLARKSVILLE and SAINT THOMAS WEST HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 29, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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