KARL M HOLMES PAC
NPI 1124006887
Physician Assistant in Keystone, IA

NPI Status: Active since January 04, 2006

Contact Information

214 3RD ST
KEYSTONE, IA
ZIP 52249
Phone: (319) 442-3215
Fax: (319) 442-3217

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  • Individual
  • Male
  • Physician Assistant
  • Accepts Insurance
  • PECOS Enrolled

About KARL HOLMES

This page provides the complete NPI Profile along with additional information for Karl Holmes, a primary care provider established in Keystone, Iowa with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1124006887 assigned on January 2006. The practitioner's primary taxonomy code is 363A00000X with license number 001034 (IA). The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI
1124006887
Provider Name
KARL M HOLMES PAC
Gender
Male
Entity Type
Individual
Location Address
214 3RD ST KEYSTONE, IA 52249
Location Phone
(319) 442-3215
Location Fax
(319) 442-3217
Mailing Address
214 3RD ST PO BOX 305 KEYSTONE, IA 52249
Mailing Phone
(319) 442-3215
Mailing Fax
(319) 442-3217
Is Sole Proprietor?
No
Enumeration Date
01-04-2006
Last Update Date
10-19-2007
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A primary care provider (PCP) like Karl Holmes 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

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
001034
License State
IA
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

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

  • Inspire by Medica Bronze $0 Copay PCP Visits - EPO
  • Inspire by Medica Bronze Share - EPO
  • Inspire by Medica Expanded Bronze Standard - EPO
  • Inspire by Medica Gold $0 Copay PCP Visits - EPO
  • Inspire by Medica Gold Share - EPO
  • Inspire by Medica Gold Standard - EPO
  • Inspire by Medica Silver $0 Copay PCP Visits - EPO
  • Inspire by Medica Silver Share - EPO
  • Inspire by Medica Silver Standard - EPO
  • Medica Insure Bronze $0 Copay PCP Visits - EPO
  • Medica Insure Bronze Premier - EPO
  • Medica Insure Bronze Share - EPO
  • Medica Insure Expanded Bronze Standard - EPO
  • Medica Insure Gold $0 Copay PCP Visits - EPO
  • Medica Insure Gold Share - EPO
  • Medica Insure Gold Standard - EPO
  • Medica Insure Silver $0 Copay PCP Visits - EPO
  • Medica Insure Silver Share - EPO
  • Medica Insure Silver Standard - 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
56451MEDICARE ID-TYPE UNSPECIFIED (04)IA 
S77504MEDICARE UPIN (02)IA 

Medicare Participation & PECOS Enrollment Status

Karl Holmes 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 60 Medicare Claims 89 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    4 DME suppliers used 27 Medicare Claims 27 Services Paid

  • DME-Other DME (DE001N)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    3 DME suppliers used 13 Medicare Claims 13 Services Paid

  • DME-Other DME (DE001N)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    5 DME suppliers used 17 Medicare Claims 17 Services Paid

  • DME-Other DME (DE001N)

    Tubing used with positive airway pressure device (HCPCS:A7037)

    5 DME suppliers used 19 Medicare Claims 19 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    5 DME suppliers used 25 Medicare Claims 146 Services Paid

  • DME-Other DME (DE001N)

    Filter, non disposable, used with positive airway pressure device (HCPCS:A7039)

    3 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    2 DME suppliers used 25 Medicare Claims 25 Services Paid

  • DME-Other DME (DE001N)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    3 DME suppliers used 17 Medicare Claims 17 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)

    4 DME suppliers used 82 Medicare Claims 82 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:K0738)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Other DME (DE000N)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    5 DME suppliers used 48 Medicare Claims 48 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)

    4 DME suppliers used 22 Medicare Claims 4409 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

    2 DME suppliers used 27 Medicare Claims 3240 Services Paid

Physician 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 52249 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $81.84
  • Minimum New Patient Price $52.96
  • Maximum New Patient Price $161.4
  • Average New Patient Copayment $20.46
  • Minimum New Patient Copayment $13.24
  • Maximum New Patient Copayment $40.35

Established Patients Visit Costs *

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

  • Average Established Patient Price $66.36
  • Minimum Established Patient Price $16.91
  • Maximum Established Patient Price $131.98
  • Average Established Patient Copayment $16.59
  • Minimum Established Patient Copayment $4.22
  • Maximum Established Patient Copayment $32.99

* 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 1124006887, we treat the final digit (7) 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

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
2
Doubled → 4
Pos 4
4
Unchanged
Pos 5
0
Doubled → 0
Pos 6
0
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
8
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
7
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 2 → 4 0 → 0 6 → 12 → 3 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 + 4 + 4 + 0 + 0 + 1 + 2 + 8 + 1 + 6 + 24 = 53

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

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1124006887.

Other Providers at the Same Location


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

Clinic/Center (Rural Health)
214 3RD ST
KEYSTONE, IA 52249

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124006887, enumerated as an "individual" on January 04, 2006.

The provider is located at 214 3RD ST KEYSTONE, IA 52249 and the phone number is (319) 442-3215.

Physician Assistant with taxonomy code 363A00000X.

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