TONI SANZANO QMHP
NPI 1255755484
Counselor - Mental Health in Salem, OR

NPI Status: Active since February 07, 2014

Contact Information

1118 OAK ST SE
SALEM, OR
ZIP 97301
Phone: (503) 585-4949

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  • Individual
  • Female
  • Years of Experience 9
  • Counselor
  • Mental Health
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About TONI SANZANO

This page provides the complete NPI Profile along with additional information for Toni Sanzano, a provider established in Salem, Oregon with a medical specialization in Counselor, focusing in mental health and more than 9 years of experience. The healthcare provider is registered in the NPI registry with number 1255755484 assigned on February 2014. The practitioner's primary taxonomy code is 101YM0800X. The provider is registered as an individual and her NPI record was last updated 8 years ago.

NPI
1255755484
Provider Name
TONI SANZANO QMHP
Other Name
TONI SANZANO
Other Name Type
Former Name (1)
Gender
Female
Entity Type
Individual
Location Address
1118 OAK ST SE SALEM, OR 97301
Location Phone
(503) 585-4949
Mailing Address
1118 OAK ST SE SALEM, OR 97301
Mailing Phone
(503) 585-4949
Mailing Fax
Medical School Name
OTHER
Graduation Year
2017
Is Sole Proprietor?
No
Enumeration Date
02-07-2014
Last Update Date
04-06-2018
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A mental health counselor like Toni Sanzano provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.

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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

Counselor Mental Health

Taxonomy Code
101YM0800X
Type
Behavioral Health & Social Service Providers

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)
1372600000XNursing Service Related Providers

Adult Companion

 

Insurance Plans Accepted

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

  • BridgeSpan Standard Bronze Plan - EPO
  • BridgeSpan Standard Gold Plan - EPO
  • BridgeSpan Standard Silver Plan - EPO
  • Bronze 8000 Individual Connect - EPO
  • Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
  • Bronze Essential 9000 With 4 Copay No Deductible Office Visits Legacy - EPO
  • Bronze HSA 7000 Individual Connect - EPO
  • Gold 2300 Individual Connect - EPO
  • Gold 2300 Legacy - EPO
  • Regence Standard Bronze Plan Individual Connect - EPO
  • Regence Standard Bronze Plan Legacy - EPO
  • Regence Standard Gold Plan Individual Connect - EPO
  • Regence Standard Gold Plan Legacy - EPO
  • Regence Standard Silver Plan Individual Connect - EPO
  • Regence Standard Silver Plan Legacy - EPO
  • Silver 6500 Individual Connect - EPO
  • Silver 6500 Legacy - 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
122994MEDICAID (05)OR 

Medicare Participation & PECOS Enrollment Status

Toni Sanzano 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.

Toni Sanzano 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: 1658899273

    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: I20250519000326

    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): 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 1255755484, we treat the final digit (4) 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 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

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
7
Doubled → 14 → 1 + 4
Pos 6
5
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
4
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
4
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 7 → 14 → 5 5 → 10 → 1 8 → 16 → 7

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 + 1 + 4 + 5 + 1 + 0 + 4 + 1 + 6 + 24 = 56

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

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1255755484.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Counselor (Mental Health)
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Counselor (Mental Health)
1118 OAK ST SE
SALEM, OR 97301
Counselor (Mental Health)
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Counselor (Mental Health)
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Counselor (Mental Health)
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Counselor (Mental Health)
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Counselor (Mental Health)
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301
Case Manager/Care Coordinator
1118 OAK ST SE
SALEM, OR 97301

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255755484, enumerated as an "individual" on February 07, 2014.

The provider is located at 1118 OAK ST SE SALEM, OR 97301 and the phone number is (503) 585-4949.

Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

The provider might be accepting Accepts: BridgeSpan Health Company, Regence BlueCross. Please consult your insurance carrier or call the provider to verify.