DR. DOUGLAS EDWARD MCGILL MD
NPI 1194704130
Physical Medicine & Rehabilitation in Charleston, SC

NPI Status: Active since January 10, 2006

Contact Information

316 CALHOUN ST
ROPER HOSPITAL
CHARLESTON, SC
ZIP 29401
Phone: (843) 971-8376
Fax: (843) 971-8377

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  • Individual
  • Male
  • Years of Experience 36
  • Physical Medicine & Rehabilitation
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About DOUGLAS MCGILL

This page provides the complete NPI Profile along with additional information for Douglas Mcgill, a provider established in Charleston, South Carolina with a medical specialization in Physical Medicine & Rehabilitation and more than 36 years of experience. He graduated from Medical University Of South Carolina College Of Medicine in 1990. The healthcare provider is registered in the NPI registry with number 1194704130 assigned on January 2006. The practitioner's primary taxonomy code is 208100000X with license number 16425 (SC). The provider is registered as an individual and his NPI record was last updated 11 years ago.

NPI
1194704130
Provider Name
DR. DOUGLAS EDWARD MCGILL MD
Gender
Male
Entity Type
Individual
Location Address
316 CALHOUN ST ROPER HOSPITAL CHARLESTON, SC 29401
Location Phone
(843) 971-8376
Location Fax
(843) 971-8377
Mailing Address
PO BOX 2356 MOUNT PLEASANT, SC 29465
Mailing Phone
(843) 568-1001
Mailing Fax
(843) 971-8377
Medical School Name
MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduation Year
1990
Is Sole Proprietor?
Yes
Enumeration Date
01-10-2006
Last Update Date
08-10-2015
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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

Physical Medicine & Rehabilitation

Taxonomy Code
208100000X
Type
Allopathic & Osteopathic Physicians
License No.
16425
License State
SC
Taxonomy Description
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.

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)
1246ZE0600XTechnologists, Technicians & Other Technical Service Providers

Specialist/Technologist, Other
Electroneurodiagnostic

16425 (SC)

Insurance Plans Accepted

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

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze with Atrium Health - HMO
  • Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Focused Silver with Atrium Health - HMO
  • Focused Silver with Atrium Health + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze with Atrium Health - 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.

*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
G10121MEDICARE UPIN (02)SC 
G101210281MEDICARE ID-TYPE UNSPECIFIED (04)SCMEDICARE PROVIDER ID

Medicare Participation & PECOS Enrollment Status

Douglas Mcgill is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Douglas Mcgill 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: 3173690567

    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: I20080926000527

    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? Yes

    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

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 (DE000N)

    Walker, folding, wheeled, adjustable or fixed height (HCPCS:E0143)

    5 DME suppliers used 28 Medicare Claims 28 Services Paid

  • DME-Other DME (DE000N)

    Walker, heavy duty, wheeled, rigid or folding, any type (HCPCS:E0149)

    3 DME suppliers used 39 Medicare Claims 39 Services Paid

  • DME-Other DME (DE000N)

    Commode chair, mobile or stationary, with fixed arms (HCPCS:E0163)

    7 DME suppliers used 25 Medicare Claims 25 Services Paid

  • DME-Other DME (DE000N)

    Commode chair, mobile or stationary, with detachable arms (HCPCS:E0165)

    5 DME suppliers used 30 Medicare Claims 30 Services Paid

  • DME-Hospital Beds (DB000N)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

    4 DME suppliers used 65 Medicare Claims 65 Services Paid

  • DME-Other DME (DE000N)

    Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) (HCPCS:E0630)

    1 DME suppliers used 14 Medicare Claims 14 Services Paid

  • DME-Wheelchairs (DD021N)

    Manual wheelchair accessory, anti-tipping device, each (HCPCS:E0971)

    2 DME suppliers used 11 Medicare Claims 20 Services Paid

  • DME-Other DME (DE000N)

    Transport chair, adult size, patient weight capacity up to and including 300 pounds (HCPCS:E1038)

    1 DME suppliers used 13 Medicare Claims 13 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 11 Medicare Claims 11 Services Paid

  • DME-Wheelchairs (DD021N)

    General use wheelchair seat cushion, width less than 22 inches, any depth (HCPCS:E2601)

    4 DME suppliers used 15 Medicare Claims 15 Services Paid

  • DME-Wheelchairs (DD000N)

    Standard wheelchair (HCPCS:K0001)

    5 DME suppliers used 158 Medicare Claims 158 Services Paid

  • DME-Wheelchairs (DD000N)

    Lightweight wheelchair (HCPCS:K0003)

    3 DME suppliers used 96 Medicare Claims 96 Services Paid

  • DME-Wheelchairs (DD021N)

    Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)

    5 DME suppliers used 112 Medicare Claims 112 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.

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 1,136 times for 262 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 128 times for 122 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

