|Provider Name||DR. THOMAS ADRAIN LEMMER DPM|
|Provider Location Address||4765 SOQUEL DR SOQUEL, CA 95073|
|Provider Mailing Address||195 HELEN CT SANTA CRUZ, CA 95065|
|NPI Entity Type||Individual|
|Is Sole Proprietor?||Yes|
|Last Update Date||05-18-2009|
A podiatrist like Dr. Thomas Adrain Lemmer Dpm provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.Thomas Lemmer 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) and a Home Health Agency (HHA)..
Thomas Lemmer is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Thomas Lemmer opted out of Medicare effective on 07-01-2013 until 07-01-2023. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
|Type||Podiatric Medicine & Surgery Service Providers|
|Taxonomy Description||A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.|
DR. THOMAS ADRAIN LEMMER DPM
4765 SOQUEL DR
Phone: (831) 476-3453
Fax: (831) 476-3453
DR. THOMAS ADRAIN LEMMER DPM
195 HELEN CT
SANTA CRUZ, CA
Phone: (831) 476-3453
Fax: (831) 476-3453
PECOS Enrollment and Medicare Participation
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
|Registered in PECOS?||Yes|
|Opted-Out of Medicare||Yes|
|Opt-Out Effective Date||07-01-2013|
|Opt-Out End Date||07-01-2023|
|Eligible to Order and Refer||Yes|
|Eligible order / refer Part B Clinical Laboratory and Imaging||Yes|
|Eligible order / refer Durable Medical Equipment||Yes|
|Eligible order / refer Home Health Agency (HHA)||Yes|
|Eligible order / refer Power Mobility Devices||No|
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
|No.||Taxonomy Code||Type||Classification||Specialization||License No.||State||Primary|
|1||213EP1101X||Podiatric Medicine & Surgery Service Providers||Podiatrist||Primary Podiatric Medicine||E3135||CA||No|
Taxonomy Description: Not Available
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
|Identifier||Type / Code||Identifier State|
|T11568||MEDICARE UPIN (02)||CA|
|BQ312Z||MEDICARE PIN (08)||CA|
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.|
|Step 1: Double the value of the alternate digits, beginning with the rightmost digit.|
|Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.|
|2 + 2 + 1 + 4 + 5 + 1 + 2 + 3 + 1 + 2 + 5 + 1 + 0 + 24 = 53|
|Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.|
|60 - 53 = 7||7|
The NPI number 1275636557 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
Dr. Thomas Adrain Lemmer Dpm is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:
- 1 = Person: individual human being who furnishes health care.
- 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.