CHELSEA GOUGH
NPI 1124477377
Physician Assistant in Charlotte, NC
NPI Status: Active since June 08, 2016
Contact Information
340 JAKE ALEXANDER BLVD. WEST
SUITE 105
CHARLOTTE, NC
ZIP 28203
Phone: (704) 403-6240
- Individual
- Female
- Physician Assistant
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About CHELSEA GOUGH
This page provides the complete NPI Profile along with additional information for Chelsea Gough, a primary care provider established in Charlotte, North Carolina with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1124477377 assigned on June 2016. The practitioner's primary taxonomy code is 363A00000X with license number 0010-06438 (NC). The provider is registered as an individual and her NPI record was last updated 9 years ago.
- NPI
- 1124477377
- Provider Name
- CHELSEA GOUGH
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 340 JAKE ALEXANDER BLVD. WEST SUITE 105 CHARLOTTE, NC 28203
- Location Phone
- (704) 403-6240
- Mailing Address
- PO BOX 602478 CHARLOTTE, NC 28260
- Mailing Phone
- (704) 403-6240
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-08-2016
- Last Update Date
- 02-27-2017
- Code Navigator
A primary care provider (PCP) like Chelsea Gough 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.
- 0010-06438
- License State
- NC
- 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:
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ Dental + Vision (No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Value ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
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 |
|---|---|---|---|
| NCU919A | MEDICARE PIN (08) | NC | |
| NCU919B | MEDICARE PIN (08) | NC | |
| 1124477377 | MEDICAID (05) | NC | |
| NCU919C | MEDICARE PIN (08) | NC | |
| 2745PA | MEDICAID (05) | SC | |
| NCU919E | MEDICARE PIN (08) | NC | |
| NCU919D | MEDICARE PIN (08) | NC |
Medicare Participation & PECOS Enrollment Status
Chelsea Gough 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: Durable Medical Equipment (DME) 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: No
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: Yes
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 28203 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.9
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $20.97
- Minimum New Patient Copayment $13.53
- Maximum New Patient Copayment $41.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $67.72
- Minimum Established Patient Price $17.21
- Maximum Established Patient Price $134.61
- Average Established Patient Copayment $16.93
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.65
* 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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Biopsy Follow-Up | 100% | 29 |
| Percentage of new patients whose biopsy results have been reviewed and communicated to the primary care/referring physician and patient by the performing physician | ||
| Care Plan | 39% | 1275 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| Documentation of Current Medications in the Medical Record | 100% | 2268 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Pneumococcal Vaccination Status for Older Adults | 82% | 765 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% | 252 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 100% | 151 |
| Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user | ||
| Tobacco use | Yes | N/A |
| Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. | ||
| Use of certified EHR to capture patient reported outcomes | Yes | N/A |
| In support of improving patient access, performing additional activities that enable capture of patient reported outcomes (e.g., home blood pressure, blood glucose logs, food diaries, at-risk health factors such as tobacco or alcohol use, etc.) or patient activation measures through use of certified EHR technology, containing this data in a separate queue for clinician recognition and review. | ||
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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 1124477377, 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 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 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.
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 63 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124477377, enumerated as an "individual" on June 08, 2016.
The provider is located at 340 JAKE ALEXANDER BLVD. WEST SUITE 105 CHARLOTTE, NC 28203 and the phone number is (704) 403-6240.
Physician Assistant with taxonomy code 363A00000X.
The provider might be accepting Accepts: UnitedHealthcare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
