WILLIAM E CAPPAERT M.D. NPI 1457304255

Ophthalmology in Cleveland, OH

NPI 1457304255 Individual Male Years of Experience 61 Ophthalmology PECOS Enrolled Accepts Medicare Approved Payment

NPI Profile for WILLIAM E CAPPAERT M.D.

William Cappaert is a provider established in Cleveland, Ohio and his medical specialization is ophthalmology with more than 61 years of experience. He graduated from Loyola University Of Chicago, Stritch School Of Medicine in 1962. The NPI number of William Cappaert is 1457304255 and was assigned on May 2006. The practitioner's primary taxonomy code is 207W00000X with license number 35029872 (OH). The provider is registered as an individual and his NPI record was last updated 10 years ago.

William Cappaert 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.

William Cappaert 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 Metrohealth System.

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.89 for a new patient copayment and $17.8 for an established patient copayment.

NPI

1457304255

Provider Name WILLIAM E CAPPAERT M.D.
Provider Location Address2500 METROHEALTH DR CLEVELAND, OH 44109
Provider Mailing AddressPO BOX 18977 CLEVELAND HEIGHTS, OH 44118
GenderMale
NPI Entity TypeIndividual
Medical School NameLOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduation Year1962
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date05-19-2006
Last Update Date03-27-2012


Primary Taxonomy

Taxonomy Code207W00000X
ClassificationOphthalmology
TypeAllopathic & Osteopathic Physicians
License No.35029872
License StateOH
Taxonomy DescriptionAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Business Address

WILLIAM E CAPPAERT M.D.
2500 METROHEALTH DR
CLEVELAND, OH
ZIP 44109
Phone: (216) 778-2236
Fax: (216) 778-4438

Get Directions


Mailing Address

WILLIAM E CAPPAERT M.D.
PO BOX 18977
CLEVELAND HEIGHTS, OH
ZIP 44118
Phone: (216) 321-3530
Fax: (216) 371-0518



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 ID4789751249
PECOS Enrollment IDI20080924000772
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 ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

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 44109 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$56.74 $173.94 $131.59
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.18 $43.48 $32.89
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.31 $141.66 $71.2
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.32 $35.41 $17.8

* 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.

Clinician Utilization

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.

  • 144Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
  • 91Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
  • 49Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)
  • 44Measurement of field of vision during daylight conditions (HCPCS:92083)
  • 31Diagnostic imaging of optic nerve of eye (HCPCS:92133)
  • 14Diagnostic imaging of retina (HCPCS:92134)
  • 13Photography of the retina (HCPCS:92250)

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. William Cappaert is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
METROHEALTH SYSTEM2500 METROHEALTH DRIVE
CLEVELAND, OH 44109
(216) 778-4196Acute Care Hospitals360059

Additional Identifiers


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
0195864MEDICAID (05)OH
0371945MEDICARE PIN (08)OH
A73885MEDICARE UPIN (02)OH

NPI Validation Check Digit Calculation


The following table explains step by step the 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.
1457304255
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
24107608210
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 0 + 7 + 6 + 0 + 8 + 2 + 1 + 0 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1457304255 is valid because the calculated check digit 5 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
1992704886 CARIE TWICHELL AA
Individual
Anesthesiologist Assistant2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4809
1104827740 JULIA A. RILEY PHARM.D.
Individual
Pharmacist2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-1946
1013909209MR. KRISTEN NILS HANSEN RPH
Individual
Pharmacist2500 METROHEALTH DR WOMENS AND CHILDRENS PLAZA
CLEVELAND, OH 44109
(216) 778-8537
1710970082MS. KELLYE KAUFMAN AA-C
Individual
Anesthesiologist Assistant2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4801
1881687564MR. BRADEN JOSEPH KUNZELMAN RPH
Individual
Pharmacist2500 METROHEALTH DR AMBULATORY PHARMACY
CLEVELAND, OH 44109
(216) 778-7548
1508859281MS. STEPHANIE E CROSS RPH
Individual
Pharmacist2500 METROHEALTH DR OUTPATIENT PHARMACY
CLEVELAND, OH 44109
(216) 778-3017
1255324943MRS. TANIA NICOLE BIERLY RPH
Individual
Pharmacist2500 METROHEALTH DR OUTPATIENT PHARMACY
CLEVELAND, OH 44109
(216) 778-2201
1154315364MR. JOSEPH PEACHMAN A.A.
Individual
Anesthesiologist Assistant2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4801
1801880596MR. MICHAEL L PYRTKO RPH
Individual
Pharmacist2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-7548
1588658157MS. EBONY NICOLE ALEXANDER RPH
Individual
Pharmacist2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-3017
1275522765 HANS C GEHO M.D.
Individual
Internal Medicine2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-7800
1376523670DR. ANDRE PROCHOROFF MD
Individual
Psychiatry & Neurology (Child & Adolescent Psychiatry)2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4933
1831166636 SHANE B ROWAN MD
Individual
Internal Medicine (Clinical Cardiac Electrophysiology)2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-2328
1144284928DR. BEN H BROUHARD MD
Individual
Pediatrics (Pediatric Nephrology)2500 METROHEALTH DR ROOM A-109
CLEVELAND, OH 44109
(216) 778-4900
1740246347 SHARI DANIELLE BOLEN M.D.
Individual
Internal Medicine2500 METROHEALTH DR METROHEALTH MEDICAL CENTER-INTERNAL MEDICINE CLINIC
CLEVELAND, OH 44109
(216) 778-2273
1316987902 SHARON LYNN MACK CNP
Individual
Nurse Practitioner2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-7800
1770523516MS. ANNETTE M LYNCH MSN, CNS
Individual
Clinical Nurse Specialist (Perinatal)2500 METROHEALTH DR DEPARTMENT OF PEDIATRICS/PERINATAL
CLEVELAND, OH 44109
(216) 778-7800
1427099183DR. KARL G WAGNER MD
Individual
Anesthesiology2500 METROHEALTH DR DEPARTMENT OF ANESTHESIOLOGY
CLEVELAND, OH 44109
(216) 778-4809
1760428155 GRAHAM H CREASEY MD
Individual
Physical Medicine & Rehabilitation (Spinal Cord Injury Medicine)2500 METROHEALTH DR MHMC-PM&R
CLEVELAND, OH 44109
(216) 778-8802
1508892290 JAMES F QUILTY MD
Individual
Pediatrics2500 METROHEALTH DR MHMC-PEDIATRICS
CLEVELAND, OH 44109
(216) 778-5198

NPI Footnotes

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
William E Cappaert M.d. 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.