HAROLD R LOCAY M.D., P.A.
NPI 1205834207
Internal Medicine - Nephrology in Gainesville, FL

NPI Status: Active since July 13, 2005

Contact Information

6520 NW 9TH BLVD
GAINESVILLE, FL
ZIP 32605
Phone: (352) 331-7987

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 39
Internal Medicine
Nephrology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About HAROLD LOCAY

This page provides the complete NPI Profile along with additional information for Harold Locay, an internist established in Gainesville, Florida with a medical specialization in Internal Medicine, focusing in nephrology and more than 39 years of experience. The healthcare provider is registered in the NPI registry with number 1205834207 assigned on July 2005. The practitioner's primary taxonomy code is 207RN0300X with license number ME61963 (FL). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI: 1205834207
Provider Name: HAROLD R LOCAY M.D., P.A.
Gender: Male
Entity Type: Individual
Location Address: 6520 NW 9TH BLVD GAINESVILLE, FL 32605
Location Phone: (352) 331-7987
Mailing Address: 2980 SE 3RD CT OCALA, FL 34471
Mailing Phone: (352) 622-4231
Mailing Fax
Medical School Name: OTHER
Graduation Year: 1987
Is Sole Proprietor?: Yes
Enumeration Date: 07-13-2005
Last Update Date: 07-21-2022
Code Navigator

An internist like Harold Locay 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

8613 SW 103rd Street Rd
Ocala, FL 34481
(352) 622-4231
2980 SE 3rd Ct
Ocala, FL 34471
(352) 622-4231
1330 Citizens Blvd Bldg 2
Leesburg, FL 34748
(352) 435-4577

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 Nephrology
Taxonomy Code: 207RN0300X
Type: Allopathic & Osteopathic Physicians
License No.: ME61963
License State: FL
Taxonomy Description: An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Insurance Plans Accepted

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

Ambetter from Superior HealthPlan

Complete VALUE Gold - HMO
Focused VALUE Silver - HMO
Focused VALUE Silver + Vision + Adult Dental - HMO
Standard Gold VALUE - HMO
Standard Silver VALUE - HMO
Standard Silver VALUE + Vision + Adult Dental - HMO

Ambetter Health

Clarity Silver - HMO
Clarity VALUE Silver - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Complete VALUE Gold - HMO
Elite Bronze - HMO
Elite Bronze + Vision + Adult Dental - HMO
Elite VALUE Bronze - HMO
Enhanced Diabetes Care Silver with $0 Drug Options - HMO
Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO

Ambetter of Alabama

Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Elite Bronze - EPO
Elite Bronze + Vision + Adult Dental - EPO
Elite Gold - EPO
Elite Gold + Vision + Adult Dental - EPO
Enhanced Diabetes Care Silver with $0 Drug Options - EPO
Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO

Florida Blue (BlueCross BlueShield FL)

BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
BlueOptions Bronze 24J01-06 (Rewards) - PPO
BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO

Florida Blue HMO (a BlueCross BlueShield FL company)

BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
BlueCare Bronze 24K01-05 (Rewards) - POS
BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
BlueCare Bronze 24K02-18 (Rewards) - POS
BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS

Health First Commercial Plans, Inc.

Bronze 1826 ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
Bronze 1826 + Adult Dental + Adult Vision ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
Bronze Savings 1820 (Primary Care Copay Visits 1-5, Open Access) - HMO
Bronze Savings 1820 + Adult Dental + Adult Vision (Primary Care Copay Visits 1-5, Open Access) - HMO
Bronze Standard 1828 - HMO
Bronze Value 1814 (High Value Network Savings, Open Access) - HMO
Bronze Value 1814 + Adult Dental + Adult Vision (High Value Network Savings, Open Access) - HMO
Catastrophic 1746 (Primary Care Copay Visits 1-3, Open Access) - HMO
Gold 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
Gold 1742 + Adult Dental + Adult Vision (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO

Oscar Health Maintenance Organization of Florida

Bronze Classic 4700 - HMO
Bronze Classic 4700 | with AdventHealth - HMO
Bronze Classic Standard - HMO
Bronze Classic Standard | with AdventHealth - HMO
Bronze Elite + PCP Saver Plus - HMO
Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
Bronze Simple Chronic Care CKM - HMO
Bronze Simple Diabetes - HMO
Gold Classic Standard - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

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
110091315	OTHER (01)	FL	RRMC (GRP)
CD4677	OTHER (01)	FL	RRMC/GROUP
373134100	MEDICAID (05)	FL

Medicare Participation & PECOS Enrollment Status

Harold Locay 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.

