DR. MICHAEL JOHN RADER O.D. NPI 1134299704
Optometrist - Corneal and Contact Management in Hilliard, OH

Individual Male Years of Experience 46 Optometrist Corneal and Contact Management PECOS Enrolled Accepts Medicare Approved Payment

About DR. MICHAEL JOHN RADER O.D.

Michael Rader is a provider established in Hilliard, Ohio and his medical specialization is Optometrist with a focus in corneal and contact management with more than 46 years of experience. He graduated from Ohio State University - College Of Optometry in 1977. The NPI number of Michael Rader is 1134299704 and was assigned on November 2006. The practitioner's primary taxonomy code is 152WC0802X with license number 3303 T964 (OH). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1134299704
Provider NameDR. MICHAEL JOHN RADER O.D.
Provider Location Address6044 PARKMEADOW LN SUITE B HILLIARD, OH 43026
Provider Mailing Address6044 PARKMEADOW LN SUITE B HILLIARD, OH 43026
GenderMale
NPI Entity TypeIndividual
Medical School NameOHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
Graduation Year1977
Is Sole Proprietor?Yes
Enumeration Date11-09-2006
Last Update Date10-08-2015

Michael Rader 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) and a Home Health Agency (HHA).

Michael Rader is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.89 for a new patient copayment and $17.8 for an established patient copayment.



Primary Taxonomy

Taxonomy Code152WC0802X
ClassificationOptometrist
TypeEye and Vision Services Providers
SpecializationCorneal and Contact Management
License No.3303 T964
License StateOH
Taxonomy DescriptionThe professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear.

Business Address

DR. MICHAEL JOHN RADER O.D.
6044 PARKMEADOW LN
SUITE B
HILLIARD, OH
ZIP 43026
Phone: (614) 876-2686
Fax: (614) 876-2687

Get Directions


Mailing Address

DR. MICHAEL JOHN RADER O.D.
6044 PARKMEADOW LN
SUITE B
HILLIARD, OH
ZIP 43026
Phone: (614) 876-2686
Fax: (614) 876-2687


PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID2264547629
PECOS Enrollment IDI20110609000832
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 order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesNo

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 43026 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$56.74 $173.94 $131.59
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.18 $43.48 $32.89
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.31 $141.66 $71.2
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.32 $35.41 $17.8

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 43Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
  • 12Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1152W00000XEye and Vision Services ProvidersOptometristOH3303OHNo

Taxonomy Description: doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
410002935OTHER (01)OHRAILROAD MEDICARE
RA0480591MEDICARE PIN (08)OH
0366152MEDICAID (05)OH
T47165MEDICARE UPIN (02)OH
0839280001MEDICARE NSC (07)OH
RA0480591MEDICARE ID-TYPE UNSPECIFIED (04)OH
410002935MEDICARE PIN (08)OH

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1134299704
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2164491870
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 6 + 4 + 4 + 9 + 1 + 8 + 7 + 0 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1134299704 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


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

NPI Name / Type Taxonomy Address
1679690176DR. JOE R JOSEPH JR. DDS
Individual
Dentist6044 PARKMEADOW LN SUITE A
HILLIARD, OH 43026
(614) 777-8722

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Michael John Rader O.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.