DR. JOHN MAX CRESTETTO DDS,MD
NPI 1063597375
Dentist - Oral and Maxillofacial Surgery in Rocky Mount, NC

NPI Status: Active since October 26, 2006

Contact Information

901 N WINSTEAD AVE
SUITE 130
ROCKY MOUNT, NC
ZIP 27804
Phone: (252) 443-7331
Fax: (252) 937-2381

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Dentist
Oral and Maxillofacial Surgery
Accepts Insurance
PECOS Enrolled
Opted-Out Medicare

About JOHN CRESTETTO

This page provides the complete NPI Profile along with additional information for John Crestetto, a provider established in Rocky Mount, North Carolina with a medical specialization in Dentist, focusing in oral and maxillofacial surgery . The healthcare provider is registered in the NPI registry with number 1063597375 assigned on October 2006. The practitioner's primary taxonomy code is 1223S0112X with license number 6759 (NC). The provider is registered as an individual and his NPI record was last updated 13 years ago.

NPI: 1063597375
Provider Name: DR. JOHN MAX CRESTETTO DDS,MD
Gender: Male
Entity Type: Individual
Location Address: 901 N WINSTEAD AVE SUITE 130 ROCKY MOUNT, NC 27804
Location Phone: (252) 443-7331
Location Fax: (252) 937-2381
Mailing Address: 901 N WINSTEAD AVE SUITE 130 ROCKY MOUNT, NC 27804
Mailing Phone: (252) 443-7331
Mailing Fax: (252) 937-2381
Is Sole Proprietor?: No
Enumeration Date: 10-26-2006
Last Update Date: 02-20-2012
Code Navigator

A dentist like John Crestetto 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. John Crestetto opted out of Medicare effective on 03-01-2017 until 03-01-2025. 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 Oral and Maxillofacial Surgery
Taxonomy Code: 1223S0112X
Type: Dental Providers
License No.: 6759
License State: NC
Taxonomy Description: An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Aetna CVS Health

Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision - HMO

Anthem Blue Cross and Blue Shield

Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Essential 9200 (+ Incentives) - HMO
Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) - HMO
Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Bronze Pathway 9200 (+ Incentives) - EPO
Anthem Bronze Pathway HMO 7450 for HSA - HMO
Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO

Blue Cross and Blue Shield of Illinois

BlueCare Dental 4 Kids? 1A - PPO
BlueCare Dental 4 Kids? 1B - PPO
BlueCare Dental? 1A - PPO
BlueCare Dental? 1B - PPO
BlueCare Dental? 1C - PPO
BlueCare Dental? 1D - PPO

Blue Cross and Blue Shield of Montana

BlueCare Dental 4 Kids? 1A - PPO
BlueCare Dental 4 Kids? 1B - PPO
BlueCare Dental? 1A - PPO
BlueCare Dental? 1B - PPO
BlueCare Dental? 1C - PPO
BlueCare Dental? 1D - PPO

Blue Cross and Blue Shield of NC

Blue Advantage Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
Blue Advantage Bronze Standard | Nationwide Doctors - PPO
Blue Advantage Gold Premier | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
Blue Advantage Gold Standard | Nationwide Doctors - PPO
Blue Advantage Silver Choice | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
Blue Advantage Silver Standard | Nationwide Doctors - PPO
Blue Care Bronze Standard | Statewide Doctors - HMO
Blue Care Gold Standard | Statewide Doctors - HMO
Blue Care Silver Standard | Statewide Doctors - HMO
Blue Home Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | with Novant Health - EPO
Blue Home Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | with UNC Health Alliance - EPO
Blue Home Bronze Complete | $60 PCP | $20 Tier 1 Rx | with UNC Health Alliance - EPO
Blue Home Bronze Standard | with Novant Health - EPO
Blue Home Bronze Standard | with UNC Health Alliance - EPO
Blue Home Gold Premier | 3 Free PCP | $10 Tier 1 Rx | with Novant Health - EPO
Blue Home Gold Premier | 3 Free PCP | $10 Tier 1 Rx | with UNC Health Alliance - EPO
Blue Home Gold Standard | with Novant Health - EPO
Blue Home Gold Standard | with UNC Health Alliance - EPO

