DR. STANLEY TYLER PACE M.D.
NPI 1366717605
Ophthalmology - Ophthalmic Plastic and Reconstructive Surgery in Knoxville, TN

NPI Status: Active since March 20, 2012

Contact Information

4528 CHAPMAN HWY
KNOXVILLE, TN
ZIP 37920
Phone: (865) 579-3920
Fax: (865) 579-3963

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  • Individual
  • Male
  • Years of Experience 14
  • Ophthalmology
  • Ophthalmic Plastic and Reconstructive Su...
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About STANLEY PACE

This page provides the complete NPI Profile along with additional information for Stanley Pace, a provider established in Knoxville, Tennessee with a medical specialization in Ophthalmology, focusing in ophthalmic plastic and reconstructive surgery and more than 14 years of experience. He graduated from Wake Forest University School Of Medicine in 2012. The healthcare provider is registered in the NPI registry with number 1366717605 assigned on March 2012. The practitioner's primary taxonomy code is 207WX0200X with license number 74072 (TN). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1366717605
Provider Name
DR. STANLEY TYLER PACE M.D.
Gender
Male
Entity Type
Individual
Location Address
4528 CHAPMAN HWY KNOXVILLE, TN 37920
Location Phone
(865) 579-3920
Location Fax
(865) 579-3963
Mailing Address
4528 CHAPMAN HWY KNOXVILLE, TN 37920
Mailing Phone
(865) 579-3920
Mailing Fax
(865) 579-3963
Medical School Name
WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
2012
Is Sole Proprietor?
No
Enumeration Date
03-20-2012
Last Update Date
07-03-2025
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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

Ophthalmology Ophthalmic Plastic and Reconstructive Surgery

Taxonomy Code
207WX0200X
Type
Allopathic & Osteopathic Physicians
License No.
74072
License State
TN
Taxonomy Description
A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207WX0200XAllopathic & Osteopathic Physicians

Ophthalmology
Ophthalmic Plastic and Reconstructive Surgery

52180 (SC)

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 (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold (QualChoice) - POS
  • Elite Gold (QualChoice) + Vision + Adult Dental - POS
  • Elite Gold (QualChoiceLife) - PPO
  • Elite Gold (QualChoiceLife) + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze (QualChoice) - POS
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + 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
  • Standard Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + 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 - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + 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
  • Standard Silver + Vision + Adult Dental - EPO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze with Atrium Health - HMO
  • Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Focused Silver with Atrium Health - HMO
  • Focused Silver with Atrium Health + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze with Atrium Health - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + 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
  • Standard Silver + Vision + Adult Dental - EPO
  • Blue Direction Bronze 1 - POS
  • Blue Direction Silver 1 - POS
  • Blue Direction Silver 1 + Adult Vision - POS
  • Blue Direction Silver 2 - POS
  • Blue Direction Standard Expanded Bronze - POS
  • Blue Direction Standard Gold - POS
  • Blue Direction Standard Silver - POS
  • Blue Reedy Bronze 1 - HMO
  • Blue Reedy Bronze 2 - HMO
  • Blue Reedy Gold 1 - HMO
  • Blue Reedy Silver 1 - HMO
  • Blue Reedy Silver 2 - HMO
  • Blue Reedy Silver 2 + Adult Vision - HMO
  • Blue Reedy Standard Expanded Bronze - HMO
  • Blue Reedy Standard Gold - HMO
  • Blue Reedy Standard Silver - HMO
  • Blue VirtuConnect Bronze 1 - EPO
  • Blue VirtuConnect Gold 1 - EPO
  • Blue VirtuConnect Silver 1 - EPO
  • BlueEssentials Bronze 4 - EPO
  • BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • First Choice Next Bronze Essential - HMO
  • First Choice Next Bronze Premier - HMO
  • First Choice Next Bronze Signature - HMO
  • First Choice Next Gold Premier - HMO
  • First Choice Next Gold Signature - HMO
  • First Choice Next Silver Essential - HMO
  • First Choice Next Silver Premier - HMO
  • First Choice Next Silver Signature - HMO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Standard - HMO
  • Molina Gold Value - HMO
  • Molina Gold Value Plus with Adult Dental and Vision - HMO
  • Molina Gold Value Plus with Adult Vision - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO
  • Molina Silver Saver - HMO
  • Molina Silver Standard - HMO
  • UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Essential (No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Gold Advantage (Virtual Urgent Care, No Referrals) - EPO
  • UHC Gold Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO
  • UHC Silver Advantage (Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Silver Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Standard (No Referrals) - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Stanley Pace 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.

