DR. MARK DOUGLAS WINBORN PH.D.
NPI 1316049893
Psychologist - Clinical in Memphis, TN

NPI Status: Active since September 03, 2006

Contact Information

5050 POPLAR AVE
SUITE 1633
MEMPHIS, TN
ZIP 38157
Phone: (901) 766-1890
Fax: (901) 766-1890

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  • Individual
  • Male
  • Years of Experience 39
  • Psychologist
  • Clinical
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MARK WINBORN

This page provides the complete NPI Profile along with additional information for Mark Winborn, a provider established in Memphis, Tennessee with a medical specialization in Psychologist, focusing in clinical and more than 39 years of experience. The healthcare provider is registered in the NPI registry with number 1316049893 assigned on September 2006. The practitioner's primary taxonomy code is 103TC0700X with license number P1316 (TN). The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI
1316049893
Provider Name
DR. MARK DOUGLAS WINBORN PH.D.
Gender
Male
Entity Type
Individual
Location Address
5050 POPLAR AVE SUITE 1633 MEMPHIS, TN 38157
Location Phone
(901) 766-1890
Location Fax
(901) 766-1890
Mailing Address
5050 POPLAR AVE SUITE 1633 MEMPHIS, TN 38157
Mailing Phone
(901) 766-1890
Mailing Fax
(901) 766-1890
Medical School Name
OTHER
Graduation Year
1987
Is Sole Proprietor?
Yes
Enumeration Date
09-03-2006
Last Update Date
07-08-2007
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A clinical psychologist like Mark Winborn assesses, diagnoses, and treats mental, emotional, and behavioral disorders. Clinical psychologists help people deal with problems ranging from short-term personal issues to severe, chronic conditions. Clinical psychologists interview patients, give diagnostic tests, provide psychotherapy and design behavior modification programs to help patients.

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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

Psychologist Clinical

Taxonomy Code
103TC0700X
Type
Behavioral Health & Social Service Providers
License No.
P1316
License State
TN
Taxonomy Description
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Insurance Plans Accepted

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

  • BlueCross B15E $0 virtual care from Teladoc Health� - EPO
  • BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross B17E $0 virtual care from Teladoc Health� + Adult Dental - EPO
  • BlueCross B19E $60 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross S27E $60 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross S29E $60 PCP Copay + $0 virtual care from Teladoc Health� + Adult Dental - EPO
  • BlueCross S34E $45 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - 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
R70654MEDICARE UPIN (02)TN 
3680904MEDICARE ID-TYPE UNSPECIFIED (04)TN 
3680904MEDICAID (05)TN 

Medicare Participation & PECOS Enrollment Status

Mark Winborn 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.

Mark Winborn 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: 3577877125

    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: I20150727002991

    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

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $40.22 for a new patient copayment and $23.4 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 38157 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99205

  • Average New Patient Price $160.89
  • Minimum New Patient Price $52.64
  • Maximum New Patient Price $160.89
  • Average New Patient Copayment $40.22
  • Minimum New Patient Copayment $13.16
  • Maximum New Patient Copayment $40.22

Established Patients Visit Costs *

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

  • Average Established Patient Price $93.6
  • Minimum Established Patient Price $16.72
  • Maximum Established Patient Price $131.41
  • Average Established Patient Copayment $23.4
  • Minimum Established Patient Copayment $4.18
  • Maximum Established Patient Copayment $32.85

* 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.

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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 1316049893, we treat the final digit (3) 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

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
3
Unchanged
Pos 3
1
Doubled → 2
Pos 4
6
Unchanged
Pos 5
0
Doubled → 0
Pos 6
4
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
8
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
3
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 1 → 2 0 → 0 9 → 18 → 9 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

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

2 + 3 + 2 + 6 + 0 + 4 + 1 + 8 + 8 + 1 + 8 + 24 = 67

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

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1316049893.

Other Providers at the Same Location


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

Internal Medicine
5050 POPLAR AVE, WHITE STATION TOWER, SUITE 611
MEMPHIS, TN 38157
Specialist
5050 POPLAR AVE, SUITE 618
MEMPHIS, TN 38157
Social Worker (Clinical)
5050 POPLAR AVE, SUITE 1118
MEMPHIS, TN 38157
Psychiatry & Neurology (Psychiatry)
5050 POPLAR AVE, SUITE 618
MEMPHIS, TN 38157
Counselor (Professional)
5050 POPLAR AVE, SUITE # 1118
MEMPHIS, TN 38157
Internal Medicine (Critical Care Medicine)
5050 POPLAR AVE, SUITE 800
MEMPHIS, TN 38157
Internal Medicine (Critical Care Medicine)
5050 POPLAR AVE, SUITE 800
MEMPHIS, TN 38157
Internal Medicine
5050 POPLAR AVE, SUITE 718
MEMPHIS, TN 38157
In Home Supportive Care
5050 POPLAR AVE, SUITE 2400
MEMPHIS, TN 38157
Home Health Aide
5050 POPLAR AVE, SUITE #2404
MEMPHIS, TN 38157
Specialist/Technologist, Other
5050 POPLAR AVE, STE 718
MEMPHIS, TN 38157
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
5050 POPLAR AVE, SUITE 710
MEMPHIS, TN 38157
Internal Medicine (Pulmonary Disease)
5050 POPLAR AVE, SUITE 800
MEMPHIS, TN 38157
Psychologist (Clinical)
5050 POPLAR AVE, SUITE 511
MEMPHIS, TN 38157
Nurse Practitioner (Critical Care Medicine)
5050 POPLAR AVE, SUITE 800
MEMPHIS, TN 38157
Nurse Practitioner (Critical Care Medicine)
5050 POPLAR AVE, SUITE 800
MEMPHIS, TN 38157
Psychologist
5050 POPLAR AVE, STE 1632
MEMPHIS, TN 38157
Internal Medicine (Sleep Medicine)
5050 POPLAR AVE, SUITE 800
MEMPHIS, TN 38157
Internal Medicine (Critical Care Medicine)
5050 POPLAR AVE, SUITE 800
MEMPHIS, TN 38157
Internal Medicine (Critical Care Medicine)
5050 POPLAR AVE, SUITE 800
MEMPHIS, TN 38157

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316049893, enumerated as an "individual" on September 03, 2006.

The provider is located at 5050 POPLAR AVE SUITE 1633 MEMPHIS, TN 38157 and the phone number is (901) 766-1890.

Psychologist with taxonomy code 103TC0700X and a focus in Clinical.

The provider might be accepting Accepts: BlueCross BlueShield of Tennessee, Providence. Please consult your insurance carrier or call the provider to verify.