MATTHEW C HAMILTON MD
NPI 1447419486
Anesthesiology - Pediatric Anesthesiology in Indianapolis, IN

NPI Status: Active since June 05, 2008

Contact Information

702 BARNHILL DR
INDIANAPOLIS, IN
ZIP 46202
Phone: (317) 274-0275
Fax: (317) 274-0256

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  • Individual
  • Male
  • Years of Experience 23
  • Anesthesiology
  • Pediatric Anesthesiology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MATTHEW HAMILTON

This page provides the complete NPI Profile along with additional information for Matthew Hamilton, a provider established in Indianapolis, Indiana with a medical specialization in Anesthesiology, focusing in pediatric anesthesiology and more than 23 years of experience. He graduated from At Still University Of Health Sciences, College Of Osteo Med, Kirksville in 2003. The healthcare provider is registered in the NPI registry with number 1447419486 assigned on June 2008. The practitioner's primary taxonomy code is 207LP3000X with license number 02002988A (IN). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1447419486
Provider Name
MATTHEW C HAMILTON MD
Gender
Male
Entity Type
Individual
Location Address
702 BARNHILL DR INDIANAPOLIS, IN 46202
Location Phone
(317) 274-0275
Location Fax
(317) 274-0256
Mailing Address
250 N SHADELAND AVE INDIANAPOLIS, IN 46219
Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduation Year
2003
Is Sole Proprietor?
No
Enumeration Date
06-05-2008
Last Update Date
02-03-2021
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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

Anesthesiology Pediatric Anesthesiology

Taxonomy Code
207LP3000X
Type
Allopathic & Osteopathic Physicians
License No.
02002988A
License State
IN
Taxonomy Description
An anesthesiologist who has had additional skill and experience in and is primarily concerned with the anesthesia, sedation, and pain management needs of infants and children. A pediatric anesthesiologist generally provides services including the evaluation of complex medical problems in infants and children when surgery is necessary, planning and care for children before and after surgery, pain control, anesthesia and sedation for any procedures out of the operating room such as MRI, CT scan, and radiation therapy.

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)
1207L00000XAllopathic & Osteopathic Physicians

Anesthesiology

02002988A (IN)

Insurance Plans Accepted

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

  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • HSA Eligible Bronze 6000 - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Platinum Zero $5 Generic Drugs - HMO
  • Platinum Zero $5 Generic Drugs + Adult Vision & Fitness - 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.

*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
200906570MEDICAID (05)IN 

Medicare Participation & PECOS Enrollment Status

Matthew Hamilton 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.

Matthew Hamilton 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: 9335212075

    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: I20080714000637

    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: $30.62 for a new patient copayment and $16.62 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 46202 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $122.49
  • Minimum New Patient Price $53.07
  • Maximum New Patient Price $161.76
  • Average New Patient Copayment $30.62
  • 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 99213

  • Average Established Patient Price $66.48
  • Minimum Established Patient Price $16.93
  • Maximum Established Patient Price $132.22
  • Average Established Patient Copayment $16.62
  • 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.

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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 1447419486, we treat the final digit (6) 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 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 6).

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
4
Doubled → 8
Pos 4
7
Unchanged
Pos 5
4
Doubled → 8
Pos 6
1
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
4
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
6
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 4 → 8 4 → 8 9 → 18 → 9 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

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

2 + 4 + 8 + 7 + 8 + 1 + 1 + 8 + 4 + 1 + 6 + 24 = 74

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

The next multiple of ten after 74 is 80. The difference is the calculated check digit.

80 - 74 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1447419486.

Other Providers at the Same Location


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

Ophthalmology
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Ophthalmology
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INDIANAPOLIS, IN 46202
Anesthesiology (Pediatric Anesthesiology)
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Anesthesiology (Pediatric Anesthesiology)
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Anesthesiology (Pediatric Anesthesiology)
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Anesthesiology (Pediatric Anesthesiology)
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Psychiatry & Neurology (Child & Adolescent Psychiatry)
702 BARNHILL DR, RM. 4300
INDIANAPOLIS, IN 46202
Psychiatry & Neurology (Child & Adolescent Psychiatry)
702 BARNHILL DR
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Psychologist
702 BARNHILL DR
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Psychiatry & Neurology (Child & Adolescent Psychiatry)
702 BARNHILL DR, ROC 4300
INDIANAPOLIS, IN 46202
Psychiatry & Neurology (Psychiatry)
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Emergency Medicine
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Pediatrics (Pediatric Endocrinology)
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Otolaryngology (Otolaryngic Allergy)
702 BARNHILL DR, SUITE 0860
INDIANAPOLIS, IN 46202
Psychologist (Clinical Child & Adolescent)
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Psychologist (Clinical Child & Adolescent)
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Pediatrics (Neonatal-Perinatal Medicine)
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Pediatrics (Neonatal-Perinatal Medicine)
702 BARNHILL DR
INDIANAPOLIS, IN 46202
Pharmacist
702 BARNHILL DR, ROC 1201
INDIANAPOLIS, IN 46202
Pharmacist
702 BARNHILL DR
INDIANAPOLIS, IN 46202

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1447419486, enumerated as an "individual" on June 05, 2008.

The provider is located at 702 BARNHILL DR INDIANAPOLIS, IN 46202 and the phone number is (317) 274-0275.

Anesthesiology with taxonomy code 207LP3000X and a focus in Pediatric Anesthesiology.

The provider might be accepting Accepts: CareSource, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.