SARA A. HENNESSY M.D. NPI 1003020264

Surgery in Culpeper, VA

NPI 1003020264 Individual Female Years of Experience 20 Surgery PECOS Enrolled Accepts Medicare Approved Payment

NPI Profile for SARA A. HENNESSY M.D.

Sara Hennessy is a provider established in Culpeper, Virginia and her medical specialization is surgery with more than 20 years of experience. She graduated from University Of Virginia School Of Medicine in 2002. The NPI number of Sara Hennessy is 1003020264 and was assigned on May 2007. The practitioner's primary taxonomy code is 208600000X with license number 0101254029 (VA). The provider is registered as an individual and her NPI record was last updated 9 years ago.

A surgeon like Sara A. Hennessy M.d. treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.

Sara Hennessy 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.

Sara Hennessy 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. According to Medicare claims data she has hospital affiliations with Ut Southwestern University Hospital - William P. Clements Jr..

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.59 for a new patient copayment and $18.37 for an established patient copayment.

NPI

1003020264

Provider Name SARA A. HENNESSY M.D.
Provider Location Address541 SUNSET LN SUITE 303 CULPEPER, VA 22701
Provider Mailing AddressPO BOX 9007 CHARLOTTESVILLE, VA 22906
GenderFemale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Graduation Year2002
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date05-09-2007
Last Update Date12-04-2013


Primary Taxonomy

Taxonomy Code208600000X
ClassificationSurgery
TypeAllopathic & Osteopathic Physicians
License No.0101254029
License StateVA
Taxonomy DescriptionA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Business Address

SARA A. HENNESSY M.D.
541 SUNSET LN
SUITE 303
CULPEPER, VA
ZIP 22701
Phone: (540) 825-2600
Fax: (540) 825-4026

Get Directions


Mailing Address

SARA A. HENNESSY M.D.
PO BOX 9007
CHARLOTTESVILLE, VA
ZIP 22906
Phone:



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 ID5597990135
PECOS Enrollment IDI20151009000657
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 DevicesYes

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 22701 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$58.76 $178.23 $90.36
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.69 $44.55 $22.59
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
$18.32 $145.63 $73.51
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.58 $36.4 $18.37

* 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.

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. Sara Hennessy is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
UT SOUTHWESTERN UNIVERSITY HOSPITAL - WILLIAM P. CLEMENTS JR.6201 HARRY HINES BLVD
DALLAS, TX 75390
(214) 633-5555Acute Care Hospitals450044

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program0116018514VANo

Taxonomy Description: an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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.
1003020264
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003020212
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 2 + 0 + 2 + 1 + 2 + 24 = 36
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
40 - 36 = 44

The NPI number 1003020264 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 15 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1437174513DR. ROBERT GOLUB M.D.
Individual
Specialist541 SUNSET LN SUITE 303
CULPEPER, VA 22701
(540) 825-2600
1922014372 PETER EDWARD GODFREY M.D.
Individual
Obstetrics & Gynecology541 SUNSET LN SUITE 301
CULPEPER, VA 22701
(540) 825-4557
1851576383CULPEPER SPECIALIST PHYSICIANS, LLC
Organization
Specialist541 SUNSET LN SUITE 102
CULPEPER, VA 22701
(540) 829-8484
1952496382 CHRISTOPHER S. MCCULLOUGH M.D.
Individual
Surgery (Surgical Critical Care)541 SUNSET LN 103
CULPEPER, VA 22701
(540) 825-2600
1659532661 MISTY R SHOEMAKER DO
Individual
Obstetrics & Gynecology541 SUNSET LN # 301
CULPEPER, VA 22701
(540) 825-4557
1861820904MED SPA OF VIRGINIA, INC.
Organization
Phlebology541 SUNSET LN SUITE 302
CULPEPER, VA 22701
(540) 825-8550
1316953839 KARL MARTIN BEIER M.D.
Individual
Phlebology541 SUNSET LN SUITE 302
CULPEPER, VA 22701
(540) 825-8550
1003821596BLUE RIDGE GYNECOLOGY & WELLNESS,INC
Organization
Obstetrics & Gynecology541 SUNSET LN SUITE 301
CULPEPER, VA 22701
(540) 825-4557
1407412851 KIMBERLY L SARGENT NP
Individual
Registered Nurse541 SUNSET LN
CULPEPER, VA 22701
(540) 829-4557
1649251521 JAMES DENTON M.D.
Individual
Surgery541 SUNSET LN STE 103
CULPEPER, VA 22701
(540) 829-4440
1861440182 CRAIG A REIGEL MD
Individual
Orthopaedic Surgery (Sports Medicine)541 SUNSET LN
CULPEPER, VA 22701
(540) 321-3120
1750306825 MARK B. GLOUDEMAN M.D.
Individual
Surgery541 SUNSET LN SUITE 103
CULPEPER, VA 22701
(540) 825-4440
1467422493 KEVIN D STOCKER M.D.
Individual
Obstetrics & Gynecology541 SUNSET LN STE 103
CULPEPER, VA 22701
(540) 321-3002
1073817839 ELENA G. SAYKALY P.A.
Individual
Physician Assistant (Surgical)541 SUNSET LN SUITE 103
CULPEPER, VA 22701
(540) 825-2600
1750319638 CHRISTINA M. AMOS PA
Individual
Physician Assistant541 SUNSET LN CULPEPER HOSPITAL EMERGENCY DEPARTMENT
CULPEPER, VA 22701
(540) 829-4189

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
Sara A. Hennessy 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.