Blue Cross and Blue Shield of Oklahoma

BlueCare Dental 4 Kids? 1A - PPO
BlueCare Dental 4 Kids? 1B - PPO
BlueCare Dental? 1A - PPO
BlueCare Dental? 1B - PPO
BlueCare Dental? 1C - PPO
BlueCare Dental? 1D - PPO

Blue Cross and Blue Shield of Texas

BlueCare Dental 1D - PPO
BlueCare Dental 4 Kids? 1A - PPO
BlueCare Dental 4 Kids? 1B - PPO
BlueCare Dental? 1A - PPO
BlueCare Dental? 1B - PPO
BlueCare Dental? 1C - PPO

Delta Dental of North Carolina

Delta Dental Basic Plan - PPO
Delta Dental Ideal Plan - PPO
Delta Dental Preferred Plan - PPO

Guardian

Guardian Basics for Families 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

Humana

Humana Dental Smart Choice - PPO
Humana Dental Smart Choice - High - PPO
Humana Dental Smart Choice - Lite - PPO
Humana Dental Smart Choice - Low - PPO
Humana Dental Smart Choice Basic - PPO
Humana Dental Smart Choice- Lite - PPO

Renaissance Dental

Alabama Preferred Plan - PPO
Alabama Preferred Plan (Pediatric Only) - PPO
Alabama Preferred Plus Plan - PPO
Alabama Preferred Plus Plan (Pediatric Only) - PPO
Alabama Wellness Essentials Plan - PPO
Florida Preferred Plan - PPO
Florida Preferred Plan (Pediatric Only) - PPO
Florida Preferred Plus Plan - PPO
Florida Preferred Plus Plan (Pediatric Only) - PPO
Florida Wellness Essentials Plan - PPO
High PPO Dental Plan - PPO
High PPO Dental Plan (Pediatric Only) - PPO
Kansas Preferred Plan - PPO
Kansas Preferred Plan (Pediatric Only) - PPO
Kansas Wellness Essentials Plan - PPO
Low PPO Dental Plan - PPO
Low PPO Dental Plan (Pediatric Only) - PPO
Mississippi Preferred Plan - PPO
Mississippi Preferred Plan (Pediatric Only) - PPO
Mississippi Wellness Essentials Plan - PPO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

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
2470371	MEDICARE ID-TYPE UNSPECIFIED (04)	NC
0102X	MEDICAID (05)	NC
U66515	MEDICARE UPIN (02)	NC
8990023	MEDICAID (05)	NC

Medicare Participation & PECOS Enrollment Status

John Crestetto 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: 03-01-2017
Opt-Out End Date: 03-01-2025
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 27804 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $83.9
Minimum New Patient Price $54.12
Maximum New Patient Price $165.09

Average New Patient Copayment $20.97
Minimum New Patient Copayment $13.53
Maximum New Patient Copayment $41.27

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $67.72
Minimum Established Patient Price $17.21
Maximum Established Patient Price $134.61

Average Established Patient Copayment $16.93
Minimum Established Patient Copayment $4.3
Maximum Established Patient Copayment $33.65

* 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.

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	5	9	7	3	7	5
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	0	12	3	10	9	14	3	14
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 2 + 3 + 1 + 0 + 9 + 1 + 4 + 3 + 1 + 4 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 5									5

The NPI number 1063597375 is valid because the calculated check digit 5 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.

MARY LINDA HAWES MD

Internal Medicine

(Nephrology)

901 N WINSTEAD AVE
ROCKY MOUNT, NC
ZIP 27804

About JOHN CRESTETTO

Location Map

Specialty - Primary Taxonomy

Dentist Oral and Maxillofacial Surgery

Insurance Plans Accepted

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

Opted-Out of Medicare? Yes

Opt-Out Effective Date: 03-01-2017

Opt-Out End Date: 03-01-2025

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

New Patients Visit Costs *

Established Patients Visit Costs *

Reviews for DR. JOHN MAX CRESTETTO DDS,MD

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions