DR. MARCY NAGPAL MD
NPI 1457644106
Obstetrics & Gynecology in Charleston, SC

NPI Status: Active since May 26, 2011

Contact Information

171 ASHLEY AVE
CHARLESTON, SC
ZIP 29425
Phone: (843) 792-1414

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 18
Obstetrics & Gynecology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About MARCY NAGPAL

This page provides the complete NPI Profile along with additional information for Marcy Nagpal, a women's health care provider established in Charleston, South Carolina with a medical specialization in Obstetrics & Gynecology and more than 18 years of experience. She graduated from New York Medical College in 2008. The healthcare provider is registered in the NPI registry with number 1457644106 assigned on May 2011. The practitioner's primary taxonomy code is 207V00000X with license number P2918 (TX). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI: 1457644106
Provider Name: DR. MARCY NAGPAL MD
Other Name: DR. MACY ROSEN MD
Other Name Type: Former Name (1)
Gender: Female
Entity Type: Individual
Location Address: 171 ASHLEY AVE CHARLESTON, SC 29425
Location Phone: (843) 792-1414
Mailing Address: PO BOX 751461 CHARLOTTE, NC 28275
Mailing Phone: (843) 792-6200
Medical School Name: NEW YORK MEDICAL COLLEGE
Graduation Year: 2008
Is Sole Proprietor?: No
Enumeration Date: 05-26-2011
Last Update Date: 12-22-2022
Code Navigator

Women's health care providers like Marcy Nagpal treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

Location Map

Secondary Locations

3327 Research Plaza Suite 206
San Antonio, TX 78235
(210) 653-5501

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: Obstetrics & Gynecology
Taxonomy Code: 207V00000X
Type: Allopathic & Osteopathic Physicians
License No.: P2918
License State: TX
Taxonomy Description: An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

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)
1	207V00000X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology	88948 (SC)

Insurance Plans Accepted

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

Ambetter from Absolute Total Care

Elite Bronze - HMO
Elite Bronze + Vision + Adult Dental - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO
Focused Silver - HMO
Standard Expanded Bronze - HMO
Standard Gold - HMO
Standard Silver - HMO
Standard Silver + Vision + Adult Dental - HMO

Ambetter of North Carolina

Clear Silver with $0 Insulin Options - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Complete Gold with Atrium Health - HMO
Complete Gold with Atrium Health + Vision + Adult Dental - HMO
Elite Bronze - HMO
Elite Bronze + Vision + Adult Dental - HMO
Elite Bronze with Atrium Health - HMO
Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO

BlueCross BlueShield of South Carolina

Blue Beaufort Bronze 1 - HMO
Blue Beaufort Bronze 2 - HMO
Blue Beaufort Gold 1 - HMO
Blue Beaufort Silver 1 - HMO
Blue Beaufort Silver 2 - HMO
Blue Beaufort Silver 2 + Adult Vision - HMO
Blue Beaufort Standard Expanded Bronze - HMO
Blue Beaufort Standard Gold - HMO
Blue Beaufort Standard Silver - HMO
Blue Cooper Bronze 1 - HMO

First Choice Next

First Choice Next Bronze Essential - HMO
First Choice Next Bronze Premier - HMO
First Choice Next Bronze Signature - HMO
First Choice Next Gold Premier - HMO
First Choice Next Gold Signature - HMO
First Choice Next Silver Essential - HMO
First Choice Next Silver Premier - HMO
First Choice Next Silver Signature - HMO

Molina Healthcare

Molina Gold Core 1640 - HMO
Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
Molina Gold Core 1640 Plus with Adult Vision - HMO
Molina Gold Standard - HMO
Molina Gold Value - HMO
Molina Gold Value Plus with Adult Dental and Vision - HMO
Molina Gold Value Plus with Adult Vision - HMO
Molina Silver Core - HMO
Molina Silver Core Plus with Adult Dental and Vision - HMO
Molina Silver Core Plus with Adult Vision - HMO

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded - HMO
UHC Bronze Copay Focus+ $0 Indiv Med Ded (Dental + Vision) - HMO
UHC Bronze Essential - HMO
UHC Bronze Essential- - HMO
UHC Bronze Standard - HMO
UHC Bronze Standard Plus Chiro - HMO
UHC Gold Advantage - HMO
UHC Gold Advantage+ (Dental + Vision) - HMO
UHC Gold Copay Focus $0 Indiv Med Ded - HMO
UHC Gold Standard - HMO

Medicare

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

Medicaid

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
302772401	MEDICAID (05)	TX

Medicare Participation & PECOS Enrollment Status

Marcy Nagpal 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.

Marcy Nagpal 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: 941457600
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: I20230301002952
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

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.

Cervical or vaginal cancer screening; pelvic and clinical breast examination
Established patient office or other outpatient visit, 30-39 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.01 for a new patient copayment and $16.78 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 29425 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $124.04
Minimum New Patient Price $53.57
Maximum New Patient Price $163.84

Average New Patient Copayment $31.01
Minimum New Patient Copayment $13.39
Maximum New Patient Copayment $40.96

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $67.12
Minimum Established Patient Price $16.96
Maximum Established Patient Price $133.52

Average Established Patient Copayment $16.78
Minimum Established Patient Copayment $4.24
Maximum Established Patient Copayment $33.38

* 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
Breast Cancer Screening	75%	53
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Colorectal Cancer Screening	21%	58
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Documentation of Current Medications in the Medical Record	92%	1746
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Engagement of New Medicaid Patients and Follow-up	Yes	N/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
e-Prescribing	81%	1621
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange	36%	144
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Medication Reconciliation	98%	434
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	61%	1680
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	8%	1130
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
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	98%	1218
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access	88%	1680
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.	Yes	N/A
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.
Screening for Osteoporosis for Women Aged 65-85 Years of Age	23%	39
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
Secure Messaging	67%	1680
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older	16%	44
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
Use of High-Risk Medications in the Elderly	16% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	44
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Marcy Nagpal is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
MUSC MEDICAL CENTER	169 ASHLEY AVE CHARLESTON, SC 29425	(843) 792-2300	Acute Care Hospitals

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 1457644106, 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 10 → 1 + 0

Pos 4

Unchanged

Pos 5

Doubled → 12 → 1 + 2

Pos 6

Unchanged

Pos 7

Doubled → 8

Pos 8

Unchanged

Pos 9

Doubled → 0

Check

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 5 → 10 → 1 6 → 12 → 3 4 → 8 0 → 0