DR. KENNETH ZOUCHA MD
NPI 1033111570
Pediatrics in Omaha, NE
NPI Status: Active since August 15, 2005
Contact Information
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
Phone: (402) 552-6007
Fax: (402) 552-6035
- Individual
- Male
- Years of Experience 38
- Pediatrics
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About KENNETH ZOUCHA
This page provides the complete NPI Profile along with additional information for Kenneth Zoucha, a pediatrician established in Omaha, Nebraska with a medical specialization in Pediatrics and more than 38 years of experience. He graduated from University Of Nebraska College Of Medicine in 1988. The healthcare provider is registered in the NPI registry with number 1033111570 assigned on August 2005. The practitioner's primary taxonomy code is 208000000X with license number 17958 (NE). The provider is registered as an individual and his NPI record was last updated 7 years ago.
- NPI
- 1033111570
- Provider Name
- DR. KENNETH ZOUCHA MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 42ND @ DEWEY ST OMAHA, NE 68198
- Location Phone
- (402) 552-6007
- Location Fax
- (402) 552-6035
- Mailing Address
- 988102 NEBRASKA MEDICAL CTR OMAHA, NE 68198
- Medical School Name
- UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
- Graduation Year
- 1988
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-15-2005
- Last Update Date
- 12-05-2018
- Code Navigator
A pediatrician like Kenneth Zoucha is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, 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
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 17958
- License State
- NE
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 174400000X | Other Service Providers | Specialist | 17958 (NE) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- HeartlandBlue Bronze HSA 6500 NEtwork Blue - EPO
- Bronze Classic - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Secure - EPO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Gold Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- Wellmark Bronze HDHP HMO HSA Qualified - HMO
- Wellmark Bronze Traditional HMO - HMO
- Wellmark Gold Traditional HMO - HMO
- Wellmark Silver Traditional HMO - HMO
- Wellmark Standard Bronze HMO - HMO
- Wellmark Standard Gold HMO - HMO
- Wellmark Standard Silver HMO - HMO
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.
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 |
---|---|---|---|
F76234 | MEDICAID (05) | NE | |
34122 | OTHER (01) | NE | BLUE CROSS BLUE SHIELD NE |
Medicare Participation & PECOS Enrollment Status
Kenneth Zoucha 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.
Kenneth Zoucha 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: 648226969
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: I20180926000454
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: $20.3 for a new patient copayment and $23.38 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 68198 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $81.2
- Minimum New Patient Price $52.69
- Maximum New Patient Price $160.21
- Average New Patient Copayment $20.3
- Minimum New Patient Copayment $13.17
- Maximum New Patient Copayment $40.05
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.55
- Minimum Established Patient Price $16.9
- Maximum Established Patient Price $131.25
- Average Established Patient Copayment $23.38
- Minimum Established Patient Copayment $4.22
- Maximum Established Patient Copayment $32.81
* 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. | |||||||||
1 | 0 | 3 | 3 | 1 | 1 | 1 | 5 | 7 | 0 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 0 | 6 | 3 | 2 | 1 | 2 | 5 | 14 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 0 + 6 + 3 + 2 + 1 + 2 + 5 + 1 + 4 + 24 = 50 | |||||||||
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
0 |
The NPI number 1033111570 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 20 providers are registered at the same or nearby location.
MARK J AKSAMIT PAC
Physician Assistant
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
CLARE ESTHER LOOKIAN PA-C
Physician Assistant
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
KATHLEEN TERESE LANGDON MSN, APRN, BC
Nurse Practitioner
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
DR. ANDREW BAUMGARTNER M.D.
Psychiatry & Neurology
(Psychiatry)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
MELISSA O'DELL M.D.
Psychiatry & Neurology
(Psychiatry)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
KELLY GASSMAN PA-C
Physician Assistant
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
MARK THOMSEN M.D.
Psychiatry & Neurology
(Psychiatry)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
DANA RAML M.D.
Psychiatry & Neurology
(Psychiatry)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
SARAH ELIZABETH WOLNISTY
Counselor
(Mental Health)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
MS. MEAGAN KANKOVSKY
Counselor
(Mental Health)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
JENNIFER A SPARROCK LIMHP
Counselor
(Mental Health)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
DR. SHERITTA ANN STRONG M.D.
Psychiatry & Neurology
(Psychiatry)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
TROYIA S.M. ANDERSON
Nurse Practitioner
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
JULIE A BIERMAN PLMHP
Counselor
(Mental Health)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
DR. RILEY DIANE MACHAL M.D.
Psychiatry & Neurology
(Psychiatry)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
STACEY LYNN HERBSTER M.D.
Psychiatry & Neurology
(Psychiatry)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
FRANCIS GANTNER LGPC
Counselor
(Mental Health)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
ZOE A FEILNER PA-C
Physician Assistant
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
DR. ROBERT MURPHY PORTLEY M.D.
Psychiatry & Neurology
(Psychiatry)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
JASON LEMEN LMHP LADC
Counselor
(Mental Health)
42ND @ DEWEY ST
OMAHA, NE
ZIP 68198
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1033111570, enumerated as an "individual" on August 15, 2005.
The provider is located at 42ND @ DEWEY ST OMAHA, NE 68198 and the phone number is (402) 552-6007.
Pediatrics with taxonomy code 208000000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Nebraska, Oscar. Please consult your insurance carrier or call the provider to verify.