DR. KELLY HEFFERON D.O.
NPI 1255474813
Internal Medicine - Geriatric Medicine in Southfield, MI

NPI Status: Active since February 14, 2007

Contact Information

21650 W 11 MILE RD STE 209
SOUTHFIELD, MI
ZIP 48076
Phone: (248) 809-9638
Fax: (248) 809-9996

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  • Individual
  • Female
  • Internal Medicine
  • Geriatric Medicine
  • Accepts Insurance
  • PECOS Enrolled

About KELLY HEFFERON

This page provides the complete NPI Profile along with additional information for Kelly Hefferon, an internist established in Southfield, Michigan with a medical specialization in Internal Medicine, focusing in geriatric medicine . The healthcare provider is registered in the NPI registry with number 1255474813 assigned on February 2007. The practitioner's primary taxonomy code is 207RG0300X with license number 5101012396 (MI). The provider is registered as an individual and her NPI record was last updated 7 years ago.

NPI
1255474813
Provider Name
DR. KELLY HEFFERON D.O.
Gender
Female
Entity Type
Individual
Location Address
21650 W 11 MILE RD STE 209 SOUTHFIELD, MI 48076
Location Phone
(248) 809-9638
Location Fax
(248) 809-9996
Mailing Address
24567 NORTHWESTERN HWY STE 150 SOUTHFIELD, MI 48075
Mailing Phone
(248) 799-0093
Is Sole Proprietor?
No
Enumeration Date
02-14-2007
Last Update Date
11-07-2019
Code Navigator

An internist like Kelly Hefferon 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

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 Geriatric Medicine

Taxonomy Code
207RG0300X
Type
Allopathic & Osteopathic Physicians
License No.
5101012396
License State
MI
Taxonomy Description
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

Insurance Plans Accepted

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

  • BlueCare EPO Bronze - EPO
  • BlueCare EPO Gold - EPO
  • BlueCare EPO Gold Plus - EPO
  • BlueCare EPO Silver Plus - EPO
  • BlueCare EPO Simple Bronze HDHP - EPO
  • BlueCare EPO Simple Silver HDHP - EPO
  • BlueCare EPO Standardized Expanded Bronze - EPO
  • BlueCare EPO Standardized Gold - EPO
  • BlueCare EPO Standardized Silver - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Kelly Hefferon 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 (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    3 DME suppliers used 15 Medicare Claims 66 Services Paid

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.

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 18 times for 18 patients

Established patient home visit, typically 25 minutes

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

This service was performed 42 times for 21 patients

Established patient home visit, typically 40 minutes

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

This service was performed 50 times for 23 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 24 times for 24 patients

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 48076 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99205

  • Average New Patient Price $177.36
  • Minimum New Patient Price $58.04
  • Maximum New Patient Price $177.36
  • Average New Patient Copayment $44.34
  • Minimum New Patient Copayment $14.51
  • Maximum New Patient Copayment $44.34

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $102.35
  • Minimum Established Patient Price $18.32
  • Maximum Established Patient Price $143.49
  • Average Established Patient Copayment $25.58
  • Minimum Established Patient Copayment $4.58
  • Maximum Established Patient Copayment $35.87

* 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 1255474813, we treat the final digit (3) 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

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
4
Doubled → 8
Pos 6
7
Unchanged
Pos 7
4
Doubled → 8
Pos 8
8
Unchanged
Pos 9
1
Doubled → 2
Check
3
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 4 → 8 4 → 8 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 + 8 + 7 + 8 + 8 + 2 + 24 = 67

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

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1255474813.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255474813, enumerated as an "individual" on February 14, 2007.

The provider is located at 21650 W 11 MILE RD STE 209 SOUTHFIELD, MI 48076 and the phone number is (248) 809-9638.

Internal Medicine with taxonomy code 207RG0300X and a focus in Geriatric Medicine.

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