ELLIOTT GHALY
NPI 1225845209
Counselor - Professional in Denton, TX
NPI Status: Active since December 13, 2024
Contact Information
1013 GREENLEE ST
DENTON, TX
ZIP 76201
Phone: (940) 382-5112
- Individual
- Male
- Years of Experience 5
- Counselor
- Professional
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
About ELLIOTT GHALY
This page provides the complete NPI Profile along with additional information for Elliott Ghaly, a provider established in Denton, Texas with a medical specialization in Counselor, focusing in professional and more than 5 years of experience. The healthcare provider is registered in the NPI registry with number 1225845209 assigned on December 2024. The practitioner's primary taxonomy code is 101YP2500X with license number 87081 (TX). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1225845209
- Provider Name
- ELLIOTT GHALY
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1013 GREENLEE ST DENTON, TX 76201
- Location Phone
- (940) 382-5112
- Mailing Address
- 2525 FREEDOM LN DENTON, TX 76209
- Medical School Name
- OTHER
- Graduation Year
- 2021
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 12-13-2024
- Last Update Date
- 12-13-2024
- Code Navigator
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
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 87081
- License State
- TX
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - EPO
- Bronze Simple Chronic Care CKM - EPO
- Bronze Simple Diabetes - EPO
- Gold Classic - EPO
- Gold Classic Guided Care - HMO
- Gold Classic Standard - EPO
- Gold Classic Standard Guided Care - HMO
- Gold Elite - EPO
- Gold Simple Diabetes Guided Care - HMO
- Gold Simple Guided Care - HMO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Classic Standard Guided Care - HMO
- Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care - HMO
- Silver Simple Chronic Care CKM Guided Care - HMO
- Silver Simple Diabetes Guided Care - HMO
- Silver Simple Guided Care - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Standard+ (Dental + Vision) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
- UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Standard - HMO
- UHC Kelsey-Seybold Bronze Copay Focus $0 Indiv Med Ded - HMO
- UHC Kelsey-Seybold Bronze Copay Focus+ $0 Indiv Med Ded (Dental + Vision) - HMO
- UHC Kelsey-Seybold Gold Copay Focus $0 Indiv Med Ded ($8 Tier 2 Rx) - HMO
- UHC Kelsey-Seybold Gold Copay Focus+ $0 Indiv Med Ded ($8 Tier 2 Rx, Dental + Vision) - HMO
- UHC Kelsey-Seybold Silver Copay Focus $0 Indiv Med Ded - HMO
- UHC Kelsey-Seybold Silver Copay Focus+ $0 Indiv Med Ded (Dental + Vision) - HMO
- UHC Sanitas Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Sanitas Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Sanitas Bronze Standard - HMO
- UHC Sanitas Gold Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
- UHC Sanitas Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Elliott Ghaly is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Elliott Ghaly 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 and Durable Medical Equipment (DME).
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: 6204338452
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: I20250905004607
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? Maybe
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): No
Eligible to Order or Refer Power Mobility Devices: No
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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 1225845209, we treat the final digit (9) 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 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 51 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1225845209, enumerated as an "individual" on December 13, 2024.
The provider is located at 1013 GREENLEE ST DENTON, TX 76201 and the phone number is (940) 382-5112.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
The provider might be accepting Accepts: Oscar Insurance Company and UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.
