CAROL GERSON MD
NPI 1356336168
Otolaryngology - Pediatric Otolaryngology in River Forest, IL
NPI Status: Active since September 19, 2005
Contact Information
1031 ASHLAND AVE
RIVER FOREST, IL
ZIP 60305
Phone: (708) 334-5160
- Individual
- Female
- Otolaryngology
- Pediatric Otolaryngology
- PECOS Enrolled
- Opted-Out Medicare
About CAROL GERSON
This page provides the complete NPI Profile along with additional information for Carol Gerson, a provider established in River Forest, Illinois with a medical specialization in Otolaryngology, focusing in pediatric otolaryngology . The healthcare provider is registered in the NPI registry with number 1356336168 assigned on September 2005. The practitioner's primary taxonomy code is 207YP0228X with license number 036-057108 (IL). The provider is registered as an individual and her NPI record was last updated 14 years ago.
- NPI
- 1356336168
- Provider Name
- CAROL GERSON MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1031 ASHLAND AVE RIVER FOREST, IL 60305
- Location Phone
- (708) 334-5160
- Mailing Address
- 1031 ASHLAND AVE RIVER FOREST, IL 60305
- Mailing Phone
- (708) 334-5160
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-19-2005
- Last Update Date
- 04-25-2012
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Carol Gerson opted out of Medicare effective on 09-06-2016 until 09-06-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
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
Otolaryngology Pediatric Otolaryngology
- Taxonomy Code
- 207YP0228X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036-057108
- License State
- IL
- Taxonomy Description
- A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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.
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 |
|---|---|---|---|
| D15666 | MEDICARE UPIN (02) | IL | |
| 1627123 | OTHER (01) | IL | BCBS PROVIDER ID |
| 036057108 | MEDICAID (05) | IL | |
| K27874 | MEDICARE PIN (08) | IL |
Medicare Participation & PECOS Enrollment Status
Carol Gerson 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
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 09-06-2016
Opt-Out End Date: 09-06-2026
Eligible to Order and Refer? 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
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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 1356336168, we treat the final digit (8) 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 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
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 52 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356336168, enumerated as an "individual" on September 19, 2005.
The provider is located at 1031 ASHLAND AVE RIVER FOREST, IL 60305 and the phone number is (708) 334-5160.
Otolaryngology with taxonomy code 207YP0228X and a focus in Pediatric Otolaryngology.
The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.
