MR. MICHAEL A WINTER PA-C
NPI 1376822627
Physician Assistant in Mount Pleasant, SC
NPI Status: Active since August 04, 2011
Contact Information
929 BOWMAN RD
STE 400
MOUNT PLEASANT, SC
ZIP 29464
Phone: (843) 730-4124
Fax: (843) 806-4295
- Individual
- Male
- Physician Assistant
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About MICHAEL WINTER
This page provides the complete NPI Profile along with additional information for Michael Winter, a primary care provider established in Mount Pleasant, South Carolina with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1376822627 assigned on August 2011. The practitioner's primary taxonomy code is 363A00000X with license number PA3222 (SC). The provider is registered as an individual and his NPI record was last updated 7 years ago.
- NPI
- 1376822627
- Provider Name
- MR. MICHAEL A WINTER PA-C
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 929 BOWMAN RD STE 400 MOUNT PLEASANT, SC 29464
- Location Phone
- (843) 730-4124
- Location Fax
- (843) 806-4295
- Mailing Address
- 929 BOWMAN RD STE 400 MOUNT PLEASANT, SC 29464
- Mailing Phone
- (843) 730-4124
- Mailing Fax
- (843) 806-4295
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-04-2011
- Last Update Date
- 06-12-2019
- Code Navigator
A primary care provider (PCP) like Michael Winter sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA3222
- License State
- SC
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
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) |
|---|---|---|---|---|
| 1 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | PA.200517 (LA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Gold - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- 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
- 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
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Michael Winter 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
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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE000N)
Neuromuscular stimulator, electronic shock unit (HCPCS:E0745)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
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.
Advance care planning, first 30 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Follow-up nursing facility visit per day, typically 10 minutes
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 25 minutes
New patient office or other outpatient visit, 45-59 minutes
X-ray of lower and sacral spine, minimum of 4 views
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
This service was performed 18 times for 18 patientsThis 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 14 times for 14 patientsThis 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 32 times for 28 patientsA follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.
This service was performed 15 times for 12 patientsA follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 297 times for 78 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 217 times for 85 patientsThis 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 65 times for 65 patientsAn X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.
This service was performed 34 times for 34 patientsPhysician Visit Costs
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 29464 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.18
- Minimum New Patient Price $53.57
- Maximum New Patient Price $163.84
- Average New Patient Copayment $20.79
- Minimum New Patient Copayment $13.39
- Maximum New Patient Copayment $40.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $67.12
- Minimum Established Patient Price $16.96
- Maximum Established Patient Price $133.52
- Average Established Patient Copayment $16.78
- Minimum Established Patient Copayment $4.24
- Maximum Established Patient Copayment $33.38
* 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.
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Advance Care Plan | 92% | 123 |
| Closing the Referral Loop: Receipt of Specialist Report | 11% | 328 |
| Documentation of Current Medications in the Medical Record | 100% | 254 |
| e-Prescribing | 100% | 497 |
| Falls: Screening for Future Fall Risk | 99% | 122 |
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 75% | 209 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% | 175 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% | 175 |
| Provide Patients Electronic Access to Their Health Information | 83% | 134 |
| Use of High-Risk Medications in Older Adults | 1% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 124 |
| Use of High-Risk Medications in Older Adults | 2% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 124 |
| Use of High-Risk Medications in Older Adults | 2% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 124 |
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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 1376822627, we treat the final digit (7) 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 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
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 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
MOUNT PLEASANT, SC 29464
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376822627, enumerated as an "individual" on August 04, 2011.
The provider is located at 929 BOWMAN RD STE 400 MOUNT PLEASANT, SC 29464 and the phone number is (843) 730-4124.
Physician Assistant with taxonomy code 363A00000X.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.
