SHAUN C SPALDING MD
NPI 1154533248
Emergency Medicine in Klamath Falls, OR
NPI Status: Active since May 03, 2007
Contact Information
2865 DAGGETT AVE
KLAMATH FALLS, OR
ZIP 97601
Phone: (541) 274-6176
- Individual
- Male
- Emergency Medicine
- Accepts Insurance
- PECOS Enrolled
About SHAUN SPALDING
This page provides the complete NPI Profile along with additional information for Shaun Spalding, a provider established in Klamath Falls, Oregon with a medical specialization in Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1154533248 assigned on May 2007. The practitioner's primary taxonomy code is 207P00000X with license number MD29160 (OR). The provider is registered as an individual and his NPI record was last updated 6 years ago.
- NPI
- 1154533248
- Provider Name
- SHAUN C SPALDING MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2865 DAGGETT AVE KLAMATH FALLS, OR 97601
- Location Phone
- (541) 274-6176
- Mailing Address
- PO BOX 1193 CORVALLIS, OR 97339
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-03-2007
- Last Update Date
- 11-10-2020
- Code Navigator
Location Map
Secondary Locations
- 525 N Santiam Hwy
Lebanon, OR 97355
(541) 258-2101
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
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD29160
- License State
- OR
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Shaun Spalding 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-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)
1 DME suppliers used 13 Medicare Claims 13 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.
Critical care, first 30-74 minutes
Emergency department visit for life threatening or functioning severity
Emergency department visit for problem of high severity
Emergency department visit for problem of mild to moderate severity
Emergency department visit for problem of moderate severity
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
This service was performed 23 times for 23 patientsAn emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
This service was performed 85 times for 84 patientsAn emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
This service was performed 146 times for 143 patientsAn emergency department visit for a mild to moderate issue is when you seek immediate medical attention for a non-life-threatening condition. This could include minor injuries, moderate pain, or illnesses like the flu. During the visit, healthcare professionals assess your condition, provide treatment, and may recommend follow-up care.
This service was performed 27 times for 26 patientsAn emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
This service was performed 45 times for 44 patientsPhysician 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 97601 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.82
- Minimum New Patient Price $54.96
- Maximum New Patient Price $166.64
- Average New Patient Copayment $21.2
- Minimum New Patient Copayment $13.74
- 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 $97.16
- Minimum Established Patient Price $17.68
- Maximum Established Patient Price $136.19
- Average Established Patient Copayment $24.29
- Minimum Established Patient Copayment $4.42
- Maximum Established Patient Copayment $34.04
* 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 1154533248, we treat the final digit (8) 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 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
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 52 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.
KLAMATH FALLS, OR 97601
KLAMATH FALLS, OR 97601
KLAMATH FALLS, OR 97601
KLAMATH FALLS, OR 97601
KLAMATH FALLS, OR 97601
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154533248, enumerated as an "individual" on May 03, 2007.
The provider is located at 2865 DAGGETT AVE KLAMATH FALLS, OR 97601 and the phone number is (541) 274-6176.
Emergency Medicine with taxonomy code 207P00000X.
The provider might be accepting Accepts: Providence Health Plan. Please consult your insurance carrier or call the provider to verify.
