DR. DOUGLAS BRIAN MICHAELS M.D.
NPI 1467463059
Pathology - Anatomic Pathology & Clinical Pathology in Austin, TX

NPI Status: Active since August 10, 2006

Contact Information

3445 EXECUTIVE CENTER DR
STE 250
AUSTIN, TX
ZIP 78731
Phone: (512) 579-4000
Fax: (512) 222-0146

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Pathology
Anatomic Pathology & Clinical Pathology
Accepts Insurance
PECOS Enrolled

About DOUGLAS MICHAELS

This page provides the complete NPI Profile along with additional information for Douglas Michaels, a provider established in Austin, Texas with a medical specialization in Pathology, focusing in anatomic pathology & clinical pathology . The healthcare provider is registered in the NPI registry with number 1467463059 assigned on August 2006. The practitioner's primary taxonomy code is 207ZP0102X with license number F6952 (TX). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI: 1467463059
Provider Name: DR. DOUGLAS BRIAN MICHAELS M.D.
Gender: Male
Entity Type: Individual
Location Address: 3445 EXECUTIVE CENTER DR STE 250 AUSTIN, TX 78731
Location Phone: (512) 579-4000
Location Fax: (512) 222-0146
Mailing Address: 3445 EXECUTIVE CENTER DR STE 250 AUSTIN, TX 78731
Mailing Phone: (512) 579-4000
Mailing Fax: (512) 222-0146
Is Sole Proprietor?: No
Enumeration Date: 08-10-2006
Last Update Date: 09-26-2019
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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: Pathology Anatomic Pathology & Clinical Pathology
Taxonomy Code: 207ZP0102X
Type: Allopathic & Osteopathic Physicians
License No.: F6952
License State: TX
Taxonomy Description: A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

Insurance Plans Accepted

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

Blue Cross and Blue Shield of Texas

Blue Advantage Bronze HMO? 204 - HMO
Blue Advantage Bronze HMO? 301 - HMO
Blue Advantage Bronze HMO? Standard - HMO
Blue Advantage Gold HMO? 206 - HMO
Blue Advantage Gold HMO? 603 - HMO
Blue Advantage Gold HMO? Standard - HMO
Blue Advantage Plus Bronze? 303 - POS
Blue Advantage Plus Bronze? 305 - POS
Blue Advantage Plus Bronze? Standard - POS
Blue Advantage Plus Gold? 203 - POS
Blue Advantage Plus Gold? 803 - POS
Blue Advantage Plus Gold? Standard - POS
Blue Advantage Plus Silver? 202 - POS
Blue Advantage Plus Silver? 605 - POS
Blue Advantage Plus Silver? Standard - POS
Blue Advantage Security HMO? 200 - HMO
Blue Advantage Silver HMO? 205 - HMO
Blue Advantage Silver HMO? 801 - HMO
Blue Advantage Silver HMO? 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
129417504	MEDICAID (05)	TX

Medicare Participation & PECOS Enrollment Status

Douglas Michaels 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: Durable Medical Equipment (DME) 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
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

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 78731 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $131.95
Minimum New Patient Price $57.88
Maximum New Patient Price $174

Average New Patient Copayment $32.98
Minimum New Patient Copayment $14.47
Maximum New Patient Copayment $43.5

Established Patients Visit Costs *

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

Average Established Patient Price $101.65
Minimum Established Patient Price $18.88
Maximum Established Patient Price $142.23

Average Established Patient Copayment $25.41
Minimum Established Patient Copayment $4.72
Maximum Established Patient Copayment $35.55

* 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.

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 1467463059, we treat the final digit (9) 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 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

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 → 12 → 1 + 2

Pos 4

Unchanged

Pos 5

Doubled → 8

Pos 6

Unchanged

Pos 7

Doubled → 6

Pos 8

Unchanged

Pos 9

Doubled → 10 → 1 + 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 6 → 12 → 3 4 → 8 3 → 6 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 4 + 1 + 2 + 7 + 8 + 6 + 6 + 0 + 1 + 0 + 24 = 61

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

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9

This NPI is valid

The calculated check digit is 9, which matches the last digit of 1467463059.