DAVID A CIRCLE MD NPI 1427011931
Emergency Medicine in Greenville, SC
About DAVID A CIRCLE MD
David Circle is a provider established in Greenville, South Carolina and his medical specialization is Emergency Medicine with more than 25 years of experience. He graduated from Medical College Of Georgia School Of Medicine in 1999. The healthcare provider is registered in the NPI registry with number 1427011931 assigned on April 2006. The practitioner's primary taxonomy code is 207P00000X with license number 23106 (SC). The provider is registered as an individual and his NPI record was last updated one year ago.
| NPI | 1427011931 |
| Provider Name | DAVID A CIRCLE MD |
| Location Address | 701 GROVE RD ER ADMINISTRATION GREENVILLE, SC 29605 |
| Location Phone | (864) 455-6372 |
| Mailing Address | 255 ENTERPRISE BLVD SUITE 250 GREENVILLE, SC 29615 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE |
| Graduation Year | 1999 |
| Is Sole Proprietor? | No |
| Enumeration Date | 04-07-2006 |
| Last Update Date | 03-07-2023 |
David Circle 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.
David Circle 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 he has hospital affiliations with St Francis-downtown and Anmed Health.
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.4 for a new patient copayment and $24.79 for an established patient copayment.
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.
| Taxonomy Code | 207P00000X |
| Classification | Emergency Medicine |
| Type | Allopathic & Osteopathic Physicians |
| License No. | 23106 |
| License State | SC |
| Taxonomy Description | An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
701 GROVE RD
ER ADMINISTRATION
GREENVILLE, SC
ZIP 29605
Phone: (864) 455-6372
Mailing Address
255 ENTERPRISE BLVD
SUITE 250
GREENVILLE, SC
ZIP 29615
Phone: (864) 454-0888
Fax: (864) 454-1130
Location Map
PECOS Enrollment and Medicare Participation Status
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 Medicare providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in the Medicare program need to enroll in PECOS with their NPI number to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 1759376064 |
| PECOS Enrollment ID | I20040416000747 |
| 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 or refer Durable Medical Equipment (DMEPOS) | Yes |
| Eligible order r refer Home Health Agency (HHA) | Yes |
| Eligible order r 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 29605 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 |
| $55.43 | $169.76 | $85.63 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $13.85 | $42.44 | $21.4 |
| 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 |
| $17.06 | $138.69 | $99.16 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.26 | $34.67 | $24.79 |
* 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.
Hospital Affiliations
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. David Circle is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| ST FRANCIS-DOWNTOWN | ONE ST FRANCIS DR GREENVILLE, SC 29601 | (800) 805-5678 | Acute Care Hospitals | 420023 | |
| ANMED HEALTH | 800 N FANT ST ANDERSON, SC 29621 | (864) 512-2830 | Acute Care Hospitals | 420027 |
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 |
|---|---|---|---|
| 167156 | OTHER (01) | SC | UNISON ID |
| 20015517 | OTHER (01) | SC | SELECT HEALTH INDIVIDUAL |
| 20031678 | OTHER (01) | SC | SELECT HEALTH GRP |
| 231065 | MEDICAID (05) | SC |
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. | |||||||||
| 1 | 4 | 2 | 7 | 0 | 1 | 1 | 9 | 3 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 4 | 7 | 0 | 1 | 2 | 9 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 4 + 7 + 0 + 1 + 2 + 9 + 6 + 24 = 59 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 59 = 1 | 1 | ||||||||
The NPI number 1427011931 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1013997824 | DR. KEVIN JOHN GREGG MD Individual | Emergency Medicine | 701 GROVE RD DEPARTMENT OF EMERGENCY MEDICINE GREENVILLE, SC 29605 (864) 455-7157 |
| 1093777393 | DR. JEFFREY MICHAEL RUGGIERI M.D. Individual | Pediatrics (Neonatal-Perinatal Medicine) | 701 GROVE RD GREENVILLE, SC 29605 (864) 455-7939 |
| 1851354286 | PRASUN H MEHTA MD Individual | Emergency Medicine | 701 GROVE RD GREENVILLE, SC 29605 (864) 455-6372 |
