MR. DAVID W PEGRAM PT NPI 1013083690
Physical Therapist in Spartanburg, SC

About MR. DAVID W PEGRAM PT

David Pegram is a provider established in Spartanburg, South Carolina and his medical specialization is Physical Therapist with more than 23 years of experience. The NPI number of David Pegram is 1013083690 and was assigned on November 2006. The practitioner's primary taxonomy code is 225100000X with license number 4544 (SC). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1013083690
Provider NameMR. DAVID W PEGRAM PT
Location Address1075 BOILING SPRINGS RD SPARTANBURG, SC 29303
Location Phone(864) 580-2001
Mailing AddressPO BOX 3408 IRMO, SC 29063
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2000
Is Sole Proprietor?No
Enumeration Date11-27-2006
Last Update Date05-25-2011

David Pegram 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 provider participated in Medicare's Quality Payment Program and the following quality measures were reported: chronic care and preventative care management for empaneled patients, documentation of current medications in the medical record, preventive care and screening: body mass index (bmi) screening and follow-up plan and use of decision support and standardized treatment protocols. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.4 for a new patient copayment and $17.43 for an established patient copayment.



Primary Taxonomy

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.

Taxonomy Code225100000X
ClassificationPhysical Therapist
TypeRespiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.4544
License StateSC
Taxonomy DescriptionPhysical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare
  • Railroad Medicare

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

Business Address

MR. DAVID W PEGRAM PT
1075 BOILING SPRINGS RD
SPARTANBURG, SC
ZIP 29303
Phone: (864) 580-2001
Fax: (864) 580-2003

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Mailing Address

MR. DAVID W PEGRAM PT
PO BOX 3408
IRMO, SC
ZIP 29063
Phone: (803) 732-5887
Fax: (803) 732-5997


Location Map

PECOS Enrollment and Medicare Participation Status

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.

PECOS PAC ID4183602618
PECOS Enrollment IDI20040712000495
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.

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 29303 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
$55.43 $169.76 $85.63
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.85 $42.44 $21.4
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
$17.06 $138.69 $69.73
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.26 $34.67 $17.43

* 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.

Quality Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Documentation of Current Medications in the Medical Record 93% 187
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 3% 433
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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.

  • 1700Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes (HCPCS:97110)
  • 612Manual (physical) therapy techniques to 1 or more regions, each 15 minutes (HCPCS:97140)
  • 479Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care (HCPCS:G0283)
  • 60Physical therapy evaluation (HCPCS:97001)

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
P00372305OTHER (01)SCRAILROAD MEDICARE PIN
Q17259MEDICARE UPIN (02)SC

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.
1013083690
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2023086618
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 8 + 6 + 6 + 1 + 8 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1013083690 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 16 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1346242757UPSTATE SPINE AND NEUROSURGERY CENTER
Organization
Neurological Surgery1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 583-7265
1407836257DR. CAVERT KEITH MCCORKLE M.D.
Individual
Neurological Surgery1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 583-7265
1457322406DR. PHILLIP GEORGE ESCE M.D.
Individual
Neurological Surgery1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 560-6880
1730152687 CHALMERS ARNOLD MILLS P.A.
Individual
Physician Assistant (Surgical)1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 583-7265
1699744300DR. DARWIN W KELLER M.D.
Individual
Neurological Surgery1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 583-7265
1346209210DR. ROBERT EDWARD FLANDRY JR. MD
Individual
Neurological Surgery1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 583-7265
1548286412DR. CHRISTOPHER CHITTUM M.D.
Individual
Neurological Surgery1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 583-7265
1447695200 JOSHUA JAMES MOORE PA-C
Individual
Physician Assistant (Surgical)1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 582-7265
1023217569MRS. JULIE SAIN JUSTICE FNP-C
Individual
Nurse Practitioner (Family)1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 583-7265
1104890870 TIMOTHY SHAWN ODELL PA-C
Individual
Physician Assistant (Surgical)1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 583-7265
1114378049MRS. ANNA BEARDEN BROWN FNP
Individual
Nurse Practitioner (Family)1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 583-7265
1437361334 JEFFREY SMITH MD
Individual
Pain Medicine (Interventional Pain Medicine)1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 583-7265
1730639519CAROLINA ORTHOPAEDIC AND NEUROSURGICAL ASSOCIATES
Organization
Orthopaedic Surgery1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 582-6396
1841768330MRS. JESSICA LYNN FRANCOIS DPT
Individual
Physical Therapist1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(803) 732-5887
1184037418MRS. JENNIFER FERGUSON TURNER FNP-BC
Individual
Nurse Practitioner (Family)1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 583-7665
1346802899 CHRISTOPHER JOE ROBERTSON DPT
Individual
Physical Therapist1075 BOILING SPRINGS RD
SPARTANBURG, SC 29303
(864) 580-2001

Frequently Asked Questions

What is Mr. David Pegram PT NPI number?

The NPI number assigned to Mr. David Pegram PT is 1013083690, registered as an "individual" on November 27, 2006

Where is Mr. David Pegram PT located?

The provider is located at 1075 Boiling Springs Rd Spartanburg, Sc 29303 and the phone number is (864) 580-2001

Which is Mr. David Pegram PT specialty?

The provider's speciality is Physical Therapist

How many years of experience does Mr. David Pegram PT have?

The provider has more than 23 years of experience.

What insurance does Mr. David Pegram PT accept?

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

How much is a visit to Mr. David Pegram PT?

Medicare beneficiaries should expect a typical cost of $85.63 with an average copayment of $21.4 for new patient appointments. Established patients should expect a typical charge of $69.73 and an average copayment of 17.43. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Mr. David Pegram PT?

The most common procedures or services performed by this practitioner are: Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes, Manual (physical) therapy techniques to 1 or more regions, each 15 minutes, Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care and Physical therapy evaluation.

How do I update my NPI information?

The NPI record of Mr. David Pegram PT was last updated on November 27, 2006. 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]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]