MARGARET JONES
NPI 1285205393
Nurse Practitioner in Berlin, VT

NPI Status: Active since July 09, 2021

Contact Information

130 FISHER RD
BERLIN, VT
ZIP 05602
Phone: (802) 471-2100

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 5
Nurse Practitioner
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About MARGARET JONES

This page provides the complete NPI Profile along with additional information for Margaret Jones, a provider established in Berlin, Vermont with a medical specialization in Nurse Practitioner and more than 5 years of experience. She graduated from University Of Vermont College Of Medicine in 2021. The healthcare provider is registered in the NPI registry with number 1285205393 assigned on July 2021. The practitioner's primary taxonomy code is 363L00000X with license number 101.0134898 (VT). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI: 1285205393
Provider Name: MARGARET JONES
Gender: Female
Entity Type: Individual
Location Address: 130 FISHER RD BERLIN, VT 05602
Location Phone: (802) 471-2100
Mailing Address: 130 FISHER RD BERLIN, VT 05602
Mailing Phone: (802) 471-2100
Medical School Name: UNIVERSITY OF VERMONT COLLEGE OF MEDICINE
Graduation Year: 2021
Is Sole Proprietor?: No
Enumeration Date: 07-09-2021
Last Update Date: 12-01-2022
Code Navigator

A nurse practitioner (NP) like Margaret Jones is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Secondary Locations

163 Veterans Dr
White River Junction, VT 05009
(802) 295-9363

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: Nurse Practitioner
Taxonomy Code: 363L00000X
Type: Physician Assistants & Advanced Practice Nursing Providers
License No.: 101.0134898
License State: VT
Taxonomy Description: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Insurance Plans Accepted

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

Anthem Blue Cross and Blue Shield

Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO

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

Medicare Participation & PECOS Enrollment Status

Margaret Jones 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.

Margaret Jones 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: 2062883648
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: I20230118000801
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.

Follow-up nursing facility visit per day, typically 15 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.47 for a new patient copayment and $24.6 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 05602 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $85.89
Minimum New Patient Price $55.8
Maximum New Patient Price $168.48

Average New Patient Copayment $21.47
Minimum New Patient Copayment $13.95
Maximum New Patient Copayment $42.12

Established Patients Visit Costs *

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

Average Established Patient Price $98.4
Minimum Established Patient Price $18.08
Maximum Established Patient Price $137.84

Average Established Patient Copayment $24.6
Minimum Established Patient Copayment $4.52
Maximum Established Patient Copayment $34.46

* 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. Margaret Jones is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
CENTRAL VERMONT MEDICAL CENTER	BOX 547 BARRE, VT 05641	(802) 371-4100	Acute Care Hospitals

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.
1	2	8	5	2	0	5	3	9	3
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	2	16	5	4	0	10	3	18
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 6 + 5 + 4 + 0 + 1 + 0 + 3 + 1 + 8 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 3									3

The NPI number 1285205393 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

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

MARIE L ZAGROBA M.D.

Anesthesiology

130 FISHER RD
CENTRAL VT MEDICAL CENTER
BERLIN, VT
ZIP 05602

About MARGARET JONES

Location Map

Secondary Locations

Specialty - Primary Taxonomy

Nurse Practitioner

Insurance Plans Accepted

Anthem Blue Cross and Blue Shield

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 2062883648

PECOS Enrollment ID: I20230118000801

Accepts Medicare Assignment? 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

Areas of Expertise

Follow-up nursing facility visit per day, typically 15 minutes

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Find Provider Hospital Affiliations - Privileges

Reviews for MARGARET JONES

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions

What is Margaret Jones's NPI number?

Where is the provider located?

What is the provider's specialty?

What insurance does Margaret Jones accept?

Is Margaret Jones affiliated with any hospitals?