DR. CARMEN APRIL D.P.M.
NPI 1205038403
Podiatrist - Foot & Ankle Surgery in Madison, TN

NPI Status: Active since June 01, 2007

Contact Information

1994 GALLATIN PIKE N
#310
MADISON, TN
ZIP 37115
Phone: (615) 252-6929
Fax: (615) 252-6929

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  • Individual
  • Female
  • Years of Experience 19
  • Podiatrist
  • Foot & Ankle Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About CARMEN APRIL

This page provides the complete NPI Profile along with additional information for Carmen April, a provider established in Madison, Tennessee with a medical specialization in Podiatrist, focusing in foot & ankle surgery and more than 19 years of experience. She graduated from Temple University School Of Medicine in 2007. The healthcare provider is registered in the NPI registry with number 1205038403 assigned on June 2007. The practitioner's primary taxonomy code is 213ES0103X with license number 702 (TN). The provider is registered as an individual and her NPI record was last updated 15 years ago.

NPI
1205038403
Provider Name
DR. CARMEN APRIL D.P.M.
Gender
Female
Entity Type
Individual
Location Address
1994 GALLATIN PIKE N #310 MADISON, TN 37115
Location Phone
(615) 252-6929
Location Fax
(615) 252-6929
Mailing Address
7051 HIGHWAY 70 S #170 NASHVILLE, TN 37221
Mailing Phone
(615) 252-6929
Mailing Fax
(615) 252-6929
Medical School Name
TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
2007
Is Sole Proprietor?
Yes
Enumeration Date
06-01-2007
Last Update Date
10-25-2011
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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

Podiatrist Foot & Ankle Surgery

Taxonomy Code
213ES0103X
Type
Podiatric Medicine & Surgery Service Providers
License No.
702
License State
TN

Insurance Plans Accepted

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

  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Simple - EPO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - EPO
  • Bronze Simple Chronic Care CKM - EPO
  • Bronze Simple Diabetes - EPO
  • Gold Classic Standard - EPO
  • Gold Elite - EPO
  • Silver Classic - EPO
  • Silver Classic Standard - EPO
  • Silver Simple Breathe Easy with Enhanced COPD Benefits - EPO
  • Silver Simple Chronic Care CKM - EPO
  • Silver Simple Diabetes - EPO
  • Silver Simple PCP Saver - EPO
  • Silver Simple Women's Health with Menopause Benefits - EPO
  • UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Essential (No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Gold Advantage (Virtual Urgent Care, No Referrals) - EPO
  • UHC Gold Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO
  • UHC Silver Advantage (Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Silver Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Standard (No Referrals) - EPO

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

Medicare Participation & PECOS Enrollment Status

Carmen April 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.

Carmen April 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

  • PECOS PAC ID: 8426240516

    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: I20101007000760

    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: No

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.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 108 times for 42 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 33 times for 26 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 14 times for 14 patients

Reviews for DR. CARMEN APRIL D.P.M.

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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 1205038403, we treat the final digit (3) 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 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).

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
2
Unchanged
Pos 3
0
Doubled → 0
Pos 4
5
Unchanged
Pos 5
0
Doubled → 0
Pos 6
3
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
4
Unchanged
Pos 9
0
Doubled → 0
Check
3
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 0 → 0 0 → 0 8 → 16 → 7 0 → 0

Step 2: Add all digits plus the NPI constant

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

2 + 2 + 0 + 5 + 0 + 3 + 1 + 6 + 4 + 0 + 24 = 47

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

The next multiple of ten after 47 is 50. The difference is the calculated check digit.

50 - 47 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1205038403.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Nurse Anesthetist, Certified Registered
1994 GALLATIN PIKE N, SUITE 202
MADISON, TN 37115
Chiropractor
1994 GALLATIN PIKE N, STE. 206
MADISON, TN 37115
Audiologist-Hearing Aid Fitter
1994 GALLATIN PIKE N, SUITE 200
MADISON, TN 37115
Speech-Language Pathologist
1994 GALLATIN PIKE N
MADISON, TN 37115
Family Medicine (Addiction Medicine)
1994 GALLATIN PIKE N
MADISON, TN 37115

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205038403, enumerated as an "individual" on June 01, 2007.

The provider is located at 1994 GALLATIN PIKE N #310 MADISON, TN 37115 and the phone number is (615) 252-6929.

Podiatrist with taxonomy code 213ES0103X and a focus in Foot & Ankle Surgery.

The provider might be accepting Accepts: Oscar Insurance Company and UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.