GASTON BERENGUER DMD MS
NPI 1053464230
Dentist - Periodontics in Stuart, FL
NPI Status: Active since January 19, 2007
Contact Information
969 S FEDERAL HWY
#201
STUART, FL
ZIP 34994
Phone: (772) 288-4444
Fax: (772) 288-4446
- Individual
- Male
- Dentist
- Periodontics
- Accepts Insurance
- PECOS Enrolled
- Opted-Out Medicare
About GASTON BERENGUER
This page provides the complete NPI Profile along with additional information for Gaston Berenguer, a provider established in Stuart, Florida with a medical specialization in Dentist, focusing in periodontics . The healthcare provider is registered in the NPI registry with number 1053464230 assigned on January 2007. The practitioner's primary taxonomy code is 1223P0300X with license number DN15935 (FL). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1053464230
- Provider Name
- GASTON BERENGUER DMD MS
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 969 S FEDERAL HWY #201 STUART, FL 34994
- Location Phone
- (772) 288-4444
- Location Fax
- (772) 288-4446
- Mailing Address
- 969 S FEDERAL HWY #201 STUART, FL 34994
- Mailing Phone
- (772) 288-4444
- Mailing Fax
- (772) 288-4446
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-19-2007
- Last Update Date
- 07-08-2007
- Code Navigator
A dentist like Gaston Berenguer is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Gaston Berenguer opted out of Medicare effective on 04-17-2016 until 04-17-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
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
Dentist Periodontics
- Taxonomy Code
- 1223P0300X
- Type
- Dental Providers
- License No.
- DN15935
- License State
- FL
- Taxonomy Description
- That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue HSA Bronze - PPO
- Blue Protect - PPO
- Blue Saver Bronze - PPO
- Blue Standardized Statewide Silver EPO - EPO
- Blue Statewide Silver EPO - EPO
- Blue Value Gold - PPO
- Blue Value Silver - PPO
- Blue Access Gold for Business - PPO
- Blue Choice Platinum for Business - PPO
- Blue HSA Silver for Business - PPO
- Blue Saver Bronze for Business - PPO
- Blue Saver Gold for Business - PPO
- Blue Secure Gold for Business - PPO
- Blue Secure Silver for Business - PPO
- Guardian Basics for Familes and Individuals - PPO
- Guardian Essentials for Families and Individuals - PPO
- Guardian Preventive Plus for Families and Individuals - PPO
- Guardian Select for Families and Individuals - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Gaston Berenguer 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).
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
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-17-2016
Opt-Out End Date: 04-17-2026
Eligible to Order and Refer? 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: No
Physician 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 34994 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $91.69
- Minimum New Patient Price $58.56
- Maximum New Patient Price $179.05
- Average New Patient Copayment $22.92
- Minimum New Patient Copayment $14.64
- Maximum New Patient Copayment $44.76
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $73
- Minimum Established Patient Price $18.44
- Maximum Established Patient Price $144.68
- Average Established Patient Copayment $18.25
- Minimum Established Patient Copayment $4.61
- Maximum Established Patient Copayment $36.17
* 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 1053464230, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
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 60 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053464230, enumerated as an "individual" on January 19, 2007.
The provider is located at 969 S FEDERAL HWY #201 STUART, FL 34994 and the phone number is (772) 288-4444.
Dentist with taxonomy code 1223P0300X and a focus in Periodontics.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Alabama and Guardian. Please consult your insurance carrier or call the provider to verify.
