MATTHEW J FACKRELL DO
NPI 1215968045
Family Medicine in Blackfoot, ID
NPI Status: Active since July 06, 2006
Contact Information
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
Phone: (208) 785-2600
Fax: (208) 785-8185
- Individual
- Male
- Years of Experience 22
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MATTHEW FACKRELL
This page provides the complete NPI Profile along with additional information for Matthew Fackrell, a primary care provider established in Blackfoot, Idaho with a medical specialization in Family Medicine and more than 22 years of experience. The healthcare provider is registered in the NPI registry with number 1215968045 assigned on July 2006. The practitioner's primary taxonomy code is 207Q00000X with license number DR.0073268 (CO). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1215968045
- Provider Name
- MATTHEW J FACKRELL DO
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1441 PARKWAY DR BLACKFOOT, ID 83221
- Location Phone
- (208) 785-2600
- Location Fax
- (208) 785-8185
- Mailing Address
- 1441 PARKWAY DR BLACKFOOT, ID 83221
- Mailing Phone
- (208) 785-2600
- Mailing Fax
- (208) 785-8185
- Medical School Name
- OTHER
- Graduation Year
- 2004
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-06-2006
- Last Update Date
- 10-22-2024
- Code Navigator
A primary care provider (PCP) like Matthew Fackrell 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
Secondary Locations
- 11417 124th Ave NE Ste 100
Kirkland, WA 98033
(800) 640-3451 - 13741 E Rice Pl Ste 101
Aurora, CO 80015
(800) 640-3451
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.
- DR.0073268
- License State
- CO
- 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.
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 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | OP61556804 (WA) |
2 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | DO221842 (OR) |
3 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | OS024313 (PA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Moda Select Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
- Moda Select Bronze HDHP 7500 - EPO
- Moda Select Gold 1000 ($0 Virtual Urgent Care through CirrusMD) - EPO
- Moda Select Gold 1800 ($0 Virtual Urgent Care through CirrusMD) - EPO
- Moda Select Silver 3500 ($0 Virtual Urgent Care through CirrusMD) - EPO
- Moda Select Silver 4800 ($0 Virtual Urgent Care through CirrusMD) - EPO
- Moda Select Silver 6400 ($0 Virtual Urgent Care through CirrusMD) - EPO
- Moda Select Texas Standard Bronze - EPO
- Moda Select Texas Standard Gold - EPO
- Moda Select Texas Standard Silver - EPO
- Connect Bronze Expanded Standard - PPO
- Connect Bronze HDHP - PPO
- Connect Catastrophic - PPO
- Connect Gold - PPO
- Connect Gold Standard - PPO
- Connect Silver - PPO
- Connect Silver Standard - PPO
- High Plains Bronze HDHP - PPO
- High Plains Bronze Standard Expanded - PPO
- High Plains Gold - PPO
- High Plains Gold HDHP - PPO
- High Plains Gold Standard - PPO
- High Plains Silver - PPO
- High Plains Silver Standard - PPO
- Plus Bronze Expanded - PPO
- Plus Bronze Standard Expanded - PPO
- Plus Gold - PPO
- Plus Gold Standard - PPO
- Plus Silver Standard - PPO
- ACCESS BRONZE - PPO
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 |
---|---|---|---|
1374716 | OTHER (01) | ID | PTAN |
807815500 | MEDICAID (05) | ID |
Medicare Participation & PECOS Enrollment Status
Matthew Fackrell 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.
