ELLIE GOLESTANIAN MD
NPI 1376500033
Internal Medicine - Pulmonary Disease in Madison, WI

NPI Status: Active since April 27, 2006

Contact Information

600 HIGHLAND AVE
MADISON, WI
ZIP 53792
Phone: (608) 263-7203
Fax: (608) 263-9103

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 37
Internal Medicine
Pulmonary Disease
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About ELLIE GOLESTANIAN

This page provides the complete NPI Profile along with additional information for Ellie Golestanian, an internist established in Madison, Wisconsin with a medical specialization in Internal Medicine, focusing in pulmonary disease and more than 37 years of experience. The healthcare provider is registered in the NPI registry with number 1376500033 assigned on April 2006. The practitioner's primary taxonomy code is 207RP1001X with license number 43042 (WI). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI: 1376500033
Provider Name: ELLIE GOLESTANIAN MD
Gender: Female
Entity Type: Individual
Location Address: 600 HIGHLAND AVE MADISON, WI 53792
Location Phone: (608) 263-7203
Location Fax: (608) 263-9103
Mailing Address: 7974 UW HEALTH CT MIDDLETON, WI 53562
Mailing Phone: (608) 829-5485
Medical School Name: OTHER
Graduation Year: 1989
Is Sole Proprietor?: No
Enumeration Date: 04-27-2006
Last Update Date: 01-14-2021
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An internist like Ellie Golestanian 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 Pulmonary Disease
Taxonomy Code: 207RP1001X
Type: Allopathic & Osteopathic Physicians
License No.: 43042
License State: WI
Taxonomy Description: An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Insurance Plans Accepted

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

Group Health Cooperative-SCW

Better Together HMO Bronze 6500 Ded/8750 MOOP HSA - HMO
Better Together HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
Better Together HMO Bronze No Medical Ded/10600 MOOP HSA - HMO
Better Together HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
Better Together HMO Gold 2000 Ded/8200 MOOP - HMO
Better Together HMO Gold 4000 Ded/4000 MOOP HSA - HMO
Better Together HMO Platinum 750 Ded/2000 MOOP with Vision - HMO
Better Together HMO Platinum No Ded/3300 MOOP - HMO
Better Together HMO Platinum No Ded/5200 MOOP - HMO
Better Together HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
Better Together HMO Silver 5975 Ded/5975 MOOP HSA - HMO
Better Together HMO Silver 6000 Ded/8900 MOOP - HMO
Partners HMO Bronze 10600 Ded/10600 MOOP HSA - HMO
Partners HMO Bronze 6000 Ded/10600 MOOP HSA - HMO
Partners HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
Partners HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
Partners HMO Gold 2000 Ded/8200 MOOP - HMO
Partners HMO Gold 4000 Ded/4000 MOOP HSA - HMO
Partners HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
Partners HMO Silver 5975 Ded/5975 MOOP HSA - HMO

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

Medicare Participation & PECOS Enrollment Status

Ellie Golestanian 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.

Ellie Golestanian 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: 749310217
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: I20100609000694
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

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $30.92 for a new patient copayment and $23.85 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 53792 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $123.69
Minimum New Patient Price $53.9
Maximum New Patient Price $163.24

Average New Patient Copayment $30.92
Minimum New Patient Copayment $13.47
Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

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

Average Established Patient Price $95.41
Minimum Established Patient Price $17.4
Maximum Established Patient Price $133.76

Average Established Patient Copayment $23.85
Minimum Established Patient Copayment $4.35
Maximum Established Patient Copayment $33.44

* 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.

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 1376500033, 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 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 14 → 1 + 4

Pos 4

Unchanged

Pos 5

Doubled → 10 → 1 + 0

Pos 6

Unchanged

Pos 7

Doubled → 0

Pos 8

Unchanged

Pos 9

Doubled → 6

Check

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 7 → 14 → 5 5 → 10 → 1 0 → 0 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 3 + 1 + 4 + 6 + 1 + 0 + 0 + 0 + 0 + 6 + 24 = 47

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

The next multiple of ten after 47 is 50. The difference is the calculated check digit.

50 - 47 = 3

This NPI is valid

The calculated check digit is 3, which matches the last digit of 1376500033.