PHILIP J FRACICA M.D.
NPI 1043320278
Internal Medicine - Pulmonary Disease in Sedalia, MO
NPI Status: Active since August 30, 2006
Contact Information
601 E 14TH ST
SEDALIA, MO
ZIP 65301
Phone: (660) 827-9488
- Individual
- Male
- Internal Medicine
- Pulmonary Disease
- Accepts Insurance
- PECOS Enrolled
About PHILIP FRACICA
This page provides the complete NPI Profile along with additional information for Philip Fracica, an internist established in Sedalia, Missouri with a medical specialization in Internal Medicine, focusing in pulmonary disease . The healthcare provider is registered in the NPI registry with number 1043320278 assigned on August 2006. The practitioner's primary taxonomy code is 207RP1001X with license number 22761 (AZ). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1043320278
- Provider Name
- PHILIP J FRACICA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 601 E 14TH ST SEDALIA, MO 65301
- Location Phone
- (660) 827-9488
- Mailing Address
- 601 E 14TH ST PO BOX 1706 SEDALIA, MO 65301
- Mailing Phone
- (660) 827-9488
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-30-2006
- Last Update Date
- 08-03-2022
- Code Navigator
An internist like Philip Fracica is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, 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
Internal Medicine Pulmonary Disease
- Taxonomy Code
- 207RP1001X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 22761
- License State
- AZ
- Taxonomy Description
- An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
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 | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | 2008007036 (MO) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue KC Community Silver Preferred-Care Blue EPO - EPO
- Blue KC First Bronze Preferred-Care Blue EPO - EPO
- Blue KC Standard Bronze Preferred-Care Blue EPO - EPO
- Blue KC Standard Gold Preferred-Care Blue EPO - EPO
- Blue KC Standard Silver Preferred-Care Blue EPO - EPO
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 |
|---|---|---|---|
| 171843 | MEDICAID (05) | AZ |
Medicare Participation & PECOS Enrollment Status
Philip Fracica 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
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
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Adm sarscov2 100mcg/0.5ml3rd
Adm sarscov2 30mcg/0.3ml 3rd
Adm sarscov2 30mcg/0.3ml bst
Administration of influenza virus vaccine
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)
Fee covid-19 vac 13 res
Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
This is the administration of a third dose of a SARS-CoV-2 vaccine, given in a dose of 100 micrograms in 0.5 milliliters. This vaccine helps your body develop immunity against the COVID-19 virus. It's a crucial step in protecting your health.
This service was performed 19 times for 19 patientsThis refers to the administration of a 30 microgram dose of a SARS-CoV-2 vaccine in a 0.3 milliliter volume. It's the third dose, often referred to as a booster shot, which helps to strengthen your body's immune response against the COVID-19 virus.
This service was performed 34 times for 34 patientsThis is an administration of a COVID-19 vaccine, specifically 30 micrograms in a 0.3 milliliter dosage. The vaccine helps your body build protection against the SARS-CoV-2 virus, which causes COVID-19.
This service was performed 15 times for 15 patientsThe administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 43 times for 43 patientsThe CDC 2019 Novel Coronavirus Real-Time RT-PCR Diagnostic Panel is a test to detect the presence of the 2019 novel coronavirus in your body. It uses a sample from your nose or throat, which is then analyzed in a lab to identify the virus.
This service was performed 427 times for 371 patientsThis is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
This service was performed 28 times for 28 patientsThe "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.
This service was performed 86 times for 86 patientsThe quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.
This service was performed 35 times for 35 patientsThis service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
This service was performed 460 times for 399 patientsPhysician Visit Costs
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 65301 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $121.96
- Minimum New Patient Price $52.28
- Maximum New Patient Price $161.24
- Average New Patient Copayment $30.49
- Minimum New Patient Copayment $13.07
- Maximum New Patient Copayment $40.31
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.24
- Minimum Established Patient Price $16.3
- Maximum Established Patient Price $131.05
- Average Established Patient Copayment $23.31
- Minimum Established Patient Copayment $4.07
- Maximum Established Patient Copayment $32.76
* 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 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 1043320278, we treat the final digit (8) 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 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SEDALIA, MO 65301
SEDALIA, MO 65301
SEDALIA, MO 65301
SEDALIA, MO 65301
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043320278, enumerated as an "individual" on August 30, 2006.
The provider is located at 601 E 14TH ST SEDALIA, MO 65301 and the phone number is (660) 827-9488.
Internal Medicine with taxonomy code 207RP1001X and a focus in Pulmonary Disease.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Kansas City,. Please consult your insurance carrier or call the provider to verify.
