POORVA TALAPATRA M.ED., LCPC
NPI 1013210194
Counselor - Mental Health in Carbondale, IL

NPI Status: Active since December 13, 2010

Contact Information

400 S LEWIS LN
CARBONDALE, IL
ZIP 62901
Phone: (618) 519-9900
Fax: (618) 529-1384

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  • Individual
  • Female
  • Years of Experience 26
  • Counselor
  • Mental Health
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About POORVA TALAPATRA

This page provides the complete NPI Profile along with additional information for Poorva Talapatra, a provider established in Carbondale, Illinois with a medical specialization in Counselor, focusing in mental health and more than 26 years of experience. The healthcare provider is registered in the NPI registry with number 1013210194 assigned on December 2010. The practitioner's primary taxonomy code is 101YM0800X with license number 178005097 (IL). The provider is registered as an individual and her NPI record was last updated 11 years ago.

NPI
1013210194
Provider Name
POORVA TALAPATRA M.ED., LCPC
Gender
Female
Entity Type
Individual
Location Address
400 S LEWIS LN CARBONDALE, IL 62901
Location Phone
(618) 519-9900
Location Fax
(618) 529-1384
Mailing Address
PO BOX 577 109 CALIFORNIA ST CARTERVILLE, IL 62918
Mailing Phone
(618) 985-8221
Mailing Fax
(618) 529-1384
Medical School Name
OTHER
Graduation Year
2000
Is Sole Proprietor?
No
Enumeration Date
12-13-2010
Last Update Date
08-25-2015
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A mental health counselor like Poorva Talapatra provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.

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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 Mental Health

Taxonomy Code
101YM0800X
Type
Behavioral Health & Social Service Providers
License No.
178005097
License State
IL

Insurance Plans Accepted

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

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*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
370966854024MEDICAID (05)IL 

Medicare Participation & PECOS Enrollment Status

Poorva Talapatra is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Poorva Talapatra 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: 1355784794

    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: I20240213001574

    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? 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 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

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. 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.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 89% 267
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.

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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 1013210194, we treat the final digit (4) 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 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).

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

Step 2: Add all digits plus the NPI constant

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

2 + 0 + 2 + 3 + 4 + 1 + 0 + 1 + 1 + 8 + 24 = 46

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

The next multiple of ten after 46 is 50. The difference is the calculated check digit.

50 - 46 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1013210194.

Other Providers at the Same Location


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

Psychologist (Clinical)
400 S LEWIS LN
CARBONDALE, IL 62901
Counselor (Mental Health)
400 S LEWIS LN
CARBONDALE, IL 62901
Physician Assistant
400 S LEWIS LN
CARBONDALE, IL 62901
Physician Assistant
400 S LEWIS LN
CARBONDALE, IL 62901
Clinical Medical Laboratory
400 S LEWIS LN
CARBONDALE, IL 62901
Clinic/Center (Methadone)
400 S LEWIS LN
CARBONDALE, IL 62901
Pediatrics
400 S LEWIS LN
CARBONDALE, IL 62901
Family Medicine
400 S LEWIS LN
CARBONDALE, IL 62901
Physician Assistant
400 S LEWIS LN
CARBONDALE, IL 62901
Family Medicine
400 S LEWIS LN
CARBONDALE, IL 62901
Nurse Practitioner (Family)
400 S LEWIS LN
CARBONDALE, IL 62901
Physician Assistant
400 S LEWIS LN
CARBONDALE, IL 62901
Counselor (Mental Health)
400 S LEWIS LN
CARBONDALE, IL 62901
Clinic/Center (Federally Qualified Health Center (FQHC))
400 S LEWIS LN
CARBONDALE, IL 62901
Dietitian, Registered
400 S LEWIS LN
CARBONDALE, IL 62901

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013210194, enumerated as an "individual" on December 13, 2010.

The provider is located at 400 S LEWIS LN CARBONDALE, IL 62901 and the phone number is (618) 519-9900.

Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.