MRS. NICOLE THERESA SHAFRAN M.S. CCC-SLP
NPI 1316231251
Speech-Language Pathologist in Neenah, WI
NPI Status: Active since June 08, 2011
- Individual
- Female
- Years of Experience 19
- Speech-Language Pathologist
- Accepts Insurance
- Accepts Medicare Approved Payment
About NICOLE SHAFRAN
This page provides the complete NPI Profile along with additional information for Nicole Shafran, a provider established in Neenah, Wisconsin with a medical specialization in Speech-language Pathologist and more than 19 years of experience. She graduated from University Of Wisconsin School Of Medicine in 2008. The healthcare provider is registered in the NPI registry with number 1316231251 assigned on June 2011. The practitioner's primary taxonomy code is 235Z00000X. The provider is registered as an individual and her NPI record was last updated 13 years ago.
- NPI
- 1316231251
- Provider Name
- MRS. NICOLE THERESA SHAFRAN M.S. CCC-SLP
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 130 2ND ST NEENAH, WI 54956
- Location Phone
- (920) 729-3349
- Mailing Address
- 130 2ND ST P.O. BOX 2021 NEENAH, WI 54956
- Mailing Phone
- (920) 729-3349
- Medical School Name
- UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
- Graduation Year
- 2008
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-08-2011
- Last Update Date
- 07-12-2013
- 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
Speech-Language Pathologist
- Taxonomy Code
- 235Z00000X
- Type
- Speech, Language and Hearing Service Providers
- Taxonomy Description
- The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold Standard $2000 - EPO
- CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver Standard $6000 - EPO
- CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam - EPO
- Premier $2,000 - 25% - HMO
- Premier $3,500 - 30% - HMO
- Premier $4,000 - 50% - HMO
- Premier $5,000 HDHP - HMO
- Premier $6,000 - 40% - HMO
- Premier $7,500 - HMO
- Premier $7,500 HDHP - HMO
- Premier HMO $1,500 - 30% - HMO
- Premier HMO $2,500 - 20% Copay - HMO
- Premier HMO $3,400 - 30% HDHP - HMO
- Premier HMO $3,500 - 30% - HMO
- Premier HMO $3,500 HDHP - HMO
- Premier HMO $4,000 - 20% HDHP - HMO
- Premier HMO $5,000 - 20% HDHP - HMO
- Premier HMO $5,500 - 40% Copay - HMO
- Premier HMO $7,500 HDHP - HMO
- Premier HMO $750 - 10% - HMO
- Premier HMO $9,500 - HMO
- Premier POS $1,500 - 30% - POS
- Premier POS $2,500 - 20% Copay - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Nicole Shafran 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: 7416387808
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: I20200427001600
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.
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.
Evaluation of speech sound production
Test to assess the ability to complete specific functional tasks applicable to environment
Treatment of speech, language, voice, communication, and/or hearing processing disorder
Evaluation of speech sound production involves assessing how well you can produce and articulate sounds. This can help identify any issues with your speech such as lisping, stuttering, or other speech disorders. The evaluation is conducted by a speech-language pathologist.
This service was performed 12 times for 11 patientsThis is a test that measures your ability to perform certain tasks that are relevant to your daily life and environment. It evaluates how well you can manage activities like cooking, cleaning, or shopping. It doesn't involve any invasive procedures.
This service was performed 21 times for 21 patientsThis treatment involves working with a specialist to improve communication skills. It could involve exercises to enhance speech clarity, language understanding, voice volume, or hearing comprehension. The goal is to enhance your ability to express and understand others effectively.
This service was performed 125 times for 26 patientsReviews for MRS. NICOLE THERESA SHAFRAN M.S. CCC-SLP
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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 1316231251, 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 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 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 49 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1316231251, enumerated as an "individual" on June 08, 2011.
The provider is located at 130 2ND ST NEENAH, WI 54956 and the phone number is (920) 729-3349.
Speech-Language Pathologist with taxonomy code 235Z00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource. Please consult your insurance carrier or call the provider to verify.