Stanley Pace 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: 4284927054

    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: I20180712002538, I20250421003049

    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.

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 11 times for 11 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 223 times for 202 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 231 times for 221 patients

Extensive repair of turning-outward eyelid defect

This procedure corrects an eyelid defect where the eyelid turns outward, exposing the eye. The extensive repair involves surgical techniques to reshape the eyelid and ensure it functions properly. This helps protect the eye and improve comfort.

This service was performed 17 times for 14 patients

Incision biopsy, first skin growth

An incision biopsy involves taking a small sample of a skin growth for further examination. A local anesthetic is used to numb the area, then a portion of the growth is removed using a surgical knife. This helps identify the nature of the growth.

This service was performed 21 times for 21 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 18 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 51 times for 51 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 51 times for 51 patients

Photography of content of eyes

Photography of the content of eyes, also known as ocular photography, captures detailed images of different parts of the eye. It helps identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. The process is non-invasive and painless.

This service was performed 423 times for 392 patients

Probing of nasal tear duct

Probing of the nasal tear duct is a procedure to treat blocked tear ducts. A thin, flexible instrument is gently inserted into the tear duct to clear any obstruction, allowing tears to drain normally again. This procedure is typically quick and can help to alleviate symptoms like excessive tearing or infection.

This service was performed 33 times for 33 patients

Removal of excessive skin and fat of upper eyelid

This procedure, also known as upper eyelid surgery, is performed to remove excess skin and fat from the upper eyelid. It can help improve vision if heavy eyelids hinder it, and can also enhance the appearance of the eyes. It's a common, safe procedure.

This service was performed 44 times for 44 patients

Removal of growth of eyelid

The removal of an eyelid growth is a procedure performed to eliminate abnormal tissue from your eyelid. It's generally a quick, outpatient treatment. The doctor numbs your eyelid, carefully removes the growth, and may stitch the area if necessary. This can help maintain eye health and vision.

This service was performed 20 times for 18 patients

Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less

This procedure involves the removal of a noncancerous skin growth on the face, ears, eyelids, nose, lips, or mouth that is 0.5 cm or less in size. It is a safe, routine treatment that helps maintain skin health and appearance.

This service was performed 29 times for 19 patients

Repair of tendon of upper eyelid

Repair of the tendon of the upper eyelid is a surgical procedure aimed at fixing a droopy eyelid. This condition can affect your vision and appearance. The procedure involves tightening the tendon to lift the eyelid to its normal position, improving both function and aesthetics.

This service was performed 56 times for 56 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

This service was performed 15 times for 15 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $30.45 for a new patient copayment and $16.5 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 37920 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $121.8
  • Minimum New Patient Price $52.64
  • Maximum New Patient Price $160.89
  • Average New Patient Copayment $30.45
  • 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 99213

  • Average Established Patient Price $66.01
  • Minimum Established Patient Price $16.72
  • Maximum Established Patient Price $131.41
  • Average Established Patient Copayment $16.5
  • 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 1366717605, we treat the final digit (5) 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 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

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
6
Doubled → 12 → 1 + 2
Pos 4
6
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
1
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
6
Unchanged
Pos 9
0
Doubled → 0
Check
5
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 6 → 12 → 3 7 → 14 → 5 7 → 14 → 5 0 → 0

Step 2: Add all digits plus the NPI constant

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

2 + 3 + 1 + 2 + 6 + 1 + 4 + 1 + 1 + 4 + 6 + 0 + 24 = 55

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

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1366717605.

Other Providers at the Same Location


The following 14 providers are registered at the same or a nearby location.

Ophthalmology
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Ophthalmology
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Ophthalmology (Cornea and External Diseases Specialist)
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Ophthalmology
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Ophthalmology (Cornea and External Diseases Specialist)
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Ophthalmology
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Specialist
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Ophthalmology (Glaucoma Specialist)
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Ophthalmology
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Ophthalmology
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Ophthalmology
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Optometrist
4528 CHAPMAN HWY
KNOXVILLE, TN 37920
Ophthalmology
4528 CHAPMAN HWY
KNOXVILLE, TN 37920

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366717605, enumerated as an "individual" on March 20, 2012.

The provider is located at 4528 CHAPMAN HWY KNOXVILLE, TN 37920 and the phone number is (865) 579-3920.

Ophthalmology with taxonomy code 207WX0200X and a focus in Ophthalmic Plastic and Reconstructive Surgery.

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