STEPHEN MARCUS PA
NPI 1114941150
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Burlington, VT
NPI Status: Active since July 26, 2006
Contact Information
111 COLCHESTER AVE
FLETCHER 4
BURLINGTON, VT
ZIP 05401
Phone: (802) 847-4044
Fax: (802) 847-8158
- Individual
- Male
- Years of Experience 39
- Thoracic Surgery (Cardiothoracic Vascula...
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About STEPHEN MARCUS
This page provides the complete NPI Profile along with additional information for Stephen Marcus, a provider established in Burlington, Vermont with a medical specialization in Thoracic Surgery (cardiothoracic Vascular Surgery) and more than 39 years of experience. The healthcare provider is registered in the NPI registry with number 1114941150 assigned on July 2006. The practitioner's primary taxonomy code is 208G00000X with license number 055-0030330 (VT). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1114941150
- Provider Name
- STEPHEN MARCUS PA
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 111 COLCHESTER AVE FLETCHER 4 BURLINGTON, VT 05401
- Location Phone
- (802) 847-4044
- Location Fax
- (802) 847-8158
- Mailing Address
- 307 MAPLEWOOD DR SHELBURNE, VT 05482
- Mailing Phone
- (802) 985-1272
- Mailing Fax
- (802) 847-8158
- Medical School Name
- OTHER
- Graduation Year
- 1987
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-26-2006
- Last Update Date
- 07-08-2007
- Code Navigator
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
Thoracic Surgery (Cardiothoracic Vascular Surgery)
- Taxonomy Code
- 208G00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 055-0030330
- License State
- VT
- Taxonomy Description
- A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/7500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/30%/9000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2500/30%/10000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/10000 - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Stephen Marcus 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.
Stephen Marcus 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: 1951463165
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: I20081223000188
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
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.
Coronary artery bypass using artery graft, 1 graft
Coronary artery bypass using vein or artery graft, 2 grafts
Harvest of vein using an endoscope
A coronary artery bypass with one artery graft is a surgical procedure to improve blood flow to your heart. An artery from another part of your body is used to bypass a blocked or narrowed coronary artery. This can help reduce chest pain and risk of heart attack.
This service was performed 23 times for 23 patientsA coronary artery bypass with 2 grafts is a surgery to improve blood flow to your heart. A surgeon takes a healthy vein or artery from your body and attaches it to the blocked coronary artery. This creates a new path for blood to flow, bypassing the blockage.
This service was performed 13 times for 13 patientsHarvesting a vein using an endoscope is a procedure where a small camera is used to help surgeons remove a vein from your body. This vein is often used to bypass a blocked artery, improving blood flow to your heart.
This service was performed 23 times for 23 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $42.12 for a new patient copayment and $17.39 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 05401 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $168.48
- Minimum New Patient Price $55.8
- Maximum New Patient Price $168.48
- Average New Patient Copayment $42.12
- Minimum New Patient Copayment $13.95
- Maximum New Patient Copayment $42.12
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $69.56
- Minimum Established Patient Price $18.08
- Maximum Established Patient Price $137.84
- Average Established Patient Copayment $17.39
- Minimum Established Patient Copayment $4.52
- Maximum Established Patient Copayment $34.46
* 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 1114941150, we treat the final digit (0) 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 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
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 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114941150, enumerated as an "individual" on July 26, 2006.
The provider is located at 111 COLCHESTER AVE FLETCHER 4 BURLINGTON, VT 05401 and the phone number is (802) 847-4044.
Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to verify.
