PROF. JOHN SCOTT HIDALGO OT
NPI 1295959401
Occupational Therapist in Opelousas, LA
NPI Status: Active since April 12, 2007
Contact Information
4027 I 49 S SERVICE RD
OPELOUSAS, LA
ZIP 70570
Phone: (337) 948-4212
Fax: (337) 942-9979
- Individual
- Male
- Years of Experience 30
- Occupational Therapist
- Accepts Insurance
- Accepts Medicare Approved Payment
About JOHN HIDALGO
This page provides the complete NPI Profile along with additional information for John Hidalgo, a provider established in Opelousas, Louisiana with a medical specialization in Occupational Therapist and more than 30 years of experience. The healthcare provider is registered in the NPI registry with number 1295959401 assigned on April 2007. The practitioner's primary taxonomy code is 225X00000X with license number Z11534 (LA). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1295959401
- Provider Name
- PROF. JOHN SCOTT HIDALGO OT
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4027 I 49 S SERVICE RD OPELOUSAS, LA 70570
- Location Phone
- (337) 948-4212
- Location Fax
- (337) 942-9979
- Mailing Address
- 420 W PINHOOK RD SUITE A LAFAYETTE, LA 70503
- Mailing Phone
- (337) 233-1307
- Mailing Fax
- (337) 942-9979
- Medical School Name
- OTHER
- Graduation Year
- 1996
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-12-2007
- Last Update Date
- 07-08-2007
- Code Navigator
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
Occupational Therapist
- Taxonomy Code
- 225X00000X
- Type
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- License No.
- Z11534
- License State
- LA
- Taxonomy Description
- An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible - PPO
- Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits - PPO
- Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits - PPO
- Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible - PPO
- Blue Max Copay (PCP) 60/40 $6000 Standardized - PPO
- Blue Max Copay (PCP) 75/55 $2000 Standardized - PPO
- Blue Saver 60/40 $6100 - PPO
- Blue Saver 90/70 $3400 - PPO
- Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
- Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
- Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
- Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
- Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits - POS
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Copay Focus + $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Silver Standard (No Referrals) - EPO
- UHC Silver Value ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - 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 |
|---|---|---|---|
| OTT.Z11534 | OTHER (01) | LA | OT LICENSE # |
Medicare Participation & PECOS Enrollment Status
John Hidalgo 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.
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.
PECOS PAC ID: 5698106920
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: I20200520002200
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.
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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 1295959401, we treat the final digit (1) 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 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
OPELOUSAS, LA 70570
OPELOUSAS, LA 70570
OPELOUSAS, LA 70570
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1295959401, enumerated as an "individual" on April 12, 2007.
The provider is located at 4027 I 49 S SERVICE RD OPELOUSAS, LA 70570 and the phone number is (337) 948-4212.
Occupational Therapist with taxonomy code 225X00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Louisiana, HMO. Please consult your insurance carrier or call the provider to verify.
