|Provider Name||MS. CANDACE D MANGUM CRNP|
|Provider Location Address||56 WEST MAIN STREET NOTASULGA, AL 36866|
|Provider Mailing Address||PO BOX 100 NOTASULGA, AL 36866|
|NPI Entity Type||Individual|
|Medical School Name||OTHER|
|Is Sole Proprietor?||No|
|Last Update Date||06-08-2009|
Candace Mangum 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.
Candace Mangum is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with The East Alabama Healthcare Authority.
The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: preventive care and screening: body mass index (bmi) screening and follow-up plan. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.48 for a new patient copayment and $24.83 for an established patient copayment.
|Type||Physician Assistants & Advanced Practice Nursing Providers|
MS. CANDACE D MANGUM CRNP
56 WEST MAIN STREET
Phone: (334) 257-1081
Fax: (334) 257-1086
MS. CANDACE D MANGUM CRNP
PO BOX 100
Phone: (334) 257-1081
Fax: (334) 257-1086
PECOS Enrollment and Medicare Participation
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
|Registered in PECOS?||Yes|
|PECOS PAC ID||7618070855|
|PECOS Enrollment ID||I20070308000642|
|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 order / refer Part B Clinical Laboratory and Imaging||Yes|
|Eligible order / refer Durable Medical Equipment||Yes|
|Eligible order / refer Home Health Agency (HHA)||Yes|
|Eligible order / refer Power Mobility Devices||Yes|
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 36866 ZIP code area.
|New Patients Office Visits Costs *|
|Most Utilized Procedure Code for new patients office visits: 99203|
|Minimum New Patient Pricing||Maximum New Patient Pricing||Typical New Patient Pricing|
|Minimum New Patient Copayment||Maximum New Patient Copayment||Typical New Patient Copayment|
|Established Patients Office Visits Costs *|
|Most Utilized Procedure Code for established patients office visits: 99214|
|Minimum Established Patient Pricing||Maximum Established Patient Pricing||Typical Established Patient Pricing|
|Minimum Established Patient Copayment||Maximum Established Patient Copayment||Typical Established Patient Copayment|
* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
|Quality Measure||Performance||Number of Patients|
|Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan||98%||169|
|Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2|
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 351Insertion of needle into vein for collection of blood sample (HCPCS:36415)
- 240Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS:85025)
- 104Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
- 88Hemoglobin A1C level (HCPCS:83036)
- 48Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
- 48Automated urinalysis test (HCPCS:81003)
- 36Administration of influenza virus vaccine (HCPCS:G0008)
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Candace Mangum is affiliated with the following medical facilities:
|Hospital Name||Address||Phone||Hospital Type||CMS Certification Number (CCN)||Overall Rating|
|THE EAST ALABAMA HEALTHCARE AUTHORITY||2000 PEPPERELL PARKWAY|
OPELIKA, AL 36801
|(334) 749-3411||Acute Care Hospitals||10029|
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
|Identifier||Type / Code||Identifier State||Identifier Issuer|
|051558482MAN||MEDICARE PIN (08)||AL|
|Q75732||MEDICARE UPIN (02)||AL|
|1164550489||OTHER (01)||ORGANIZATIONAL NPI|
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
|Start with the original NPI number, the last digit is the check digit and is not used in the calculation.|
|Step 1: Double the value of the alternate digits, beginning with the rightmost digit.|
|Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.|
|2 + 4 + 0 + 7 + 1 + 8 + 2 + 8 + 3 + 1 + 6 + 24 = 66|
|Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.|
|70 - 66 = 4||4|
The NPI number 1407924384 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the same location
The following provider is registered at the same or nearby location.
|NPI||Name / Type||Taxonomy||Address|
|1164550489||NOTASULGA HEALTHCARE |
|Nurse Practitioner (Primary Care)||56 WEST MAIN STREET |
NOTASULGA, AL 36866
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
Ms. Candace D Mangum Crnp is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:
- 1 = Person: individual human being who furnishes health care.
- 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.