This service was performed 52 times for 50 patients

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Anticoagulant Management ImprovementsYesN/A
Individual MIPS eligible clinicians and groups who prescribe oral Vitamin K antagonist therapy (warfarin) must attest that, for 60 percent of practice patients in the transition year and 75 percent of practice patients in Quality Payment Program Year 2 and future years, their ambulatory care patients receiving warfarin are being managed by one or more of the following improvement activities: • Patients are being managed by an anticoagulant management service, that involves systematic and coordinated care, incorporating comprehensive patient education, systematic prothrombin time (PT-INR) testing, tracking, follow-up, and patient communication of results and dosing decisions; • Patients are being managed according to validated electronic decision support and clinical management tools that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; • For rural or remote patients, patients are managed using remote monitoring or telehealth options that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; and/or • For patients who demonstrate motivation, competency, and adherence, patients are managed using either a patient self-testing (PST) or patient-self-management (PSM) program.
Care Plan 100% 163
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Documentation of Current Medications in the Medical Record 100% 87
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Glycemic Referring ServicesYesN/A
For at-risk outpatient Medicare beneficiaries, individual MIPS eligible clinicians and groups must attest to implementation of systematic preventive approaches in clinical practice for at least 60 percent for the CY 2018 performance period and 75 percent in future years, of medical records with documentation of referring eligible patients with prediabetes to a CDC-recognized diabetes prevention program operating under the framework of the National Diabetes Prevention Program.
Glycemic Screening ServicesYesN/A
For at-risk outpatient Medicare beneficiaries, individual MIPS eligible clinicians and groups must attest to implementation of systematic preventive approaches in clinical practice for at least 60 percent for the 2018 performance period and 75 percent in future years, of electronic medical records with documentation of screening patients for abnormal blood glucose according to current US Preventive Services Task Force (USPSTF) and/or American Diabetes Association (ADA) guidelines.
Pain Assessment and Follow-Up 100% 119
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
Participation in Systematic Anticoagulation ProgramYesN/A
Participation in a systematic anticoagulation program (coagulation clinic, patient self-reporting program, or patient self-management program) for 60 percent of practice patients in the transition year and 75 percent of practice patients in Quality Payment Program Year 2 and future years, who receive anti-coagulation medications (warfarin or other coagulation cascade inhibitors).

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. Douglas Mcgill is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
TRIDENT MEDICAL CENTER9330 MEDICAL PLAZA DR
CHARLESTON, SC 29406
(843) 847-4100Acute Care Hospitals

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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 1194704130, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

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
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
4
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
0
Unchanged
Pos 7
4
Doubled → 8
Pos 8
1
Unchanged
Pos 9
3
Doubled → 6
Check
0
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 9 → 18 → 9 7 → 14 → 5 4 → 8 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 8 + 4 + 1 + 4 + 0 + 8 + 1 + 6 + 24 = 60

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

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

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1194704130.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine (Infectious Disease)
316 CALHOUN ST
CHARLESTON, SC 29401
Internal Medicine
316 CALHOUN ST
CHARLESTON, SC 29401
Pediatrics (Neonatal-Perinatal Medicine)
316 CALHOUN ST
CHARLESTON, SC 29401
Pediatrics (Neonatal-Perinatal Medicine)
316 CALHOUN ST
CHARLESTON, SC 29401
Pathology (Anatomic Pathology & Clinical Pathology)
316 CALHOUN ST
CHARLESTON, SC 29401
Pathology (Anatomic Pathology)
316 CALHOUN ST
CHARLESTON, SC 29401
Pathology (Anatomic Pathology & Clinical Pathology)
316 CALHOUN ST
CHARLESTON, SC 29401
Pathology (Anatomic Pathology & Clinical Pathology)
316 CALHOUN ST
CHARLESTON, SC 29401
Pathology (Anatomic Pathology & Clinical Pathology)
316 CALHOUN ST
CHARLESTON, SC 29401
Pathology (Anatomic Pathology & Clinical Pathology)
316 CALHOUN ST
CHARLESTON, SC 29401
Pathology (Anatomic Pathology & Clinical Pathology)
316 CALHOUN ST
CHARLESTON, SC 29401
Pathology (Anatomic Pathology & Clinical Pathology)
316 CALHOUN ST
CHARLESTON, SC 29401
Pathology (Anatomic Pathology & Clinical Pathology)
316 CALHOUN ST
CHARLESTON, SC 29401
Pathology (Anatomic Pathology & Clinical Pathology)
316 CALHOUN ST
CHARLESTON, SC 29401
Emergency Medicine
316 CALHOUN ST, EMERGENCY DEPARTMENT
CHARLESTON, SC 29401
Nurse Practitioner (Adult Health)
316 CALHOUN ST
CHARLESTON, SC 29401
Pathology (Anatomic Pathology & Clinical Pathology)
316 CALHOUN ST
CHARLESTON, SC 29401
Internal Medicine
316 CALHOUN ST
CHARLESTON, SC 29401
Internal Medicine (Hospice and Palliative Medicine)
316 CALHOUN ST
CHARLESTON, SC 29401
Nurse Practitioner (Neonatal)
316 CALHOUN ST
CHARLESTON, SC 29401

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194704130, enumerated as an "individual" on January 10, 2006.

The provider is located at 316 CALHOUN ST ROPER HOSPITAL CHARLESTON, SC 29401 and the phone number is (843) 971-8376.

Physical Medicine & Rehabilitation with taxonomy code 208100000X.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.

Douglas Mcgill is affiliated with: TRIDENT MEDICAL CENTER.