DR. EMMANUEL MICHAEL ILLICAL MD, FRCSC
NPI 1275926578
Orthopaedic Surgery in Brooklyn, NY

NPI Status: Active since March 10, 2015

Contact Information

450 CLARKSON AVE
BROOKLYN, NY
ZIP 11203
Phone: (718) 270-8995
Fax: (718) 270-1309

NPI Profile Information
Primary Taxonomy
Medicare Participation & PECOS Status
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Orthopaedic Surgery
PECOS Enrolled
Medicare Quality Reporting

About EMMANUEL ILLICAL

This page provides the complete NPI Profile along with additional information for Emmanuel Illical, a provider established in Brooklyn, New York with a medical specialization in Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1275926578 assigned on March 2015. The practitioner's primary taxonomy code is 207X00000X with license number 278062-1 (NY). The provider is registered as an individual and his NPI record was last updated 10 years ago.

NPI: 1275926578
Provider Name: DR. EMMANUEL MICHAEL ILLICAL MD, FRCSC
Gender: Male
Entity Type: Individual
Location Address: 450 CLARKSON AVE BROOKLYN, NY 11203
Location Phone: (718) 270-8995
Location Fax: (718) 270-1309
Mailing Address: 450 CLARKSON AVE BOX 30 BROOKLYN, NY 11203
Mailing Phone: (718) 270-3200
Mailing Fax: (718) 270-1309
Is Sole Proprietor?: Yes
Enumeration Date: 03-10-2015
Last Update Date: 04-08-2016
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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: Orthopaedic Surgery
Taxonomy Code: 207X00000X
Type: Allopathic & Osteopathic Physicians
License No.: 278062-1
License State: NY
Taxonomy Description: An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Medicare Participation & PECOS Enrollment Status

Emmanuel Illical 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

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 11203 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $105.06
Minimum New Patient Price $67.4
Maximum New Patient Price $203.53

Average New Patient Copayment $26.26
Minimum New Patient Copayment $16.85
Maximum New Patient Copayment $50.88

Established Patients Visit Costs *

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

Average Established Patient Price $83.44
Minimum Established Patient Price $21.66
Maximum Established Patient Price $164.45

Average Established Patient Copayment $20.86
Minimum Established Patient Copayment $5.41
Maximum Established Patient Copayment $41.11

* 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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Measurement and Improvement at the Practice and Panel Level	Yes	N/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Use of decision support and standardized treatment protocols	Yes	N/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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 1275926578, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 14 → 1 + 4

Pos 4

Unchanged

Pos 5

Doubled → 18 → 1 + 8

Pos 6

Unchanged

Pos 7

Doubled → 12 → 1 + 2

Pos 8

Unchanged

Pos 9

Doubled → 14 → 1 + 4

Check

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 7 → 14 → 5 9 → 18 → 9 6 → 12 → 3 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

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

2 + 2 + 1 + 4 + 5 + 1 + 8 + 2 + 1 + 2 + 5 + 1 + 4 + 24 = 62

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

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8

This NPI is valid

The calculated check digit is 8, which matches the last digit of 1275926578.