ETHAN MARSHALL WINDHAM MD
NPI 1174101406
Internal Medicine in Sarasota, FL
NPI Status: Active since March 30, 2021
Contact Information
1921 WALDEMERE ST STE 405
SARASOTA, FL
ZIP 34239
Phone: (941) 917-3500
Fax: (941) 917-3501
- Individual
- Male
- Years of Experience 5
- Internal Medicine
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
About ETHAN WINDHAM
This page provides the complete NPI Profile along with additional information for Ethan Windham, an internist established in Sarasota, Florida with a medical specialization in Internal Medicine and more than 5 years of experience. He graduated from University Of Florida College Of Medicine in 2021. The healthcare provider is registered in the NPI registry with number 1174101406 assigned on March 2021. The practitioner's primary taxonomy code is 207R00000X with license number ME167713 (FL). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1174101406
- Provider Name
- ETHAN MARSHALL WINDHAM MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1921 WALDEMERE ST STE 405 SARASOTA, FL 34239
- Location Phone
- (941) 917-3500
- Location Fax
- (941) 917-3501
- Mailing Address
- PO BOX 947407 ATLANTA, GA 30394
- Mailing Phone
- (941) 917-2600
- Mailing Fax
- (941) 917-3501
- Medical School Name
- UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
- Graduation Year
- 2021
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-30-2021
- Last Update Date
- 07-23-2024
- Code Navigator
An internist like Ethan Windham 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
Secondary Locations
- 1600 SW Archer Rd
Gainesville, FL 32610
(352) 265-8017
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
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- ME167713
- License State
- FL
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
- BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
- BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
- BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
- BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) - PPO
- BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) - PPO
- BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
- BlueSelect Bronze 1449 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - EPO
- BlueSelect Bronze 2139 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - EPO
- BlueSelect Bronze 2139E ($0 Virtual PCP Visits / $50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
- BlueSelect Bronze 2139V ($0 Virtual PCP Visits / $50 PCP Visits / Adult Vision / Rewards) - EPO
- BlueSelect Bronze 2342S ($50 PCP Visits / Multilingual Available / Rewards) - EPO
- BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
- BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
- BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) - POS
- BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) - POS
- BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
- BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) - POS
- BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
- BlueCare Gold 24K01-10 ($0 Virtual PCP Visits / $15 Labs / Rewards) - POS
- BlueCare Gold 24K01-33S ($30 PCP Visits / Multilingual Available/ Rewards) - POS
- BlueCare Gold 24K02-20 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
- BlueCare Gold 24K02-28S ($30 PCP Visits / Multilingual Available / Rewards) - POS
- BlueCare Platinum 24K01-04 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K01-07 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
- BlueCare Platinum 24K02-15 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
- BlueCare Silver 24K01-02 ($0 Virtual PCP Visits / $0 Labs / Rewards) - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Ethan Windham is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Ethan Windham 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
PECOS PAC ID: 6507262854
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20240805000070
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
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 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
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 34239 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $130.04
- Minimum New Patient Price $56
- Maximum New Patient Price $171.84
- Average New Patient Copayment $32.51
- Minimum New Patient Copayment $14
- Maximum New Patient Copayment $42.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $99.16
- Minimum Established Patient Price $17.57
- Maximum Established Patient Price $139.16
- Average Established Patient Copayment $24.79
- Minimum Established Patient Copayment $4.39
- Maximum Established Patient Copayment $34.79
* 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.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Ethan Windham is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| SARASOTA MEMORIAL HOSPITAL | 1700 S TAMIAMI TRL SARASOTA, FL 34239 | (941) 917-9000 | Acute Care Hospitals |
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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. | |||||||||
| 1 | 1 | 7 | 4 | 1 | 0 | 1 | 4 | 0 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 2 | 0 | 2 | 4 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 2 + 0 + 2 + 4 + 0 + 24 = 44 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 44 = 6 | 6 | ||||||||
The NPI number 1174101406 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
DR. BHAVESH A. SHAH M.D.
Family Medicine
1921 WALDEMERE ST STE 405
SARASOTA, FL
ZIP 34239
DR. JEFFREY ALLEN HUMBARGER M.D.
Internal Medicine
1921 WALDEMERE ST STE 405
SARASOTA, FL
ZIP 34239
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174101406, enumerated as an "individual" on March 30, 2021.
The provider is located at 1921 WALDEMERE ST STE 405 SARASOTA, FL 34239 and the phone number is (941) 917-3500.
Internal Medicine with taxonomy code 207R00000X.
The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL) and Florida. Please consult your insurance carrier or call the provider to verify.
Ethan Windham is affiliated with: SARASOTA MEMORIAL HOSPITAL.
