NABIL ZUHAYR MADHUN DO
NPI 1144682469
Internal Medicine - Endocrinology, Diabetes & Metabolism in Parma Heights, OH

NPI Status: Active since March 25, 2016

Contact Information

6785 W 130TH ST STE 101
PARMA HEIGHTS, OH
ZIP 44130
Phone: (440) 843-8888
Fax: (440) 843-8887

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  • Individual
  • Male
  • Internal Medicine
  • Endocrinology, Diabetes & Metabolism
  • Accepts Insurance
  • PECOS Enrolled

About NABIL MADHUN

This page provides the complete NPI Profile along with additional information for Nabil Madhun, an internist established in Parma Heights, Ohio with a medical specialization in Internal Medicine, focusing in endocrinology, diabetes & metabolism . The healthcare provider is registered in the NPI registry with number 1144682469 assigned on March 2016. The practitioner's primary taxonomy code is 207RE0101X with license number 34.012981 (OH). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1144682469
Provider Name
NABIL ZUHAYR MADHUN DO
Gender
Male
Entity Type
Individual
Location Address
6785 W 130TH ST STE 101 PARMA HEIGHTS, OH 44130
Location Phone
(440) 843-8888
Location Fax
(440) 843-8887
Mailing Address
6785 W 130TH ST STE 101 PARMA HEIGHTS, OH 44130
Mailing Phone
(440) 843-8888
Is Sole Proprietor?
Yes
Enumeration Date
03-25-2016
Last Update Date
10-04-2024
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An internist like Nabil Madhun is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, 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

Internal Medicine Endocrinology, Diabetes & Metabolism

Taxonomy Code
207RE0101X
Type
Allopathic & Osteopathic Physicians
License No.
34.012981
License State
OH
Taxonomy Description
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Insurance Plans Accepted

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

  • Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 8500 for HSA - HMO
  • Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Bronze Pathway 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Silver Pathway 5000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 4000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 5500 for HSA - HMO
  • Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Silver 6000 $20 Generic Drugs - HMO
  • Bronze $8,300 w/ Adult Dental ON-EX - HMO
  • Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
  • Bronze HSA $7,300 ON-EX - HMO
  • Bronze Standard w/ Virtual & Wellness - HMO
  • Gold $1,000 w/ Adult Dental ON-EX - HMO
  • Gold $1,000 w/ Virtual & Wellness ON-EX - HMO
  • Gold $500 w/ Virtual & Wellness ON-EX - HMO
  • Gold Standard w/ Virtual & Wellness - HMO
  • Silver $5,000 w/ Adult Dental ON-EX - HMO
  • Silver $5,000 w/ Virtual & Wellness ON-EX - HMO
  • Silver $5,800 w/ Virtual & Wellness ON-EX - HMO
  • Silver Standard w/ Virtual & Wellness - HMO
  • Molina Bronze Enhanced 3500 - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
  • Molina Bronze Saver 7000 - HMO
  • Molina Bronze Saver 7000 Plus with Adult Dental and Vision - HMO
  • Molina Bronze Saver 7000 Plus with Adult Vision - HMO
  • Molina Bronze Smart Heart Health - HMO
  • Molina Bronze Standard - HMO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Enhanced 895 - HMO
  • Molina Gold Enhanced 895 Plus with Adult Dental and Vision - HMO
  • Molina Gold Enhanced 895 Plus with Adult Vision - HMO
  • Molina Gold Smart Heart Health - HMO
  • Molina Gold Standard - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO
  • Molina Silver Saver with Four Free PCP Visits - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Nabil Madhun 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)

    29 DME suppliers used 60 Medicare Claims 222 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    9 DME suppliers used 12 Medicare Claims 30 Services Paid

  • DME-Other DME (DE017N)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    5 DME suppliers used 93 Medicare Claims 93 Services Paid

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.

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 20 times for 20 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 13 times for 13 patients

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 44130 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $126.12
  • Minimum New Patient Price $54.34
  • Maximum New Patient Price $166.65
  • Average New Patient Copayment $31.53
  • Minimum New Patient Copayment $13.58
  • Maximum New Patient Copayment $41.66

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $96.44
  • Minimum Established Patient Price $17.1
  • Maximum Established Patient Price $135.4
  • Average Established Patient Copayment $24.11
  • Minimum Established Patient Copayment $4.27
  • Maximum Established Patient Copayment $33.85

* 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 1144682469, we treat the final digit (9) 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 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

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
4
Doubled → 8
Pos 4
4
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
8
Unchanged
Pos 7
2
Doubled → 4
Pos 8
4
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
9
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 4 → 8 6 → 12 → 3 2 → 4 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 8 + 4 + 1 + 2 + 8 + 4 + 4 + 1 + 2 + 24 = 61

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

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1144682469.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1144682469, enumerated as an "individual" on March 25, 2016.

The provider is located at 6785 W 130TH ST STE 101 PARMA HEIGHTS, OH 44130 and the phone number is (440) 843-8888.

Internal Medicine with taxonomy code 207RE0101X and a focus in Endocrinology, Diabetes & Metabolism.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource,. Please consult your insurance carrier or call the provider to verify.