Harold Locay 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: 1456439827
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: I20100811000811
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

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.

Balloon dilation of dialysis segment with review by radiologist
Balloon dilation of dialysis segment with review by radiologist
Complete ultrasound of artery and vein blood flow pre-op assessment on both sides of body for hemodialysis access
Complete ultrasound of artery and vein blood flow pre-op assessment on both sides of body for hemodialysis access
Dialysis services, 4 or more physician visits per month (20 years or older)
Follow-up hospital inpatient care per day, typically 35 minutes
Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist
Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist
Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist
Insertion of needle and/or tube into hemodialysis circuit with review by radiologist
Insertion of needle and/or tube into hemodialysis circuit with review by radiologist
Insertion of tube into chest or arm artery, each first order branch
Insertion of tube into chest or arm artery, each first order branch
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml
Removal of tunneled central venous tube
Removal of tunneled central venous tube
Review by radiologist of arm or leg artery image
Review by radiologist of arm or leg artery image
Ultrasound evaluation of blood vessel with review by radiologist, each additional vessel
Ultrasound evaluation of blood vessel with review by radiologist, initial vessel
Ultrasound of hemodialysis access
Ultrasound of hemodialysis access
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes
Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes
Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.51 for a new patient copayment and $24.79 for an established patient copayment.

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 32605 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.

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
Annual registration in the Prescription Drug Monitoring Program	Yes	N/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
CDC Training on CDC's Guideline for Prescribing Opioids for Chronic Pain	Yes	N/A
Completion of all the modules of the Centers for Disease Control and Prevention (CDC) course “Applying CDC’s Guideline for Prescribing Opioids” that reviews the 2016 “Guideline for Prescribing Opioids for Chronic Pain.” Note: This activity may be selected once every 4 years, to avoid duplicative information given that some of the modules may change on a year by year basis but over 4 years there would be a reasonable expectation for the set of modules to have undergone substantive change, for the improvement activities performance category score.
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement	Yes	N/A
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan.
Engagement of New Medicaid Patients and Follow-up	Yes	N/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
Falls: Screening for Future Fall Risk	93%	157
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Implementation of condition-specific chronic disease self-management support programs	Yes	N/A
Provide condition-specific chronic disease self-management support programs or coaching or link patients to those programs in the community.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop	Yes	N/A
Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology.
Improved Practices that Engage Patients Pre-Visit	Yes	N/A
Implementation of workflow changes that engage patients prior to the visit, such as a pre-visit development of a shared visit agenda with the patient, or targeted pre-visit laboratory testing that will be resulted and available to the MIPS eligible clinician to review and discuss during the patient’s appointment..
Pneumococcal Vaccination Status for Older Adults	87%	159
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Use of certified EHR to capture patient reported outcomes	Yes	N/A
In support of improving patient access, performing additional activities that enable capture of patient reported outcomes (e.g., home blood pressure, blood glucose logs, food diaries, at-risk health factors such as tobacco or alcohol use, etc.) or patient activation measures through use of certified EHR technology, containing this data in a separate queue for clinician recognition and review.
Use of QCDR to promote standard practices, tools and processes in practice for improvement in care coordination	Yes	N/A
Participation in a Qualified Clinical Data Registry, demonstrating performance of activities that promote use of standard practices, tools and processes for quality improvement (e.g., documented preventative screening and vaccinations that can be shared across MIPS eligible clinician or groups).

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 1205834207, we treat the final digit (7) 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 0

Pos 4

Unchanged

Pos 5

Doubled → 16 → 1 + 6

Pos 6

Unchanged

Pos 7

Doubled → 8

Pos 8

Unchanged

Pos 9

Doubled → 0

Check

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 8 → 16 → 7 4 → 8 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 + 1 + 6 + 3 + 8 + 2 + 0 + 24 = 53

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

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7

This NPI is valid

The calculated check digit is 7, which matches the last digit of 1205834207.