MR. MICHAEL G. FROST RADCI
NPI 1003950965
Counselor - Addiction (Substance Use Disorder) in Menasha, WI

NPI Status: Active since February 16, 2007

Contact Information

1201 TUCKAWAY LN
MENASHA, WI
ZIP 54952
Phone: (920) 733-4443
Fax: (920) 733-4796

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  • Individual
  • Male
  • Years of Experience 20
  • Counselor
  • Addiction (Substance Use Disorder)
  • Accepts Insurance
  • May Accept Medicare Approved Payment
  • PECOS Enrolled

About MICHAEL FROST

This page provides the complete NPI Profile along with additional information for Michael Frost, a provider established in Menasha, Wisconsin with a medical specialization in Counselor, focusing in addiction (substance use disorder) and more than 20 years of experience. The healthcare provider is registered in the NPI registry with number 1003950965 assigned on February 2007. The practitioner's primary taxonomy code is 101YA0400X. The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI
1003950965
Provider Name
MR. MICHAEL G. FROST RADCI
Gender
Male
Entity Type
Individual
Location Address
1201 TUCKAWAY LN MENASHA, WI 54952
Location Phone
(920) 733-4443
Location Fax
(920) 733-4796
Mailing Address
936 GREEN ST SEYMOUR, WI 54165
Mailing Phone
(920) 833-7085
Medical School Name
OTHER
Graduation Year
2006
Is Sole Proprietor?
No
Enumeration Date
02-16-2007
Last Update Date
07-08-2007
Code Navigator

A Substance Abuse or Addiction Counselor like Michael Frost advices patients who experience alcoholism, drug addiction, eating disorders, mental health issues, or other mental or behavioral problems. Substance Abuse counselors provide treatment and support to help clients recover from addiction or modify problem behaviors. Many counselors incorporate the principles of 12-step programs, such as Alcoholics Anonymous (AA). They educate clients how to cope with stress and life’s issues in ways that help them recover. Counselors also help patients improve their personal relationships and find ways to discuss their addiction or other problems with family and friends.

Location Map

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

Counselor Addiction (Substance Use Disorder)

Taxonomy Code
101YA0400X
Type
Behavioral Health & Social Service Providers

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • HMO Bronze $0 Medical Deductible - HMO
  • HMO Bronze 10000 - HMO
  • HMO Bronze 7500 - HMO
  • HMO Catastrophic 10600 with 3 free PCP visits - HMO
  • HMO Gold 2000 - HMO
  • HMO Gold 2700 - HMO
  • HMO HDHP Silver 5900 - HMO
  • HMO Silver 6000 - HMO
  • HMO Silver 6600 - HMO
  • POS Bronze 7500 - POS
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
  • Atlas $1,300 Gold - PPO
  • Atlas $2,000 Standard Gold - PPO
  • Atlas $3,050 Plus Silver - PPO
  • Atlas $3,800 HSA Silver - PPO
  • Atlas $6,000 Standard Silver - PPO
  • Atlas $6,800 Plus Bronze HSA - PPO
  • Atlas $7,500 Standard Bronze HSA - PPO
  • Atlas $8,400 HSA Bronze - PPO
  • NE WI Select $3,150 Plus Silver - PPO
  • NE WI Select $3,800 HSA Silver - PPO
  • Prestige Bronze $0 Medical Deductible - HMO
  • Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
  • Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
  • Prestige Bronze Essential + 3 Free PCP Visits - HMO
  • Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Prestige Bronze Plus - HMO
  • Prestige Gold - HMO
  • Prestige Gold 50 + 1 Free PCP Visit - HMO
  • Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
  • Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • Enrich $2,000 - 25% - HMO
  • Enrich $3,500 - 30% - HMO
  • Enrich $4,000 - 50% - HMO
  • Enrich $5,000 HDHP - HMO
  • Enrich $6,000 - 40% - HMO
  • Enrich $7,500 - HMO
  • Enrich $7,500 HDHP - HMO
  • Enrich $9,500 - HMO
  • Enrich Protection - HMO
  • Premier $2,000 - 25% - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

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

Medicare Participation & PECOS Enrollment Status

Michael Frost 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.

Michael Frost 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 and Durable Medical Equipment (DME).

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: 3476991290

    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: I20240329000326

    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): No

  • Eligible to Order or Refer Power Mobility Devices: No

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1003950965, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
0
Doubled → 0
Pos 4
3
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
5
Unchanged
Pos 7
0
Doubled → 0
Pos 8
9
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 9 → 18 → 9 0 → 0 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 0 + 3 + 1 + 8 + 5 + 0 + 9 + 1 + 2 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1003950965.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Counselor (Addiction (Substance Use Disorder))
1201 TUCKAWAY LN
MENASHA, WI 54952
Counselor (Addiction (Substance Use Disorder))
1201 TUCKAWAY LN
MENASHA, WI 54952
Counselor (Addiction (Substance Use Disorder))
1201 TUCKAWAY LN
MENASHA, WI 54952
Licensed Practical Nurse
1201 TUCKAWAY LN
MENASHA, WI 54952
Licensed Practical Nurse
1201 TUCKAWAY LN
MENASHA, WI 54952
Non-emergency Medical Transport (VAN)
1201 TUCKAWAY LN
MENASHA, WI 54952

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003950965, enumerated as an "individual" on February 16, 2007.

The provider is located at 1201 TUCKAWAY LN MENASHA, WI 54952 and the phone number is (920) 733-4443.

Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus Health. Please consult your insurance carrier or call the provider to verify.