DR. WILLIAM P. GRABENSTEIN M.D. NPI 1003013160

Family Medicine in Clarksville, TN

NPI 1003013160 Individual Male Years of Experience 37 Family Medicine PECOS Enrolled May Accept Medicare Approved Payment

NPI Profile for DR. WILLIAM P. GRABENSTEIN M.D.

William Grabenstein is a primary care provider established in Clarksville, Tennessee and his medical specialization is family medicine with more than 37 years of experience. He graduated from University Of Tennessee, Hsc, College Of Medicine in 1985. The NPI number of William Grabenstein is 1003013160 and was 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 7 years ago.

A primary care provider (PCP) like Dr. William P. Grabenstein M.d. 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 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.

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. According to Medicare claims data he has hospital affiliations with Tennova Healthcare-clarksville and Saint Thomas West Hospital.

NPI

1003013160

Provider NameDR. WILLIAM P. GRABENSTEIN M.D.
Provider Location Address1822 MEMORIAL DR CLARKSVILLE, TN 37043
Provider Mailing Address1822 MEMORIAL DR CLARKSVILLE, TN 37043
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year1985
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date06-29-2007
Last Update Date07-29-2015


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.MD017935
License StateTN
Taxonomy DescriptionFamily 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.

Business Address

DR. WILLIAM P. GRABENSTEIN M.D.
1822 MEMORIAL DR
CLARKSVILLE, TN
ZIP 37043
Phone: (931) 552-8012
Fax: (931) 551-3118

Get Directions


Mailing Address

DR. WILLIAM P. GRABENSTEIN M.D.
1822 MEMORIAL DR
CLARKSVILLE, TN
ZIP 37043
Phone: (931) 552-8012
Fax: (931) 551-3118



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 ID6103863931
PECOS Enrollment IDI20050419001400
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 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 DevicesYes

Clinician Utilization

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 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 118Administration of influenza virus vaccine (HCPCS:G0008)
  • 85Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
  • 29Destruction of skin growth (HCPCS:17000)
  • 26Urinalysis, manual test (HCPCS:81002)
  • 18Destruction of 2-14 skin growths (HCPCS:17003)
  • 17Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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 CMS Certification Number (CCN) Overall Rating
TENNOVA HEALTHCARE-CLARKSVILLE651 DUNLOP LANE
CLARKSVILLE, TN 37040
(931) 502-1000Acute Care Hospitals440035
SAINT THOMAS WEST HOSPITAL4220 HARDING RD, PO BOX 380
NASHVILLE, TN 37205
(615) 222-2111Acute Care Hospitals440082

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes 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

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.
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

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. William P. Grabenstein M.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.