DR. MARK ALAN ABPLANALP O.D.
NPI 1174528962
Optometrist - Corneal and Contact Management in Oxford, OH
NPI Status: Active since June 17, 2005
Contact Information
5720 COLLEGE CORNER PIKE
OXFORD, OH
ZIP 45056
Phone: (513) 523-8798
Fax: (513) 523-5710
- Individual
- Male
- Optometrist
- Corneal and Contact Management
- Accepts Insurance
- PECOS Enrolled
About MARK ABPLANALP
This page provides the complete NPI Profile along with additional information for Mark Abplanalp, a provider established in Oxford, Ohio with a medical specialization in Optometrist, focusing in corneal and contact management . The healthcare provider is registered in the NPI registry with number 1174528962 assigned on June 2005. The practitioner's primary taxonomy code is 152WC0802X with license number 3842 (OH). The provider is registered as an individual and his NPI record was last updated 11 years ago.
- NPI
- 1174528962
- Provider Name
- DR. MARK ALAN ABPLANALP O.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 5720 COLLEGE CORNER PIKE OXFORD, OH 45056
- Location Phone
- (513) 523-8798
- Location Fax
- (513) 523-5710
- Mailing Address
- 8352 E COUNTY RD 1250 N SUNMAN, IN 47041
- Mailing Phone
- (513) 405-2496
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-17-2005
- Last Update Date
- 12-05-2015
- Code Navigator
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
Optometrist Corneal and Contact Management
- Taxonomy Code
- 152WC0802X
- Type
- Eye and Vision Services Providers
- License No.
- 3842
- License State
- OH
- Taxonomy Description
- The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear.
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 | 152WC0802X | Eye and Vision Services Providers | Optometrist | 18002235 (IN) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
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 |
|---|---|---|---|
| U47697 | MEDICARE UPIN (02) | OH | |
| 1174528962 | MEDICARE PIN (08) | OH |
Medicare Participation & PECOS Enrollment Status
Mark Abplanalp 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) and a Home Health Agency (HHA).
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: No
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 45056 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 99213
- Average Established Patient Price $68.07
- Minimum Established Patient Price $17.1
- Maximum Established Patient Price $135.4
- Average Established Patient Copayment $17.01
- 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 1174528962, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
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 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
OXFORD, OH 45056
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174528962, enumerated as an "individual" on June 17, 2005.
The provider is located at 5720 COLLEGE CORNER PIKE OXFORD, OH 45056 and the phone number is (513) 523-8798.
Optometrist with taxonomy code 152WC0802X and a focus in Corneal and Contact Management.
The provider might be accepting Accepts: BlueCross BlueShield of Tennessee, Medicare and. Please consult your insurance carrier or call the provider to verify.
