ROBERT ANDREW DE WALL LCPC
NPI 1114228384
Counselor - Professional in Pocatello, ID

NPI Status: Active since November 04, 2010

Contact Information

444 HOSPITAL WAY STE 477
POCATELLO, ID
ZIP 83201
Phone: (208) 233-7832
Fax: (208) 233-7835

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

Individual
Male
Years of Experience 18
Counselor
Professional
Accepts Insurance
May Accept Medicare Approved Payment
PECOS Enrolled

About ROBERT DE WALL

This page provides the complete NPI Profile along with additional information for Robert De Wall, a provider established in Pocatello, Idaho with a medical specialization in Counselor, focusing in professional and more than 18 years of experience. The healthcare provider is registered in the NPI registry with number 1114228384 assigned on November 2010. The practitioner's primary taxonomy code is 101YP2500X with license number LCPC-4672 (ID). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI: 1114228384
Provider Name: ROBERT ANDREW DE WALL LCPC
Gender: Male
Entity Type: Individual
Location Address: 444 HOSPITAL WAY STE 477 POCATELLO, ID 83201
Location Phone: (208) 233-7832
Location Fax: (208) 233-7835
Mailing Address: 65 FORDHAM ST POCATELLO, ID 83201
Mailing Phone: (208) 317-0027
Mailing Fax: (208) 233-7835
Medical School Name: OTHER
Graduation Year: 2008
Is Sole Proprietor?: Yes
Enumeration Date: 11-04-2010
Last Update Date: 10-22-2021
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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: Counselor Professional
Taxonomy Code: 101YP2500X
Type: Behavioral Health & Social Service Providers
License No.: LCPC-4672
License State: ID

Insurance Plans Accepted

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

Moda Health Plan, Inc.

Moda Select Alaska Bronze 6500 - PPO
Moda Select Alaska Bronze HDHP 5500 - PPO
Moda Select Alaska Gold 1500 - PPO
Moda Select Alaska Silver 4500 - PPO
Moda Select Alaska Standard Bronze - PPO
Moda Select Alaska Standard Gold - PPO
Moda Select Alaska Standard Silver - PPO
Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
Moda Select Texas Bronze HDHP 7500 - EPO
Moda Select Texas Standard Bronze - EPO
Moda Select Texas Standard Gold - EPO
Moda Select Texas Standard Silver - EPO

PacificSource Health Plans

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

Providence Health Plan

Connect 1500 Gold - EPO
Connect 6000 Silver - EPO
Connect 9800 Bronze - EPO
HSA Qualified 7500 Bronze - Choice Network - EPO
HSA-E Qualified 7500 Bronze - Signature Network - EPO
Providence Oregon Standard Bronze Plan - Choice Network - EPO
Providence Oregon Standard Bronze Plan - Signature Network - EPO
Providence Oregon Standard Gold Plan - Choice Network - EPO
Providence Oregon Standard Gold Plan - Signature Network - EPO
Providence Oregon Standard Silver Plan - Choice Network - EPO
Providence Oregon Standard Silver Plan - Signature Network - EPO

Select Health

Med Benchmark Expanded Bronze Select Copay Plan - HMO
Med Benchmark Expanded Bronze Standardized Plan - HMO
Med Benchmark Gold Standardized Plan - HMO
Med Benchmark Platinum - HMO
Med Benchmark Platinum Standardized Plan - HMO
Med Benchmark Silver 6000 Medical Deductible w/Vision - HMO
Med Benchmark Silver Standardized Plan - HMO
Med Gold 1500 Medical Deductible - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Robert De Wall is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Robert De Wall 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 and Durable Medical Equipment (DME).

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: 3577803618
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: I20240105001480
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? Maybe
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): No
Eligible to Order or Refer Power Mobility Devices: No

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 1114228384, we treat the final digit (4) 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 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

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.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 2

Pos 4

Unchanged

Pos 5

Doubled → 4

Pos 6

Unchanged

Pos 7

Doubled → 16 → 1 + 6

Pos 8

Unchanged

Pos 9

Doubled → 16 → 1 + 6

Check

Target digit

Regular digit Doubled digit Check digit

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.

1 → 2 1 → 2 2 → 4 8 → 16 → 7 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 2 + 4 + 4 + 2 + 1 + 6 + 3 + 1 + 6 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4

This NPI is valid

The calculated check digit is 4, which matches the last digit of 1114228384.