ALLISON SUE HERMAN PA-C
NPI 1023888922
Physician Assistant in Niceville, FL

NPI Status: Active since January 03, 2024

Contact Information

550 HWY 85
SUITE A
NICEVILLE, FL
ZIP 32578
Phone: (850) 517-9041

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  • Individual
  • Female
  • Years of Experience 3
  • Physician Assistant
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ALLISON HERMAN

This page provides the complete NPI Profile along with additional information for Allison Herman, a primary care provider established in Niceville, Florida with a medical specialization in Physician Assistant and more than 3 years of experience. She graduated from Florida State University College Of Medicine in 2023. The healthcare provider is registered in the NPI registry with number 1023888922 assigned on January 2024. The practitioner's primary taxonomy code is 363A00000X. The provider is registered as an individual and her NPI record was last updated one year ago.

NPI
1023888922
Provider Name
ALLISON SUE HERMAN PA-C
Gender
Female
Entity Type
Individual
Location Address
550 HWY 85 SUITE A NICEVILLE, FL 32578
Location Phone
(850) 517-9041
Mailing Address
550 FL 85 SUITE A NICEVILLE, FL 32578
Mailing Phone
(850) 517-9041
Medical School Name
FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year
2023
Is Sole Proprietor?
No
Enumeration Date
01-03-2024
Last Update Date
08-02-2024
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A primary care provider (PCP) like Allison Herman sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

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

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License State
FL
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

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

  • Clear VALUE Silver - HMO
  • Complete VALUE Gold - HMO
  • Focused VALUE Silver - HMO
  • Focused VALUE Silver + Vision + Adult Dental - HMO
  • Standard Gold VALUE - HMO
  • Standard Silver VALUE - HMO
  • Standard Silver VALUE + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete VALUE Gold - HMO
  • Complete VALUE Silver - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Silver - HMO
  • Elite Silver + Vision + Adult Dental - HMO
  • Elite VALUE Bronze - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Focused VALUE Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Gold Classic Standard - EPO
  • Gold Elite - EPO
  • Gold Elite Saver Plus - EPO
  • Secure - EPO
  • Silver Classic Standard - EPO
  • Silver Elite - EPO
  • Silver Simple Chronic Care CKM - EPO
  • Silver Simple Diabetes - EPO
  • Silver Simple PCP Saver - EPO

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

Medicare Participation & PECOS Enrollment Status

Allison Herman 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.

Allison Herman 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.

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: 2668815952

    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: I20240202002571

    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): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.9 for a new patient copayment and $17.51 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 32578 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $87.62
  • Minimum New Patient Price $56
  • Maximum New Patient Price $171.84
  • Average New Patient Copayment $21.9
  • Minimum New Patient Copayment $14
  • Maximum New Patient Copayment $42.96

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $70.04
  • Minimum Established Patient Price $17.57
  • Maximum Established Patient Price $139.16
  • Average Established Patient Copayment $17.51
  • Minimum Established Patient Copayment $4.39
  • Maximum Established Patient Copayment $34.79

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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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.
1023888922
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20431681694
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 4 + 3 + 1 + 6 + 8 + 1 + 6 + 9 + 4 + 24 = 68
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 68 = 22

The NPI number 1023888922 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023888922, enumerated as an "individual" on January 03, 2024.

The provider is located at 550 HWY 85 SUITE A NICEVILLE, FL 32578 and the phone number is (850) 517-9041.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Ambetter from Superior HealthPlan, Ambetter. Please consult your insurance carrier or call the provider to verify.