PAUL E SHINGLEDECKER M.D.
NPI 1245210392
Internal Medicine in Hamilton, MT
NPI Status: Active since January 17, 2006
Contact Information
1200 WESTWOOD DR
HAMILTON, MT
ZIP 59840
Phone: (406) 363-2211
Fax: (406) 375-4846
- Individual
- Male
- Internal Medicine
- Accepts Insurance
- PECOS Enrolled
About PAUL SHINGLEDECKER
This page provides the complete NPI Profile along with additional information for Paul Shingledecker, an internist established in Hamilton, Montana with a medical specialization in Internal Medicine. The healthcare provider is registered in the NPI registry with number 1245210392 assigned on January 2006. The practitioner's primary taxonomy code is 207R00000X with license number 42849 (MT). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1245210392
- Provider Name
- PAUL E SHINGLEDECKER M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1200 WESTWOOD DR HAMILTON, MT 59840
- Location Phone
- (406) 363-2211
- Location Fax
- (406) 375-4846
- Mailing Address
- 1200 WESTWOOD DR HAMILTON, MT 59840
- Mailing Phone
- (406) 363-2211
- Mailing Fax
- (406) 375-4846
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 01-17-2006
- Last Update Date
- 04-25-2024
- Code Navigator
An internist like Paul Shingledecker 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
- 715 Main St
Stevensville, MT 59870
(406) 777-5522
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
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 42849
- License State
- MT
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
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 | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | 42849 (MT) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Peak PPO Bronze HDHP - PPO
- Peak PPO Bronze Standard - PPO
- Peak PPO Catastrophic - PPO
- Peak PPO Gold - PPO
- Peak PPO Gold Standard - PPO
- Peak PPO Silver - PPO
- Peak PPO Silver Standard - PPO
- Plus Bronze - PPO
- Plus Bronze Standard - PPO
- Plus Gold - PPO
- Plus Gold Standard - PPO
- Plus Silver Standard - PPO
- PEAK PPO BRONZE - PPO
- PEAK PPO BRONZE HDHP - PPO
- PEAK PPO GOLD - PPO
- PEAK PPO GOLD HDHP - PPO
- PEAK PPO SILVER - PPO
- PEAK PPO SILVER HDHP - PPO
- Plus Bronze HDHP - PPO
- Plus Gold HDHP - PPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
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 |
|---|---|---|---|
| 01303502 | MEDICAID (05) | CO | |
| 1245210392 | MEDICAID (05) | ID | |
| 1245210392 | MEDICAID (05) | MT |
Medicare Participation & PECOS Enrollment Status
Paul Shingledecker 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 (DE000N)
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar (HCPCS:E0910)
1 DME suppliers used 12 Medicare Claims 12 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)
2 DME suppliers used 18 Medicare Claims 18 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
1 DME suppliers used 15 Medicare Claims 15 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
2 DME suppliers used 14 Medicare Claims 14 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)
3 DME suppliers used 21 Medicare Claims 1650 Services Paid
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 59840 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $130.52
- Minimum New Patient Price $56.81
- Maximum New Patient Price $172.26
- Average New Patient Copayment $32.63
- Minimum New Patient Copayment $14.2
- Maximum New Patient Copayment $43.06
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.16
- Minimum Established Patient Price $18.24
- Maximum Established Patient Price $140.32
- Average Established Patient Copayment $25.04
- Minimum Established Patient Copayment $4.56
- Maximum Established Patient Copayment $35.08
* 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.
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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 1245210392, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
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 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
HAMILTON, MT 59840
HAMILTON, MT 59840
HAMILTON, MT 59840
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245210392, enumerated as an "individual" on January 17, 2006.
The provider is located at 1200 WESTWOOD DR HAMILTON, MT 59840 and the phone number is (406) 363-2211.
Internal Medicine with taxonomy code 207R00000X.
The provider might be accepting Accepts: Mountain Health CO-OP, Providence Health Plan,. Please consult your insurance carrier or call the provider to verify.