| 1427011980 | DR. MARSHALL WHITSON WALKER M.D. Individual | Pediatrics (Neonatal-Perinatal Medicine) | 701 GROVE RD DEPT. OF NEONATOLOGY, GREENVILLE HOSPITAL SYSTEM GREENVILLE, SC 29605 (864) 455-7939 |
| 1124081534 | JESSE T FELDER III MD Individual | Emergency Medicine | 701 GROVE RD ER ADMINISTRATION GREENVILLE, SC 29605 (864) 455-6372 |
| 1013970433 | DR. FRANK J FERLISI MD Individual | Emergency Medicine | 701 GROVE RD GREENVILLE, SC 29605 (864) 455-7157 |
| 1760445837 | JO ANN SOUSA MD Individual | Emergency Medicine | 701 GROVE RD ER ADMINISTRATION GREENVILLE, SC 29605 (864) 455-6372 |
| 1902869993 | JACK E COLKER MD Individual | Emergency Medicine | 701 GROVE RD ER ADMINISTRATION GREENVILLE, SC 29605 (864) 455-6372 |
| 1669435327 | DR. KEVIN J MEWBORN MD Individual | Emergency Medicine | 701 GROVE RD GREENVILLE, SC 29605 (864) 455-7000 |
| 1225092059 | DR. BRYAN LAWRENCE OHNING M.D., PH.D. Individual | Pediatrics (Neonatal-Perinatal Medicine) | 701 GROVE RD GREENVILLE HOSPITAL SYSTEM, NEONATOLOGY DEPT. GREENVILLE, SC 29605 (864) 455-7939 |
| 1942264700 | ARIC H BLACK CRNA Individual | Nurse Anesthetist, Certified Registered | 701 GROVE RD ANESTHESIA DEPT 2ND FLOOR GREENVILLE, SC 29605 (864) 455-7111 |
| 1336199751 | JACK W. BONNER III M.D. Individual | Psychiatry & Neurology (Psychiatry) | 701 GROVE RD GREENVILLE, SC 29605 (864) 455-8431 |
| 1871544510 | MRS. AMY A KOONS CRNA Individual | Nurse Anesthetist, Certified Registered | 701 GROVE RD GREENVILLE, SC 29605 (864) 455-7000 |
| 1225080302 | DR. CHRISTINA L LARSON M.D. Individual | Pediatrics (Neonatal-Perinatal Medicine) | 701 GROVE RD GHS DEPARTMENT OF NEONATOLOGY GREENVILLE, SC 29605 (864) 455-7939 |
| 1639122088 | PAULA HALMES WILLIAMS CRNA Individual | Nurse Anesthetist, Certified Registered | 701 GROVE RD 2ND FLOOR ANESTHESIA DEPT GREENVILLE, SC 29605 (864) 455-7111 |
| 1922051713 | FREDDIE S. ROWLAND CRNA Individual | Nurse Anesthetist, Certified Registered | 701 GROVE RD 2ND FLOOR ANESTHESIA DEPT. GREENVILLE, SC 29605 (864) 455-7111 |
| 1144273921 | DAVID C. BUCKREIS CRNA Individual | Nurse Anesthetist, Certified Registered | 701 GROVE RD 2ND FLOOR ANESTHESIA DEPT. GREENVILLE, SC 29605 (864) 455-7111 |
| 1639124027 | DONALD JOSEPH SCHONDELMAIER CRNA Individual | Nurse Anesthetist, Certified Registered | 701 GROVE RD 2ND FLOOR ANESTHESIA DEPT GREENVILLE, SC 29605 (864) 455-7111 |
| 1174578538 | DR. JEFFREY C. CRADDOCK M.D. Individual | Psychiatry & Neurology (Psychiatry) | 701 GROVE RD GREENVILLE, SC 29605 (864) 455-8431 |
| 1568418515 | TARA W KEMP CRNA Individual | Nurse Anesthetist, Certified Registered | 701 GROVE RD 2ND FLOOR ANESTHESIA DEPT GREENVILLE, SC 29605 (864) 455-7111 |
Frequently Asked Questions
What is David Circle MD NPI number?
The NPI number assigned to this healthcare provider is 1427011931, enumerated in the NPI registry as an "individual" on April 07, 2006
Where is the provider located?
The provider is located at 701 Grove Rd Er Administration Greenville, Sc 29605 and the phone number is (864) 455-6372
What is the provider specialty code?
The provider's speciality is Emergency Medicine with taxonomy code 207P00000X
How many years of experience does David Circle MD have?
The provider has more than 25 years of experience. He graduated from Medical College Of Georgia School Of Medicine in 1999.
What insurance does David Circle MD accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is David Circle MD registered in PECOS?
Yes, as of September 14, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary 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.
How much is a visit to David Circle MD?
Medicare beneficiaries should expect a typical cost of $85.63 with an average copayment of $21.4 for new patient appointments. Established patients should expect a typical charge of $99.16 and an average copayment of 24.79. Please review your insurance plan or contact the provider directly to determine your specific costs.
Is David Circle MD affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: ST FRANCIS-DOWNTOWN and ANMED HEALTH. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
This NPI record was last updated on April 07, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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