MR. THOMAS E GUTTMACHER M.D.
NPI 1215085816
Family Medicine in Riverside, RI

NPI Status: Active since January 08, 2007

Contact Information

100 BULLOCKS POINT AVE
RIVERSIDE, RI
ZIP 02915
Phone: (401) 437-1008
Fax: (401) 433-3042

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Family Medicine
PECOS Enrolled

About THOMAS GUTTMACHER

This page provides the complete NPI Profile along with additional information for Thomas Guttmacher, a primary care provider established in Riverside, Rhode Island with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1215085816 assigned on January 2007. The practitioner's primary taxonomy code is 207Q00000X with license number MD08324 (RI). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI: 1215085816
Provider Name: MR. THOMAS E GUTTMACHER M.D.
Gender: Male
Entity Type: Individual
Location Address: 100 BULLOCKS POINT AVE RIVERSIDE, RI 02915
Location Phone: (401) 437-1008
Location Fax: (401) 433-3042
Mailing Address: 100 BULLOCKS POINT AVE RIVERSIDE, RI 02915
Mailing Phone: (401) 437-1008
Mailing Fax: (401) 433-3042
Is Sole Proprietor?: No
Enumeration Date: 01-08-2007
Last Update Date: 07-08-2007
Code Navigator

A primary care provider (PCP) like Thomas Guttmacher 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.: MD08324
License State: RI
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:

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
F65766	MEDICARE UPIN (02)	RI
411803	OTHER (01)	RI	UGS
7005617	MEDICAID (05)	RI
411813	OTHER (01)	RI	UGS
411833	OTHER (01)	RI	UGS

Medicare Participation & PECOS Enrollment Status

Thomas Guttmacher 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)
5 DME suppliers used 11 Medicare Claims 27 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.

Testing for presence of drug, read by direct observation

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 02915 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $90.48
Minimum New Patient Price $58.57
Maximum New Patient Price $177.03

Average New Patient Copayment $22.62
Minimum New Patient Copayment $14.64
Maximum New Patient Copayment $44.25

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $103.1
Minimum Established Patient Price $18.92
Maximum Established Patient Price $144.38

Average Established Patient Copayment $25.77
Minimum Established Patient Copayment $4.73
Maximum Established Patient Copayment $36.09

* 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.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	2	1	5	0	8	5	8	1	6
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	2	2	5	0	8	10	8	2
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 2 + 5 + 0 + 8 + 1 + 0 + 8 + 2 + 24 = 54
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 54 = 6									6

The NPI number 1215085816 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.