DR. DONALD FORREST BIAS JR. MD
NPI 1174517221
Family Medicine in Lincolnton, NC
NPI Status: Active since September 06, 2005
Contact Information
1470 E GASTON ST STE 300
LINCOLNTON, NC
ZIP 28092
Phone: (704) 735-7474
Fax: (704) 735-8788
- Individual
- Male
- Family Medicine
- Accepts Insurance
- PECOS Enrolled
About DONALD BIAS
This page provides the complete NPI Profile along with additional information for Donald Bias, a primary care provider established in Lincolnton, North Carolina with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1174517221 assigned on September 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 9700469 (NC). The provider is registered as an individual and his NPI record was last updated 7 years ago.
- NPI
- 1174517221
- Provider Name
- DR. DONALD FORREST BIAS JR. MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1470 E GASTON ST STE 300 LINCOLNTON, NC 28092
- Location Phone
- (704) 735-7474
- Location Fax
- (704) 735-8788
- Mailing Address
- 1470 E GASTON ST STE 300 LINCOLNTON, NC 28092
- Mailing Phone
- (704) 735-7474
- Mailing Fax
- (704) 735-8788
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-06-2005
- Last Update Date
- 02-25-2019
- Code Navigator
A primary care provider (PCP) like Donald Bias sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 9700469
- License State
- NC
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
- AmeriHealth Caritas Next Gold Premier + No Referrals - HMO
- AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
- AmeriHealth Caritas Next Silver Essential + No Referrals - HMO
- AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
- AmeriHealth Caritas Next Silver Signature + No Referrals - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 116472 | OTHER (01) | WELLPATH | |
| 890176L | MEDICAID (05) | NC | |
| CH4510 | OTHER (01) | RAILROAD MEDICARE | |
| 0176L | OTHER (01) | NC | BCBS |
| 1627444 | OTHER (01) | CIGNA | |
| 1174517221 | MEDICAID (05) | NC |
Medicare Participation & PECOS Enrollment Status
Donald Bias 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)
9 DME suppliers used 20 Medicare Claims 39 Services Paid
DME-Other DME (DE001N)
Full face mask used with positive airway pressure device, each (HCPCS:A7030)
2 DME suppliers used 15 Medicare Claims 15 Services Paid
DME-Other DME (DE001N)
Face mask interface, replacement for full face mask, each (HCPCS:A7031)
2 DME suppliers used 13 Medicare Claims 30 Services Paid
DME-Other DME (DE001N)
Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)
3 DME suppliers used 11 Medicare Claims 56 Services Paid
DME-Other DME (DE001N)
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)
5 DME suppliers used 17 Medicare Claims 17 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
6 DME suppliers used 17 Medicare Claims 17 Services Paid
DME-Other DME (DE001N)
Tubing used with positive airway pressure device (HCPCS:A7037)
4 DME suppliers used 23 Medicare Claims 23 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
6 DME suppliers used 23 Medicare Claims 138 Services Paid
DME-Other DME (DE001N)
Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)
6 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
3 DME suppliers used 37 Medicare Claims 37 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
2 DME suppliers used 17 Medicare Claims 17 Services Paid
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)
3 DME suppliers used 41 Medicare Claims 42 Services Paid
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 28092 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.9
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $20.97
- Minimum New Patient Copayment $13.53
- Maximum New Patient Copayment $41.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.94
- Minimum Established Patient Price $17.21
- Maximum Established Patient Price $134.61
- Average Established Patient Copayment $23.98
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.65
* 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 1174517221, we treat the final digit (1) 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 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).
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 49 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
LINCOLNTON, NC 28092
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174517221, enumerated as an "individual" on September 06, 2005.
The provider is located at 1470 E GASTON ST STE 300 LINCOLNTON, NC 28092 and the phone number is (704) 735-7474.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: AmeriHealth Caritas Next, Medicare, Medicaid,. Please consult your insurance carrier or call the provider to verify.
