MATTHEW STEWART BAUMGARTNER LPC
NPI 1154967016
Counselor - Professional in Minot, ND

NPI Status: Active since November 25, 2019

Contact Information

6301 19TH AVE NW
MINOT, ND
ZIP 58703
Phone: (701) 852-3628
Fax: (701) 852-1190

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Counselor
Professional
Accepts Insurance
PECOS Enrolled

About MATTHEW BAUMGARTNER

This page provides the complete NPI Profile along with additional information for Matthew Baumgartner, a provider established in Minot, North Dakota with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1154967016 assigned on November 2019. The practitioner's primary taxonomy code is 101YP2500X with license number 1039-11-19 (ND). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI: 1154967016
Provider Name: MATTHEW STEWART BAUMGARTNER LPC
Gender: Male
Entity Type: Individual
Location Address: 6301 19TH AVE NW MINOT, ND 58703
Location Phone: (701) 852-3628
Location Fax: (701) 852-1190
Mailing Address: 1237 W DIVIDE AVE BISMARCK, ND 58501
Mailing Phone: (701) 368-8418
Is Sole Proprietor?: No
Enumeration Date: 11-25-2019
Last Update Date: 11-04-2021
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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: Counselor Professional
Taxonomy Code: 101YP2500X
Type: Behavioral Health & Social Service Providers
License No.: 1039-11-19
License State: ND

Insurance Plans Accepted

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

Medica

Altru Prime by Medica Bronze $0 Copay PCP Visits - HMO
Altru Prime by Medica Bronze Share - HMO
Altru Prime by Medica Expanded Bronze Standard - HMO
Altru Prime by Medica Gold $0 Copay PCP Visits - HMO
Altru Prime by Medica Gold Share - HMO
Altru Prime by Medica Gold Standard - HMO
Altru Prime by Medica Silver $0 Copay PCP Visits - HMO
Altru Prime by Medica Silver Share - HMO
Altru Prime by Medica Silver Standard - HMO
Essentia Choice Care with Medica Bronze $0 Copay PCP Visits - HMO
Essentia Choice Care with Medica Bronze Share - HMO
Essentia Choice Care with Medica Expanded Bronze Standard - HMO
Essentia Choice Care with Medica Gold $0 Copay PCP Visits - HMO
Essentia Choice Care with Medica Gold Share - HMO
Essentia Choice Care with Medica Gold Standard - HMO
Essentia Choice Care with Medica Silver $0 Copay PCP Visits - HMO
Essentia Choice Care with Medica Silver Share - HMO
Essentia Choice Care with Medica Silver Standard - HMO
Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
Medica Individual Choice Bronze Share - HMO

Sanford Health Plan

Sanford Individual TRUE $1,750 - HMO
Sanford Individual TRUE $10,600 - HMO
Sanford Individual TRUE $3,500 - HMO
Sanford Individual TRUE $4,750 - HMO
Sanford Individual TRUE $6,500 - HMO
Sanford Individual TRUE $7,200 HSA Qualified - HMO
Sanford Individual TRUE Standardized $2,000 - HMO
Sanford Individual TRUE Standardized $6,000 - HMO
Sanford Individual TRUE Standardized $7,500 - HMO

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

Medicare Participation & PECOS Enrollment Status

Matthew Baumgartner 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 and Durable Medical Equipment (DME).

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): No
Eligible to Order or Refer Power Mobility Devices: No

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 1154967016, we treat the final digit (6) 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 10 → 1 + 0

Pos 4

Unchanged

Pos 5

Doubled → 18 → 1 + 8

Pos 6

Unchanged

Pos 7

Doubled → 14 → 1 + 4

Pos 8

Unchanged

Pos 9

Doubled → 2

Check

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 5 → 10 → 1 9 → 18 → 9 7 → 14 → 5 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 0 + 4 + 1 + 8 + 6 + 1 + 4 + 0 + 2 + 24 = 54

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

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6

This NPI is valid

The calculated check digit is 6, which matches the last digit of 1154967016.