Matthew Fackrell 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: 2668400458
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: I20240906003540
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 (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
2 DME suppliers used 13 Medicare Claims 36 Services Paid
DME-Hospital Beds (DB000N)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
3 DME suppliers used 51 Medicare Claims 51 Services Paid
DME-Oxygen and Supplies (DC000N)
Stationary oxygen contents, liquid, 1 month's supply = 1 unit (HCPCS:E0442)
1 DME suppliers used 24 Medicare Claims 24 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable oxygen contents, gaseous, 1 month's supply = 1 unit (HCPCS:E0443)
2 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable oxygen contents, liquid, 1 month's supply = 1 unit (HCPCS:E0444)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
2 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 103 Medicare Claims 104 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
4 DME suppliers used 84 Medicare Claims 84 Services Paid
DME-Other DME (DE017N)
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system (HCPCS:K0554)
2 DME suppliers used 13 Medicare Claims 13 Services Paid
Drugs Administered Through DME
DME-Drugs Administered Through DME (DG006N)
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)
2 DME suppliers used 12 Medicare Claims 1740 Services Paid
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.28 for a new patient copayment and $23.31 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 83221 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $81.13
- Minimum New Patient Price $52.44
- Maximum New Patient Price $160.17
- Average New Patient Copayment $20.28
- Minimum New Patient Copayment $13.11
- Maximum New Patient Copayment $40.04
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.26
- Minimum Established Patient Price $16.68
- Maximum Established Patient Price $130.93
- Average Established Patient Copayment $23.31
- Minimum Established Patient Copayment $4.17
- Maximum Established Patient Copayment $32.73
* 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.
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. Matthew Fackrell is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
EASTERN IDAHO REGIONAL MEDICAL CENTER | 3100 CHANNING WAY IDAHO FALLS, ID 83404 | (208) 529-6111 | Acute Care Hospitals | |
PORTNEUF MEDICAL CENTER | 777 HOSPITAL WAY POCATELLO, ID 83201 | (208) 239-1000 | Acute Care Hospitals | |
MOUNTAIN VIEW HOSPITAL | 2325 CORONADO STREET IDAHO FALLS, ID 83404 | (208) 557-2700 | Acute Care Hospitals | |
BINGHAM MEMORIAL HOSPITAL | 98 POPLAR STREET BLACKFOOT, ID 83221 | (208) 785-4100 | Critical Access Hospitals |
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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 | 9 | 6 | 8 | 0 | 4 | 5 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 2 | 5 | 18 | 6 | 16 | 0 | 8 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 2 + 2 + 5 + 1 + 8 + 6 + 1 + 6 + 0 + 8 + 24 = 65 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 65 = 5 | 5 |
The NPI number 1215968045 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
DR. FRANCIS T JOHANSEN D.O.
Internal Medicine
(Critical Care Medicine)
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
DR. JASON MICHAEL BAILEY PHARM.D
Pharmacist
(Pharmacotherapy)
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
FRANCIS BRYCE MOSER DO
Family Medicine
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
JULENE M PARSON
Pediatrics
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
CHRISTOPHER S RILEY MD
Surgery
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
GORDON E DIXON JR. DO
Family Medicine
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
GARY W SOUCIE MD
Family Medicine
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
STEVEN J CLINGER MD
Family Medicine
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
KIRT M MCKINLAY MD
Family Medicine
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
DEBRA ERRAMOUSPE PA
Physician Assistant
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
RHONDA GRANDEE PA
Physician Assistant
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
DOUGLAS GILBERT NP
Nurse Practitioner
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
PAUL BECKETT DO
Family Medicine
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
BRIAN DON BOEHME
Physical Therapist
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
RUBY LEE WALKER LPCP
Counselor
(Mental Health)
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
BLACKFOOT MEDICAL CLINIC INC
Clinical Medical Laboratory
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
HEATHER FAYE GRIMMETT PA
Physician Assistant
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
BLACKFOOT MEDICAL CLINIC RHC
Family Medicine
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
SHAWNA MARIE REYNOLDS PA
Physician Assistant
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
SADIE ELLIS DPT
Physical Therapist
1441 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215968045, enumerated as an "individual" on July 06, 2006.
The provider is located at 1441 PARKWAY DR BLACKFOOT, ID 83221 and the phone number is (208) 785-2600.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Moda Health Plan, Inc., Mountain Health CO-OP,. Please consult your insurance carrier or call the provider to verify.
Matthew Fackrell is affiliated with: EASTERN IDAHO REGIONAL MEDICAL CENTER, PORTNEUF MEDICAL CENTER, MOUNTAIN VIEW HOSPITAL and BINGHAM MEMORIAL HOSPITAL.