MARIE BAILEY MD
NPI 1316985294
Internal Medicine - Gastroenterology in Flourtown, PA

NPI Status: Active since June 03, 2006

Contact Information

1811 BETHLEHEM PIKE
FLOURTOWN, PA
ZIP 19031
Phone: (215) 402-0800
Fax: (215) 402-0449

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  • Individual
  • Female
  • Years of Experience 30
  • Internal Medicine
  • Gastroenterology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MARIE BAILEY

This page provides the complete NPI Profile along with additional information for Marie Bailey, an internist established in Flourtown, Pennsylvania with a medical specialization in Internal Medicine, focusing in gastroenterology and more than 30 years of experience. She graduated from Medical College Of Pennsylvania in 1996. The healthcare provider is registered in the NPI registry with number 1316985294 assigned on June 2006. The practitioner's primary taxonomy code is 207RG0100X with license number MD066608L (PA). The provider is registered as an individual and her NPI record was last updated 16 years ago.

NPI
1316985294
Provider Name
MARIE BAILEY MD
Gender
Female
Entity Type
Individual
Location Address
1811 BETHLEHEM PIKE FLOURTOWN, PA 19031
Location Phone
(215) 402-0800
Location Fax
(215) 402-0449
Mailing Address
1811 BETHLEHEM PIKE FLOURTOWN, PA 19031
Mailing Phone
(215) 402-0800
Mailing Fax
(215) 402-0449
Medical School Name
MEDICAL COLLEGE OF PENNSYLVANIA
Graduation Year
1996
Is Sole Proprietor?
No
Enumeration Date
06-03-2006
Last Update Date
12-29-2009
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An internist like Marie Bailey is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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

Internal Medicine Gastroenterology

Taxonomy Code
207RG0100X
Type
Allopathic & Osteopathic Physicians
License No.
MD066608L
License State
PA
Taxonomy Description
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Insurance Plans Accepted

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

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Principal Bronze HSA - EPO
  • Principal Bronze HSA + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - 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
H64062MEDICARE UPIN (02)PA 
P00033456OTHER (01)PARAILROAD
1397257LDDMEDICARE PIN (08)PA 
1898962MEDICAID (05)PA 

Medicare Participation & PECOS Enrollment Status

Marie Bailey 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.

Marie Bailey 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: 3870694235

    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: I20100913000427

    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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

This service was performed 23 times for 20 patients

Biopsy of large bowel using a flexible endoscope

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

This service was performed 26 times for 26 patients

Colonoscopy

A colonoscopy is a medical procedure that allows your doctor to examine your colon (the large intestine). It utilizes a thin, flexible tube with a tiny camera on the end, which is inserted through the rectum. This procedure can help identify issues such as polyps, inflammation, or early signs of cancer. It's usually recommended for people over 50 or those with specific risk factors.

This service was performed for 94 patients

Colorectal cancer screening; colonoscopy on individual at high risk

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

This service was performed 42 times for 42 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

This service was performed 84 times for 82 patients

Upper gastrointestinal (GI) endoscopy for acid reflux

An upper GI endoscopy is a procedure to examine your esophagus and stomach using a thin, flexible tube called an endoscope. It helps diagnose conditions like acid reflux by identifying any inflammation or damage. It's generally safe, performed under sedation, and takes about 15-30 minutes.

This service was performed for 41 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $34.29 for a new patient copayment and $26.3 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 19031 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $137.17
  • Minimum New Patient Price $59.88
  • Maximum New Patient Price $180.99
  • Average New Patient Copayment $34.29
  • Minimum New Patient Copayment $14.97
  • Maximum New Patient Copayment $45.24

Established Patients Visit Costs *

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

  • Average Established Patient Price $105.21
  • Minimum Established Patient Price $19.3
  • Maximum Established Patient Price $147.29
  • Average Established Patient Copayment $26.3
  • Minimum Established Patient Copayment $4.82
  • Maximum Established Patient Copayment $36.82

* 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. Marie Bailey is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
CONEMAUGH MEMORIAL MEDICAL CENTER1086 FRANKLIN STREET
JOHNSTOWN, PA 15905
(814) 534-9000Acute Care Hospitals

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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 1316985294, we treat the final digit (4) 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 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

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
9
Doubled → 18 → 1 + 8
Pos 6
8
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
2
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
4
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 9 → 18 → 9 5 → 10 → 1 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 + 1 + 8 + 8 + 1 + 0 + 2 + 1 + 8 + 24 = 66

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

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1316985294.

Other Providers at the Same Location


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

Ophthalmology
1811 BETHLEHEM PIKE, BLDG B2 STE 223
FLOURTOWN, PA 19031
Internal Medicine (Gastroenterology)
1811 BETHLEHEM PIKE
FLOURTOWN, PA 19031
Internal Medicine (Gastroenterology)
1811 BETHLEHEM PIKE
FLOURTOWN, PA 19031
Family Medicine
1811 BETHLEHEM PIKE, A108
FLOURTOWN, PA 19031
Internal Medicine (Gastroenterology)
1811 BETHLEHEM PIKE
FLOURTOWN, PA 19031
Internal Medicine (Gastroenterology)
1811 BETHLEHEM PIKE
FLOURTOWN, PA 19031
Pediatrics
1811 BETHLEHEM PIKE, SUITE A106
FLOURTOWN, PA 19031
Pediatrics
1811 BETHLEHEM PIKE, A106
FLOURTOWN, PA 19031
Pediatrics
1811 BETHLEHEM PIKE, A106
FLOURTOWN, PA 19031
Pediatrics
1811 BETHLEHEM PIKE, A106
FLOURTOWN, PA 19031
Pediatrics
1811 BETHLEHEM PIKE, A106
FLOURTOWN, PA 19031
Pediatrics
1811 BETHLEHEM PIKE, A106
FLOURTOWN, PA 19031
Internal Medicine
1811 BETHLEHEM PIKE, SUITE B 232
FLOURTOWN, PA 19031
Physical Medicine & Rehabilitation (Pain Medicine)
1811 BETHLEHEM PIKE, SUITE 221
FLOURTOWN, PA 19031
Dentist (General Practice)
1811 BETHLEHEM PIKE, SUITE A-102
FLOURTOWN, PA 19031
Nurse Practitioner (Family)
1811 BETHLEHEM PIKE, SUITE A108
FLOURTOWN, PA 19031
Dentist (General Practice)
1811 BETHLEHEM PIKE, SUITE A-102
FLOURTOWN, PA 19031
Anesthesiology
1811 BETHLEHEM PIKE, C-300
FLOURTOWN, PA 19031
Nurse Practitioner (Pediatrics)
1811 BETHLEHEM PIKE, SUITE A 106
FLOURTOWN, PA 19031
Early Intervention Provider Agency
1811 BETHLEHEM PIKE, BLDG B-1 SUITE 211
FLOURTOWN, PA 19031

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316985294, enumerated as an "individual" on June 03, 2006.

The provider is located at 1811 BETHLEHEM PIKE FLOURTOWN, PA 19031 and the phone number is (215) 402-0800.

Internal Medicine with taxonomy code 207RG0100X and a focus in Gastroenterology.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter. Please consult your insurance carrier or call the provider to verify.

Marie Bailey is affiliated with: CONEMAUGH MEMORIAL MEDICAL CENTER.