DR. MICHAEL JACK COULTER M.D.
NPI 1124477211
Otolaryngology in Camp Pendleton, CA
NPI Status: Active since June 08, 2016
Contact Information
200 MERCY CIRCLE
CAMP PENDLETON, CA
ZIP 92055
Phone: (760) 725-6646
- Individual
- Male
- Years of Experience 10
- Otolaryngology
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MICHAEL COULTER
This page provides the complete NPI Profile along with additional information for Michael Coulter, a provider established in Camp Pendleton, California with a medical specialization in Otolaryngology and more than 10 years of experience. He graduated from State University Of New York At Stony Brook, School Of Medicine in 2016. The healthcare provider is registered in the NPI registry with number 1124477211 assigned on June 2016. The practitioner's primary taxonomy code is 207Y00000X with license number D7935901 (CA). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1124477211
- Provider Name
- DR. MICHAEL JACK COULTER M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 200 MERCY CIRCLE CAMP PENDLETON, CA 92055
- Location Phone
- (760) 725-6646
- Mailing Address
- PO BOX 555191 CAMP PENDLETON, CA 92055
- Mailing Phone
- (760) 725-6646
- Medical School Name
- STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
- Graduation Year
- 2016
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-08-2016
- Last Update Date
- 08-23-2022
- 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
Otolaryngology
- Taxonomy Code
- 207Y00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- D7935901
- License State
- CA
- Taxonomy Description
- An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
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) |
|---|---|---|---|---|
| 1 | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | A150427 (CA) |
Medicare Participation & PECOS Enrollment Status
Michael Coulter 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.
Michael Coulter 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: 345766838
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: I20250428003181
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: $35.05 for a new patient copayment and $19.21 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 92055 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $140.22
- Minimum New Patient Price $62.1
- Maximum New Patient Price $184.71
- Average New Patient Copayment $35.05
- Minimum New Patient Copayment $15.52
- Maximum New Patient Copayment $46.17
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $76.87
- Minimum Established Patient Price $20.62
- Maximum Established Patient Price $151.42
- Average Established Patient Copayment $19.21
- Minimum Established Patient Copayment $5.15
- Maximum Established Patient Copayment $37.85
* 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 1124477211, 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.
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 59 is 60. 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.
CAMP PENDLETON, CA 92055
CAMP PENDLETON, CA 92055
CAMP PENDLETON, CA 92055
CAMP PENDLETON, CA 92055
CAMP PENDLETON, CA 92055
CAMP PENDLETON, CA 92055
CAMP PENDLETON, CA 92055
CAMP PENDLETON, CA 92055
CAMP PENDLETON, CA 92055
CAMP PENDLETON, CA 92055
CAMP PENDLETON, CA 92055
OCEANSIDE, CA 92055
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124477211, enumerated as an "individual" on June 08, 2016.
The provider is located at 200 MERCY CIRCLE CAMP PENDLETON, CA 92055 and the phone number is (760) 725-6646.
Otolaryngology with taxonomy code 207Y00000X.
