WINTHROP BRIAN HEDRICK DO
NPI 1437144367
Family Medicine in Evansville, IN

NPI Status: Active since September 16, 2005

Contact Information

4506 1ST AVE
EVANSVILLE, IN
ZIP 47710
Phone: (812) 428-6161
Fax: (812) 421-2883

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  • Individual
  • Male
  • Years of Experience 31
  • Family Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About WINTHROP HEDRICK

This page provides the complete NPI Profile along with additional information for Winthrop Hedrick, a primary care provider established in Evansville, Indiana with a medical specialization in Family Medicine and more than 31 years of experience. He graduated from Chicago College Of Osteopathy in 1995. The healthcare provider is registered in the NPI registry with number 1437144367 assigned on September 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 02001992A (IN). The provider is registered as an individual and his NPI record was last updated 13 years ago.

NPI
1437144367
Provider Name
WINTHROP BRIAN HEDRICK DO
Gender
Male
Entity Type
Individual
Location Address
4506 1ST AVE EVANSVILLE, IN 47710
Location Phone
(812) 428-6161
Location Fax
(812) 421-2883
Mailing Address
PO BOX 1510 EVANSVILLE, IN 47706
Mailing Phone
(812) 428-6161
Mailing Fax
(812) 421-2883
Medical School Name
CHICAGO COLLEGE OF OSTEOPATHY
Graduation Year
1995
Is Sole Proprietor?
No
Enumeration Date
09-16-2005
Last Update Date
07-23-2013
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A primary care provider (PCP) like Winthrop Hedrick 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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
02001992A
License State
IN
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

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

  • Anthem Bronze Essential 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential 10150 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
  • Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Catastrophic Essential (+ Incentives) - HMO
  • Anthem Gold Essential 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Heart Healthy Bronze Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Heart Healthy Silver Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Essential 3500 HSA (+ Incentives) - HMO
  • Anthem Silver Essential 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Essential 7000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Essential 7000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

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

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
G80123MEDICARE UPIN (02) 
M400071338MEDICARE PIN (08)IN 
200197810MEDICAID (05)IN 
P00331472OTHER (01)INRR MEDICARE

Medicare Participation & PECOS Enrollment Status

Winthrop Hedrick 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.

Winthrop Hedrick 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: 9638126147

    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: I20050406001183

    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

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)

    Nebulizer, with compressor (HCPCS:E0570)

    1 DME suppliers used 12 Medicare Claims 12 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.

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

This service was performed 43 times for 35 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 42 times for 37 patients

Telephone medical discussion with physician, 11-20 minutes

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

This service was performed 16 times for 15 patients

Telephone medical discussion with physician, 5-10 minutes

A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.

This service was performed 68 times for 50 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.51 for a new patient copayment and $23.55 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 47710 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.04
  • Minimum New Patient Price $53.07
  • Maximum New Patient Price $161.76
  • Average New Patient Copayment $20.51
  • Minimum New Patient Copayment $13.26
  • Maximum New Patient Copayment $40.44

Established Patients Visit Costs *

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

  • Average Established Patient Price $94.22
  • Minimum Established Patient Price $16.93
  • Maximum Established Patient Price $132.22
  • Average Established Patient Copayment $23.55
  • Minimum Established Patient Copayment $4.23
  • Maximum Established Patient Copayment $33.05

* 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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. 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
Care Plan 17% 372
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan

Reviews for WINTHROP BRIAN HEDRICK DO

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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 1437144367, 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.

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

Step 2: Add all digits plus the NPI constant

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

2 + 4 + 6 + 7 + 2 + 4 + 8 + 3 + 1 + 2 + 24 = 63

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.

70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1437144367.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Family Medicine
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Family Medicine
4506 1ST AVE
EVANSVILLE, IN 47710
Clinic/Center (Occupational Medicine)
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Family Medicine
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Family Medicine
4506 1ST AVE
EVANSVILLE, IN 47710
Physician Assistant
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Physician Assistant
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710
Nurse Practitioner
4506 1ST AVE
EVANSVILLE, IN 47710

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1437144367, enumerated as an "individual" on September 16, 2005.

The provider is located at 4506 1ST AVE EVANSVILLE, IN 47710 and the phone number is (812) 428-6161.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare,. Please consult your insurance carrier or call the provider to verify.