DR. CONSTANTINOS JOHN BACAS OD
NPI 1063136489
Optometrist in Madison, NJ
NPI Status: Active since September 29, 2022
Contact Information
311 MAIN ST
MADISON, NJ
ZIP 07940
Phone: (973) 377-1060
Fax: (973) 660-1133
- Individual
- Male
- Years of Experience 4
- Optometrist
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About CONSTANTINOS BACAS
This page provides the complete NPI Profile along with additional information for Constantinos Bacas, a provider established in Madison, New Jersey with a medical specialization in Optometrist and more than 4 years of experience. He graduated from State University Of New York - State College Optometry in 2022. The healthcare provider is registered in the NPI registry with number 1063136489 assigned on September 2022. The practitioner's primary taxonomy code is 152W00000X with license number 27OA00717200 (NJ). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1063136489
- Provider Name
- DR. CONSTANTINOS JOHN BACAS OD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 311 MAIN ST MADISON, NJ 07940
- Location Phone
- (973) 377-1060
- Location Fax
- (973) 660-1133
- Mailing Address
- 311 MAIN ST MADISON, NJ 07940
- Mailing Phone
- (973) 377-1060
- Mailing Fax
- (973) 660-1133
- Medical School Name
- STATE UNIVERSITY OF NEW YORK - STATE COLLEGE OPTOMETRY
- Graduation Year
- 2022
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-29-2022
- Last Update Date
- 02-14-2024
- Code Navigator
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
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 27OA00717200
- License State
- NJ
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- Blue Precision Bronze HMO? 205 - HMO
- Blue Precision Bronze HMO? 701 - HMO
- Blue Precision Bronze HMO? Standard - Select Rx Copays - HMO
- Blue Precision Gold HMO? 207 - HMO
- Blue Precision Gold HMO? 703 - HMO
- Blue Precision Gold HMO? Standard - Rx Copays - HMO
- Blue Precision Silver HMO? 206 - HMO
- Blue Precision Silver HMO? 704 - HMO
- Blue Precision Silver HMO? Standard - Select Rx Copays - HMO
- BlueCare Direct Bronze? Standard - Select Rx Copays with Advocate - HMO
- BlueCare Direct Gold? Standard - Rx Copays with Advocate - HMO
- Blue Focus Bronze POS? 205 - POS
- Blue Focus Bronze POS? 705 - POS
- Blue Focus Bronze POS? Standard - POS
- Blue Focus Gold POS? 207 - POS
- Blue Focus Gold POS? Standard - POS
- Blue Focus Silver POS? 206 - POS
- Blue Focus Silver POS? Standard - POS
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? 204 - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? 203 - PPO
- Blue Preferred Silver PPO? 308 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- Blue Advantage Bronze PPO? 202 - PPO
- Blue Advantage Bronze PPO? 203 - PPO
- Blue Advantage Bronze PPO? Standard - PPO
- Blue Advantage Gold PPO? 309 - PPO
- Blue Advantage Gold PPO? 604 - PPO
- Blue Advantage Gold PPO? Standard - PPO
- Blue Advantage Silver PPO? 204 - PPO
- Blue Advantage Silver PPO? 501 - PPO
- Blue Advantage Silver PPO? Standard - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- MyBlue Gold HMO? 704 - HMO
- MyBlue Gold HMO? 804 - HMO
- MyBlue Gold HMO? Standard - HMO
- MyBlue Silver HMO? 705 - HMO
- MyBlue Silver HMO? 803 - HMO
- MyBlue Silver HMO? Standard - HMO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Constantinos Bacas 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.
Constantinos Bacas 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
PECOS PAC ID: 2264808351
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: I20221013003580
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: No
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $36.21 for a new patient copayment and $19.77 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 07940 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $144.86
- Minimum New Patient Price $63.84
- Maximum New Patient Price $190.92
- Average New Patient Copayment $36.21
- Minimum New Patient Copayment $15.96
- Maximum New Patient Copayment $47.73
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $79.09
- Minimum Established Patient Price $20.97
- Maximum Established Patient Price $155.92
- Average Established Patient Copayment $19.77
- Minimum Established Patient Copayment $5.24
- Maximum Established Patient Copayment $38.98
* 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 | 6 | 3 | 1 | 3 | 6 | 4 | 8 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 12 | 3 | 2 | 3 | 12 | 4 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 2 + 3 + 2 + 3 + 1 + 2 + 4 + 1 + 6 + 24 = 51 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 51 = 9 | 9 | ||||||||
The NPI number 1063136489 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
PAUL NAFTALI O D P A
Optometrist
(Corneal and Contact Management)
311 MAIN ST
MADISON, NJ
ZIP 07940
DR. PAUL E. NAFTALI O.D.
Optometrist
311 MAIN ST
MADISON, NJ
ZIP 07940
DR. SONYA MALANI O.D.
Optometrist
311 MAIN ST
MADISON, NJ
ZIP 07940
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063136489, enumerated as an "individual" on September 29, 2022.
The provider is located at 311 MAIN ST MADISON, NJ 07940 and the phone number is (973) 377-1060.
Optometrist with taxonomy code 152W00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Blue Cross. Please consult your insurance carrier or call the provider to verify.
