ALBERT J HALLS M.D.
NPI 1063476471
Family Medicine in Onley, VA
NPI Status: Active since April 13, 2006
Contact Information
20306 BADGER LANE
ONLEY, VA
ZIP 23418
Phone: (757) 787-7374
Fax: (757) 787-4513
- Individual
- Male
- Years of Experience 38
- Family Medicine
- PECOS Enrolled
- Accepts Medicare Approved Payment
About ALBERT HALLS
Albert Halls is a primary care provider established in Onley, Virginia and his medical specialization is Family Medicine with more than 38 years of experience. He graduated from Creighton University School Of Medicine in 1986. The healthcare provider is registered in the NPI registry with number 1063476471 assigned on April 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 17503 (NE). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1063476471
- Provider Name
- ALBERT J HALLS M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 20306 BADGER LANE ONLEY, VA 23418
- Location Phone
- (757) 787-7374
- Location Fax
- (757) 787-4513
- Mailing Address
- PO BOX 159 20306 BADGER LANE ONLEY, VA 23418
- Mailing Phone
- (757) 787-7374
- Mailing Fax
- (757) 787-4513
- Medical School Name
- CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 1986
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-13-2006
- Last Update Date
- 04-03-2014
- Code Navigator
A primary care provider (PCP) like Albert Halls 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
Albert Halls 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.
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.59 for a new patient copayment and $26.08 for an established patient copayment.
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 17503
- License State
- NE
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Medicare
Medicaid
*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 |
---|---|---|---|
E07355 | MEDICARE UPIN (02) | ||
277804 | MEDICARE ID-TYPE UNSPECIFIED (04) |
PECOS Enrollment and Medicare Participation Status
Albert Halls 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: 547230492
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: I20140509001952
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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
Other DME (D1E)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
10 DME suppliers used 46 Medicare Claims 160 Services Paid
Other DME (D1E)
Normal, low and high calibrator solution / chips (HCPCS:A4256)
4 DME suppliers used 16 Medicare Claims 16 Services Paid
Other DME (D1E)
Lancets, per box of 100 (HCPCS:A4259)
5 DME suppliers used 19 Medicare Claims 43 Services Paid
Other DME (D1E)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
2 DME suppliers used 12 Medicare Claims 60 Services Paid
Hospital beds (D1B)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)
1 DME suppliers used 18 Medicare Claims 18 Services Paid
Oxygen and supplies (D1C)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
Other DME (D1E)
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) (HCPCS:E0630)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
Oxygen and supplies (D1C)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
1 DME suppliers used 18 Medicare Claims 18 Services Paid
Drugs Administered through DME (D1G)
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)
4 DME suppliers used 22 Medicare Claims 6760 Services Paid
Wheelchairs (D1D)
Standard wheelchair (HCPCS:K0001)
1 DME suppliers used 17 Medicare Claims 17 Services Paid
Other DME (D1E)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
2 DME suppliers used 16 Medicare Claims 16 Services Paid
Drugs and Nutritional Products
Enteral and parenteral (O1C)
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4034)
1 DME suppliers used 12 Medicare Claims 360 Services Paid
Enteral and parenteral (O1C)
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4149)
1 DME suppliers used 12 Medicare Claims 5962 Services Paid
Other drugs (O1E)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
4 DME suppliers used 15 Medicare Claims 15 Services Paid
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 23418 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $90.36
- Minimum New Patient Price $58.76
- Maximum New Patient Price $178.23
- Average New Patient Copayment $22.59
- Minimum New Patient Copayment $14.69
- Maximum New Patient Copayment $44.55
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $104.32
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $145.63
- Average Established Patient Copayment $26.08
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $36.4
* 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.
Clinician Services
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.
- 275
Hemoglobin a1c level (HCPCS:83036)
- 64
Urinalysis, manual test (HCPCS:81002)
- 53
Testing for presence of drug (HCPCS:80305)
- 23
X-ray of chest, 2 views (HCPCS:71046)
Hospital Affiliations
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Albert Halls is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
RIVERSIDE SHORE MEMORIAL HOSPITAL | 20480 MARKET STREET ONANCOCK, VA 23417 | (757) 414-8000 | Acute Care Hospitals |
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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 | 4 | 7 | 6 | 4 | 7 | 1 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 0 | 12 | 3 | 8 | 7 | 12 | 4 | 14 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 0 + 1 + 2 + 3 + 8 + 7 + 1 + 2 + 4 + 1 + 4 + 24 = 59 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 59 = 1 | 1 |
The NPI number 1063476471 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 14 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1003894262 | HEATHER STARK MD Individual | Family Medicine | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7374 |
1326026584 | JUDITH WICKLUND NP Individual | Nurse Practitioner (Adult Health) | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7374 |
1619226438 | LUCAS ALLEN FUSSELL NP Individual | Nurse Practitioner (Family) | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7374 |
1104241678 | JENNIFER FOWLER LUCAS PA-C Individual | Physician Assistant (Medical) | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7374 |
1689172975 | VICTORIA RENEE WILLIS HOUTROUW PA-C Individual | Physician Assistant | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7374 |
1477700169 | SANDRA HEARN NP Individual | Nurse Practitioner (Pediatrics) | 20306 BADGER LANE ONLEY, VA 23418 (757) 414-0400 |
1386622611 | THOMAS HOLLANDSWORTH MD Individual | Family Medicine | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7374 |
1013995117 | ANN SCHLAEFER NP Individual | Nurse Practitioner (Pediatrics) | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7374 |
1669405502 | DR. MARGARET M STILES MD Individual | Family Medicine | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7374 |
1972507721 | ELIZABETH H HUBBARD FNP Individual | Nurse Practitioner (Family) | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7341 |
1316586225 | PAIGE REW MCLEAN LCSW Individual | Social Worker (Clinical) | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7374 |
1568592426 | EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED Organization | Clinic/Center (Federally Qualified Health Center (FQHC)) | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7374 |
1972111375 | MS. FRANCES EVONNE BUTLER FNP-C Individual | Nurse Practitioner (Family) | 20306 BADGER LANE ONLEY, VA 23418 (757) 787-7374 |
1528775939 | EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED Organization | Pharmacy (Community/Retail Pharmacy) | 20306 BADGER LANE ONLEY, VA 23418 (757) 302-9066 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063476471, enumerated in the NPI registry as an "individual" on April 13, 2006
The provider is located at 20306 Badger Lane Onley, Va 23418 and the phone number is (757) 787-7374
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider has more than 38 years of experience. He graduated from Creighton University School Of Medicine in 1986.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
Medicare beneficiaries should expect a typical cost of $90.36 with an average copayment of $22.59 for new patient appointments. Established patients should expect a typical charge of $104.32 and an average copayment of 26.08. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Hemoglobin a1c level, Urinalysis, manual test, Testing for presence of drug and X-ray of chest, 2 views.
The practitioner is affiliated to the following hospital(s): RIVERSIDE SHORE MEMORIAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on April 13, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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