DR. DOUGLAS J. MARKERT M.D.
NPI 1114907631
Radiology - Vascular & Interventional Radiology in Gainesville, VA

NPI Status: Active since January 19, 2006

Contact Information

14540 JOHN MARSHALL HWY STE 104
GAINESVILLE, VA
ZIP 20155
Phone: (703) 712-6062
Fax: (571) 445-3075

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NPPES record last updated: July 31, 2021. Verified against the NPPES registry weekly; last sync: July 12, 2026.

Record update history: Jul 31, 2021, Oct 6, 2020, Mar 17, 2018 (3 updates tracked since 2018).

  • Individual
  • Male
  • Years of Experience 33
  • Radiology
  • Vascular & Interventional Radiology
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About DOUGLAS MARKERT

This page provides the complete NPI Profile along with additional information for Douglas Markert, a provider established in Gainesville, Virginia with a medical specialization in Radiology, focusing in vascular & interventional radiology and more than 33 years of experience. He graduated from Eastern Virginia Medical School in 1994. The healthcare provider is registered in the NPI registry with number 1114907631 assigned on January 2006. The practitioner's primary taxonomy code is 2085R0204X with license number 0101059112 (VA). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1114907631
Provider Name
DR. DOUGLAS J. MARKERT M.D.
Gender
Male
Entity Type
Individual
Location Address
14540 JOHN MARSHALL HWY STE 104 GAINESVILLE, VA 20155
Location Phone
(703) 712-6062
Location Fax
(571) 445-3075
Mailing Address
PO BOX 9007 CHARLOTTESVILLE, VA 22906
Medical School Name
EASTERN VIRGINIA MEDICAL SCHOOL
Graduation Year
1994
Is Sole Proprietor?
No
Enumeration Date
01-19-2006
Last Update Date
07-31-2021
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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

Radiology Vascular & Interventional Radiology

Taxonomy Code
2085R0204X
Type
Allopathic & Osteopathic Physicians
License No.
0101059112
License State
VA
Taxonomy Description
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
12085R0202XAllopathic & Osteopathic Physicians

Radiology
Diagnostic Radiology

0101059112 (VA)

Insurance Plans Accepted

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

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.

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
0101059112MEDICAID (05)VA 
7237936MEDICAID (05)VA 
6688-0015OTHER (01)VACAREFIRST
70569267OTHER (01)VATRICARE
7237766MEDICAID (05)VA 
7220952MEDICAID (05)VA 
7237782MEDICAID (05)VA 
7237774MEDICAID (05)VA 

Medicare Participation & PECOS Enrollment Status

Douglas Markert 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.

Douglas Markert 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: 1052317062

    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: I20100119000149

    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

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.72 for a new patient copayment and $17.52 for an established patient copayment.

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 20155 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $86.88
  • Minimum New Patient Price $56.19
  • Maximum New Patient Price $170.3
  • Average New Patient Copayment $21.72
  • Minimum New Patient Copayment $14.04
  • Maximum New Patient Copayment $42.57

Established Patients Visit Costs *

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

  • Average Established Patient Price $70.08
  • Minimum Established Patient Price $18.07
  • Maximum Established Patient Price $138.91
  • Average Established Patient Copayment $17.52
  • Minimum Established Patient Copayment $4.51
  • Maximum Established Patient Copayment $34.72

* 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 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 1114907631, we treat the final digit (1) 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 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

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
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
1
Doubled → 2
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
0
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
6
Unchanged
Pos 9
3
Doubled → 6
Check
1
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 9 → 18 → 9 7 → 14 → 5 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 2 + 4 + 1 + 8 + 0 + 1 + 4 + 6 + 6 + 24 = 59

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

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1114907631.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Radiology (Vascular & Interventional Radiology)
14540 JOHN MARSHALL HWY STE 104
GAINESVILLE, VA 20155

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114907631, enumerated as an "individual" on January 19, 2006.

The provider is located at 14540 JOHN MARSHALL HWY STE 104 GAINESVILLE, VA 20155 and the phone number is (703) 712-6062.

Radiology with taxonomy code 2085R0204X and a focus in Vascular & Interventional Radiology.

The provider might be accepting Accepts: Medicare, Medicaid and Tricare. Please consult your insurance carrier or call the provider to verify.