GERALD B CALIA NPI 1013912393

Podiatrist in Oak Ridge, TN

NPI 1013912393 Individual Male Podiatrist PECOS Enrolled

NPI Profile for GERALD B CALIA

Gerald Calia is a provider established in Oak Ridge, Tennessee and his medical specialization is podiatrist. The NPI number of Gerald Calia is 1013912393 and was assigned on June 2005. The practitioner's primary taxonomy code is 213E00000X with license number DPM264 (TN). The provider is registered as an individual and his NPI record was last updated 10 years ago.

A podiatrist like Gerald B Calia provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.

Gerald Calia 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) and a Home Health Agency (HHA)..

Gerald Calia is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1013912393

Provider Name GERALD B CALIA
Provider Location Address162 RIDGEWAY CTR OAK RIDGE, TN 37830
Provider Mailing Address162 RIDGEWAY CTR OAK RIDGE, TN 37830
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date06-14-2005
Last Update Date12-28-2012


Primary Taxonomy

Taxonomy Code213E00000X
ClassificationPodiatrist
TypePodiatric Medicine & Surgery Service Providers
License No.DPM264
License StateTN
Taxonomy DescriptionA podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Business Address

GERALD B CALIA
162 RIDGEWAY CTR
OAK RIDGE, TN
ZIP 37830
Phone: (865) 482-3441
Fax: (865) 483-6299

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Mailing Address

GERALD B CALIA
162 RIDGEWAY CTR
OAK RIDGE, TN
ZIP 37830
Phone: (865) 482-3441
Fax: (865) 483-6299



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
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 DevicesNo

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.

  • 583Removal of tissue from 6 or more finger or toe nails (HCPCS:11721)
  • 143Removal of tissue from wounds per session (HCPCS:97597)
  • 47Injections of tendon sheath, ligament, or muscle membrane (HCPCS:20550)
  • 30Biopsy of single growth of skin and/or tissue (HCPCS:11100)
  • 21Biopsy of each additional growth of skin and/or tissue (HCPCS:11101)
  • 16X-ray of foot, minimum of 3 views (HCPCS:73630)
  • 15Removal of tissue from 1 to 5 finger or toe nails (HCPCS:11720)

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
3351215MEDICARE PIN (08)TN
38741OTHER (01)TNBLUE CROSS
U25604MEDICARE UPIN (02)TN
3351215MEDICAID (05)TN
1232770001MEDICARE NSC (07)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.
1013912393
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20231814318
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 1 + 8 + 1 + 4 + 3 + 1 + 8 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1013912393 is valid because the calculated check digit 3 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
1003003922GERALD B CALIA
Organization
Podiatrist (Primary Podiatric Medicine)162 RIDGEWAY CTR
OAK RIDGE, TN 37830
(865) 482-3441

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
Gerald B Calia 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.