DR. GARY ALAN CALHOUN MD NPI 1083687990

Family Medicine in Albertville, AL

NPI 1083687990 Individual Male Years of Experience 33 Family Medicine PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About GARY CALHOUN

Gary Calhoun is a primary care provider established in Albertville, Alabama and his medical specialization is family medicine with more than 33 years of experience. He graduated from University Of Alabama School Of Medicine in 1989. The NPI number of Gary Calhoun is 1083687990 and was assigned on February 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 15304 (AL). The provider is registered as an individual and his NPI record was last updated one year ago.

A primary care provider (PCP) like Dr. Gary Alan Calhoun Md 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

Gary Calhoun is enrolled in PECOS and is eligible to order or refer healthcare 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

Gary Calhoun is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Marshall Medical Centers.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: preventive care and screening: body mass index (bmi) screening and follow-up plan. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

NPI

1083687990

Provider NameDR. GARY ALAN CALHOUN MD
Provider Location Address11491 US HIGHWAY 431 ALBERTVILLE, AL 35950
Provider Mailing AddressPO BOX 668 ALBERTVILLE, AL 35950
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year1989
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date02-10-2006
Last Update Date07-16-2020


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.15304
License StateAL
Taxonomy DescriptionFamily 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.

Business Address

DR. GARY ALAN CALHOUN MD
11491 US HIGHWAY 431
ALBERTVILLE, AL
ZIP 35950
Phone: (256) 894-6976

Get Directions


Mailing Address

DR. GARY ALAN CALHOUN MD
PO BOX 668
ALBERTVILLE, AL
ZIP 35950
Phone: (256) 505-6826
Fax: (256) 571-2862



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID2961594536
PECOS Enrollment IDI20070828000155
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 order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Clinician Utilization

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 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 130Removal of skin and tissue first 20 sq cm or less (HCPCS:11042)
  • 39Management and supervision of oxygen chamber therapy per session (HCPCS:99183)

Quality Reporting

The following quality measures meets Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Rate Number of Patients
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 100% 58
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Gary Calhoun is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
MARSHALL MEDICAL CENTERS2505 U S HIGHWAY 431 NORTH
BOAZ, AL 35957
(256) 593-8310Acute Care Hospitals10005

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
051514931OTHER (01)AL
051501161OTHER (01)AL

Other Providers at the same location


The following 14 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1912909771MR. WILLIAM H BEEKLEY MD
Individual
Specialist11491 US HIGHWAY 431 SUITE D
ALBERTVILLE, AL 35950
(256) 894-6976
1760577878MARSHALL IMAGING CENTER, LLC
Organization
Clinic/Center (Magnetic Resonance Imaging (MRI))11491 US HIGHWAY 431
ALBERTVILLE, AL 35950
(256) 894-6950
1235373234JOHN CHRISTOPHER BREWER
Organization
Family Medicine11491 US HIGHWAY 431 STE. D
ALBERTVILLE, AL 35950
(256) 891-5102
1669601720MARSHALL MEDICAL CENTER SOUTH HEATHER KRAUSSE MD
Organization
Psychiatry & Neurology (Psychiatry)11491 US HIGHWAY 431
ALBERTVILLE, AL 35950
(256) 891-5102
1154513109WILLIAM ALEXANDER NIXON LLC
Organization
Family Medicine11491 US HIGHWAY 431
ALBERTVILLE, AL 35950
(256) 505-6826
1447662242SCOTT PFITZER MD LLC
Organization
General Practice11491 US HIGHWAY 431
ALBERTVILLE, AL 35950
(256) 505-6826
1538511340MARSHALL MEDICAL CENTER SOUTH
Organization
Internal Medicine (Rheumatology)11491 US HIGHWAY 431
ALBERTVILLE, AL 35950
(256) 593-8310
1427556679 BOBBY JOE SMITH FNP-C
Individual
Nurse Practitioner (Family)11491 US HIGHWAY 431
ALBERTVILLE, AL 35950
(256) 894-6007
1356630958DR. RANDALL NARVIN BEYL JR. MD
Individual
Internal Medicine11491 US HIGHWAY 431
ALBERTVILLE, AL 35950
(256) 894-6700
1164083218NORTHEAST ALABAMA VASCULAR AND VEIN SPECIALIST
Organization
Surgery (Vascular Surgery)11491 US HIGHWAY 431
ALBERTVILLE, AL 35950
(256) 894-6800
1225219256 ALAN K WILLIS M.D.
Individual
Surgery (Vascular Surgery)11491 US HIGHWAY 431
ALBERTVILLE, AL 35950
(256) 894-6800
1972737302STEPHEN L BRITT MD PC
Organization
Family Medicine11491 US HIGHWAY 431 STE. D
ALBERTVILLE, AL 35950
(256) 891-5102
1629625041MARTIN WOUND CARE LLC
Organization
Specialist11491 US HIGHWAY 431
ALBERTVILLE, AL 35950
(256) 505-6826
1952901928 AMY P SAMPSON CCSH, RPSGT, RST
Individual
Clinic/Center (Sleep Disorder Diagnostic)11491 US HIGHWAY 431
ALBERTVILLE, AL 35950
(256) 894-6850

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.