MARIANNE R NEAL M.D.
NPI 1255380317
Radiology - Diagnostic Radiology in Johnson City, TN

NPI Status: Active since May 08, 2006

Contact Information

1301 SUNSET DR
STE 3
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 926-4966
Fax: (423) 926-1823

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  • Individual
  • Female
  • Years of Experience 25
  • Radiology
  • Diagnostic Radiology
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MARIANNE NEAL

This page provides the complete NPI Profile along with additional information for Marianne Neal, a provider established in Johnson City, Tennessee with a medical specialization in Radiology, focusing in diagnostic radiology and more than 25 years of experience. The healthcare provider is registered in the NPI registry with number 1255380317 assigned on May 2006. The practitioner's primary taxonomy code is 2085R0202X with license number 31365 (TN). The provider is registered as an individual and her NPI record was last updated 19 years ago.

NPI
1255380317
Provider Name
MARIANNE R NEAL M.D.
Gender
Female
Entity Type
Individual
Location Address
1301 SUNSET DR STE 3 JOHNSON CITY, TN 37604
Location Phone
(423) 926-4966
Location Fax
(423) 926-1823
Mailing Address
1301 SUNSET DR STE 3 JOHNSON CITY, TN 37604
Mailing Phone
(423) 926-4966
Mailing Fax
(423) 926-1823
Medical School Name
OTHER
Graduation Year
2002
Is Sole Proprietor?
Yes
Enumeration Date
05-08-2006
Last Update Date
07-08-2007
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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

Radiology Diagnostic Radiology

Taxonomy Code
2085R0202X
Type
Allopathic & Osteopathic Physicians
License No.
31365
License State
TN
Taxonomy Description
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Insurance Plans Accepted

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

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.

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
89063JKOTHER (01)NCNORTH CAROLINA MEDICAID
3840962MEDICARE ID-TYPE UNSPECIFIED (04)TN 
7222084OTHER (01)VAVIRGINIA MEDICAID
G07844MEDICARE UPIN (02)TN 
64018062OTHER (01)KYKENTUCKY MEDICAID
3130527OTHER (01)TNBCBS
3840962MEDICAID (05)TN 

Medicare Participation & PECOS Enrollment Status

Marianne Neal 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.

Marianne Neal 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: 3476654237

    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: I20101008000355

    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

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.

Dxa bone density measurement of hip, pelvis, spine

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

This service was performed 47 times for 47 patients

Dxa bone density measurement of hip, pelvis, spine

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

This service was performed 11 times for 11 patients

Dxa bone density measurement of hip, pelvis, spine including spine fracture assessment

A DXA bone density measurement is a non-invasive scan that helps assess the strength of your bones, specifically in the hip, pelvis, and spine areas. It can detect early signs of osteoporosis and evaluate fracture risk. This test uses low-dose X-rays for accurate results.

This service was performed 82 times for 82 patients

Dxa bone density measurement of hip, pelvis, spine including spine fracture assessment

A DXA bone density measurement is a non-invasive scan that helps assess the strength of your bones, specifically in the hip, pelvis, and spine areas. It can detect early signs of osteoporosis and evaluate fracture risk. This test uses low-dose X-rays for accurate results.

This service was performed 131 times for 131 patients

Imaging for evaluation of swallowing function

This process, known as a swallowing study, uses imaging technology to view how food and liquid move from your mouth to your stomach. It helps identify any issues you may have swallowing, which can be crucial for determining the best treatment plan.

This service was performed 43 times for 41 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.38 for a new patient copayment and $16.5 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 37604 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $81.53
  • Minimum New Patient Price $52.64
  • Maximum New Patient Price $160.89
  • Average New Patient Copayment $20.38
  • Minimum New Patient Copayment $13.16
  • Maximum New Patient Copayment $40.22

Established Patients Visit Costs *

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

  • Average Established Patient Price $66.01
  • Minimum Established Patient Price $16.72
  • Maximum Established Patient Price $131.41
  • Average Established Patient Copayment $16.5
  • Minimum Established Patient Copayment $4.18
  • Maximum Established Patient Copayment $32.85

* 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. Marianne Neal is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
JOHNSON CITY MEDICAL CENTER400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604
(423) 431-6111Acute Care Hospitals

Reviews for MARIANNE R NEAL M.D.

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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 1255380317, we treat the final digit (7) 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

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.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
5
Unchanged
Pos 5
3
Doubled → 6
Pos 6
8
Unchanged
Pos 7
0
Doubled → 0
Pos 8
3
Unchanged
Pos 9
1
Doubled → 2
Check
7
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 5 → 10 → 1 3 → 6 0 → 0 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 0 + 5 + 6 + 8 + 0 + 3 + 2 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1255380317.

Other Providers at the Same Location


The following 18 providers are registered at the same or a nearby location.

Radiology (Diagnostic Radiology)
1301 SUNSET DR, STE 3
JOHNSON CITY, TN 37604
Radiology (Diagnostic Radiology)
1301 SUNSET DR, STE 3
JOHNSON CITY, TN 37604
Radiology (Diagnostic Radiology)
1301 SUNSET DR, STE 3
JOHNSON CITY, TN 37604
Radiology (Diagnostic Radiology)
1301 SUNSET DR, STE 3
JOHNSON CITY, TN 37604
Radiology (Diagnostic Radiology)
1301 SUNSET DR, STE 3
JOHNSON CITY, TN 37604
Radiology (Diagnostic Radiology)
1301 SUNSET DR, STE 3
JOHNSON CITY, TN 37604
Radiology (Diagnostic Radiology)
1301 SUNSET DR, STE 3
JOHNSON CITY, TN 37604
Dentist (General Practice)
1301 SUNSET DR, SUITE 6
JOHNSON CITY, TN 37604
Radiology (Diagnostic Radiology)
1301 SUNSET DR, SUITE 3
JOHNSON CITY, TN 37604
Dentist (General Practice)
1301 SUNSET DR, SUITE 1
JOHNSON CITY, TN 37604
Dentist
1301 SUNSET DR, SUITE 6
JOHNSON CITY, TN 37604
Dentist (General Practice)
1301 SUNSET DR, SUITE 6
JOHNSON CITY, TN 37604
Radiology Practitioner Assistant
1301 SUNSET DR, SUITE #3
JOHNSON CITY, TN 37604
Radiology (Diagnostic Radiology)
1301 SUNSET DR, STE 3
JOHNSON CITY, TN 37604
Radiology (Diagnostic Radiology)
1301 SUNSET DR, SUITE 3
JOHNSON CITY, TN 37604
Radiology (Diagnostic Radiology)
1301 SUNSET DR, STE 3
JOHNSON CITY, TN 37604
Radiology (Diagnostic Radiology)
1301 SUNSET DR, STE 3
JOHNSON CITY, TN 37604
Radiology (Vascular & Interventional Radiology)
1301 SUNSET DR, STE 3
JOHNSON CITY, TN 37604

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255380317, enumerated as an "individual" on May 08, 2006.

The provider is located at 1301 SUNSET DR STE 3 JOHNSON CITY, TN 37604 and the phone number is (423) 926-4966.

Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.

Marianne Neal is affiliated with: JOHNSON CITY MEDICAL CENTER.