MATTHEW RANDALL DPT
NPI 1235392234
Physical Therapist in Falls Church, VA

NPI Status: Active since July 09, 2008

Contact Information

5115 LEESBURG PIKE
FALLS CHURCH, VA
ZIP 22041
Phone: (703) 824-0701
Fax: (703) 824-0704

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 19
Physical Therapist
Accepts Insurance
Accepts Medicare Approved Payment

About MATTHEW RANDALL

This page provides the complete NPI Profile along with additional information for Matthew Randall, a provider established in Falls Church, Virginia with a medical specialization in Physical Therapist and more than 19 years of experience. The healthcare provider is registered in the NPI registry with number 1235392234 assigned on July 2008. The practitioner's primary taxonomy code is 225100000X with license number 2305205355 (VA). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI: 1235392234
Provider Name: MATTHEW RANDALL DPT
Gender: Male
Entity Type: Individual
Location Address: 5115 LEESBURG PIKE FALLS CHURCH, VA 22041
Location Phone: (703) 824-0701
Location Fax: (703) 824-0704
Mailing Address: PO BOX 1769 MIDDLEBURG, VA 20118
Mailing Phone: (540) 687-8181
Mailing Fax: (703) 824-0704
Medical School Name: OTHER
Graduation Year: 2007
Is Sole Proprietor?: No
Enumeration Date: 07-09-2008
Last Update Date: 05-22-2013
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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

Physical Therapist

Taxonomy Code

225100000X

Type

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

License No.

2305205355

License State

Taxonomy Description

Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:

Diagnose and manage movement dysfunction and enhance physical and functional abilities.
Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.

PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Insurance Plans Accepted

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

Aetna CVS Health

Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Gold 10 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Silver 6 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO

Molina Healthcare

Gold 1 - HMO
Gold 1 with Adult Vision Services - HMO
Gold 8 - HMO
Silver 1 - HMO
Silver 1 with Adult Vision Services - HMO
Silver 12 with First 4 Primary Care Visits Free - HMO
Silver 8 - HMO

University of Utah Health Plans

Healthy Premier Bronze HSA - EPO
Healthy Premier Expanded Bronze Standard - EPO
Healthy Premier Gold Copay - EPO
Healthy Premier Gold Standard - EPO
Healthy Premier Silver Copay - EPO
Healthy Premier Silver Standard - EPO

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
142213YXP	MEDICARE PIN (08)	DC

Medicare Participation & PECOS Enrollment Status

Matthew Randall 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.

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.

PECOS PAC ID: 7911061395
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: I20151104001511
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.

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $25.07 for a new patient copayment and $20.16 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 22041 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $100.31
Minimum New Patient Price $65.18
Maximum New Patient Price $194.86

Average New Patient Copayment $25.07
Minimum New Patient Copayment $16.29
Maximum New Patient Copayment $48.71

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $80.66
Minimum Established Patient Price $21.4
Maximum Established Patient Price $158.88

Average Established Patient Copayment $20.16
Minimum Established Patient Copayment $5.35
Maximum Established Patient Copayment $39.72

* 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	3	5	3	9	2	2	3	4
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	2	6	5	6	9	4	2	6
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 6 + 5 + 6 + 9 + 4 + 2 + 6 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 4									4

The NPI number 1235392234 is valid because the calculated check digit 4 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. JAMES R GLASS II BPHARM

Pharmacist

5115 LEESBURG PIKE
FALLS CHURCH, VA
ZIP 22041

About MATTHEW RANDALL

Location Map

Specialty - Primary Taxonomy

Physical Therapist

Insurance Plans Accepted

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

PECOS PAC ID: 7911061395

PECOS Enrollment ID: I20151104001511

Accepts Medicare Assignment? Yes

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Reviews for MATTHEW RANDALL DPT

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions