MR. THOMAS SCOTT DUNCAN MD
NPI 1093770893
Family Medicine in Astoria, OR
NPI Status: Active since April 18, 2006
Contact Information
595 18TH ST
ASTORIA, OR
ZIP 97103
Phone: (503) 325-9131
Fax: (503) 325-8797
- Individual
- Male
- Family Medicine
- Accepts Insurance
- PECOS Enrolled
About THOMAS DUNCAN
This page provides the complete NPI Profile along with additional information for Thomas Duncan, a primary care provider established in Astoria, Oregon with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1093770893 assigned on April 2006. The practitioner's primary taxonomy code is 207Q00000X with license number MD09168 (OR). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1093770893
- Provider Name
- MR. THOMAS SCOTT DUNCAN MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 595 18TH ST ASTORIA, OR 97103
- Location Phone
- (503) 325-9131
- Location Fax
- (503) 325-8797
- Mailing Address
- 595 18TH ST ASTORIA, OR 97103
- Mailing Phone
- (503) 325-9131
- Mailing Fax
- (503) 325-8797
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 04-18-2006
- Last Update Date
- 07-08-2007
- Code Navigator
A primary care provider (PCP) like Thomas Duncan 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 .
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD09168
- License State
- OR
- 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:
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
- Core Bronze HSA 10600 - EPO
- Core Bronze HSA 7500 - EPO
- Core Bronze HSA 8300 - EPO
- Core Gold 1500 - EPO
- Core Gold 3000 - EPO
- Core Silver 3500 - EPO
- Core Silver 4500 - EPO
- Core Silver 5000 - EPO
- Core Silver 7500 - EPO
- Core Standard Expanded Bronze HSA - EPO
- Core Standard Gold - EPO
- Core Standard Silver - EPO
- PacificSource Oregon Standard Bronze HSA Plan Core - EPO
- PacificSource Oregon Standard Gold Plan Core - EPO
- PacificSource Oregon Standard Silver Plan Core - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
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 | Identifier Issuer |
|---|---|---|---|
| 130985 | MEDICARE ID-TYPE UNSPECIFIED (04) | OR | |
| 048140 | MEDICAID (05) | OR | |
| C92546 | MEDICARE UPIN (02) |
Medicare Participation & PECOS Enrollment Status
Thomas Duncan 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
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
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
6 DME suppliers used 31 Medicare Claims 52 Services Paid
DME-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
2 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
2 DME suppliers used 13 Medicare Claims 78 Services Paid
DME-Hospital Beds (DB000N)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE000N)
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
DME-Wheelchairs (DD021N)
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each (HCPCS:E0955)
1 DME suppliers used 15 Medicare Claims 15 Services Paid
DME-Wheelchairs (DD021N)
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory (HCPCS:E1028)
1 DME suppliers used 15 Medicare Claims 15 Services Paid
DME-Wheelchairs (DD000N)
Manual adult size wheelchair, includes tilt in space (HCPCS:E1161)
1 DME suppliers used 15 Medicare Claims 15 Services Paid
DME-Oxygen and Supplies (DC002N)
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 11 Medicare Claims 12 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
Drugs Administered Through DME
DME-Drugs Administered Through DME (DG006N)
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)
2 DME suppliers used 11 Medicare Claims 1017 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Follow-up nursing facility visit per day, typically 15 minutes
Initial nursing facility visit per day, typically 35 minutes
Initial nursing facility visit per day, typically 45 minutes
Insertion of needle into vein for collection of blood sample
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Removal of impacted ear wax by washing
Urinalysis, manual test
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 42 times for 42 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 15 times for 14 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 404 times for 236 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 370 times for 228 patientsA follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 67 times for 26 patientsAn initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
This service was performed 20 times for 18 patientsAn initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
This service was performed 38 times for 38 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 158 times for 127 patientsThis service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
This service was performed 37 times for 20 patientsImpacted ear wax removal by washing, also known as ear irrigation, involves using a pressurized flow of water to break up and dislodge the ear wax. This safe procedure helps restore normal hearing and relieve discomfort caused by the blockage.
This service was performed 15 times for 13 patientsA urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
This service was performed 21 times for 19 patientsPhysician 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 97103 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.82
- Minimum New Patient Price $54.96
- Maximum New Patient Price $166.64
- Average New Patient Copayment $21.2
- Minimum New Patient Copayment $13.74
- Maximum New Patient Copayment $41.66
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.16
- Minimum Established Patient Price $17.68
- Maximum Established Patient Price $136.19
- Average Established Patient Copayment $24.29
- Minimum Established Patient Copayment $4.42
- Maximum Established Patient Copayment $34.04
* 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 1093770893, we treat the final digit (3) 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
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 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093770893, enumerated as an "individual" on April 18, 2006.
The provider is located at 595 18TH ST ASTORIA, OR 97103 and the phone number is (503) 325-9131.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Moda Health Plan, Inc., PacificSource Health. Please consult your insurance carrier or call the provider to verify.