STEPHEN MARK THOMAS M.D.
NPI 1508956673
Family Medicine in Mount Pleasant, SC
NPI Status: Active since October 12, 2006
Contact Information
1204 PALMETTO PENINSULA DR
MOUNT PLEASANT, SC
ZIP 29464
Phone: (843) 901-2386
Fax: (843) 936-1626
- Individual
- Male
- Family Medicine
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About STEPHEN THOMAS
This page provides the complete NPI Profile along with additional information for Stephen Thomas, a primary care provider established in Mount Pleasant, South Carolina with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1508956673 assigned on October 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 28138 (SC). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1508956673
- Provider Name
- STEPHEN MARK THOMAS M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1204 PALMETTO PENINSULA DR MOUNT PLEASANT, SC 29464
- Location Phone
- (843) 901-2386
- Location Fax
- (843) 936-1626
- Mailing Address
- 1204 PALMETTO PENINSULA DR MOUNT PLEASANT, SC 29464
- Mailing Phone
- (843) 901-2386
- Mailing Fax
- (843) 936-1626
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-12-2006
- Last Update Date
- 04-25-2017
- Code Navigator
A primary care provider (PCP) like Stephen Thomas 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.
- 28138
- License State
- SC
- 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:
- 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
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 |
|---|---|---|---|
| AA20815282 | MEDICARE PIN (08) | SC | |
| 281386 | MEDICAID (05) | SC | |
| AA20817126 | MEDICARE PIN (08) | SC | |
| GP1551 | OTHER (01) | SC | MEDICAID GROUP |
| P00630905 | OTHER (01) | SC | RR MEDICARE |
Medicare Participation & PECOS Enrollment Status
Stephen Thomas 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
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 (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
4 DME suppliers used 15 Medicare Claims 58 Services Paid
DME-Other DME (DE000N)
Normal, low and high calibrator solution / chips (HCPCS:A4256)
4 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
3 DME suppliers used 11 Medicare Claims 25 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Tape, waterproof, per 18 square inches (HCPCS:A4452)
1 DME suppliers used 11 Medicare Claims 1100 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Collagen based wound filler, dry form, sterile, per gram of collagen (HCPCS:A6010)
1 DME suppliers used 14 Medicare Claims 202 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Hydrocolloid dressing, wound filler, paste, sterile, per ounce (HCPCS:A6240)
1 DME suppliers used 12 Medicare Claims 72 Services Paid
DME-Other DME (DE000N)
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)
1 DME suppliers used 12 Medicare Claims 24 Services Paid
DME-Other DME (DE000N)
Filter, disposable, used with aerosol compressor or ultrasonic generator (HCPCS:A7013)
1 DME suppliers used 12 Medicare Claims 13 Services Paid
DME-Hospital Beds (DB000N)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)
2 DME suppliers used 37 Medicare Claims 37 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
1 DME suppliers used 17 Medicare Claims 17 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
4 DME suppliers used 43 Medicare Claims 43 Services Paid
DME-Wheelchairs (DD000N)
Lightweight wheelchair (HCPCS:K0003)
3 DME suppliers used 26 Medicare Claims 26 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.
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes
Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes
New patient custodial care facility, group care, or assisted living visit, typically 1 hour
New patient custodial care facility, group care, or assisted living visit, typically 30 minutes
New patient custodial care facility, group care, or assisted living visit, typically 45 minutes
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 147 times for 147 patientsThis refers to a routine medical visit for an established patient living in a group care facility, custodial care, or assisted living. The visit typically lasts 25 minutes and includes a check-up and discussion about ongoing healthcare needs.
This service was performed 453 times for 190 patientsThis is a routine visit for established patients residing in care facilities like nursing homes or assisted living. The visit typically lasts about 40 minutes, during which the healthcare provider checks your overall health, discusses any concerns, and adjusts care plans as needed.
This service was performed 1,156 times for 273 patientsThis service involves a one-hour visit for a new patient at a custodial care facility, group care home, or assisted living facility. During this time, a healthcare professional will assess the patient's health condition, discuss care plans, and address any concerns the patient may have.
This service was performed 12 times for 12 patientsThis service involves a 30-minute visit to a new patient in a custodial care facility, group care, or assisted living setting. The purpose is to assess the patient's health status, discuss care plans, and address any concerns. The visit aims to ensure optimal health and well-being.
This service was performed 20 times for 20 patientsThis service involves a medical professional visiting a new patient at a care facility or assisted living for about 45 minutes. During this visit, the professional will assess the patient's health, discuss any concerns, and plan for future care. This service aims to ensure the patient's well-being and comfort in their new environment.
This service was performed 82 times for 82 patientsPhysician 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 29464 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.18
- Minimum New Patient Price $53.57
- Maximum New Patient Price $163.84
- Average New Patient Copayment $20.79
- 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 99214
- Average Established Patient Price $95.12
- Minimum Established Patient Price $16.96
- Maximum Established Patient Price $133.52
- Average Established Patient Copayment $23.78
- 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 | 7% | 27 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Dementia: Cognitive Assessment | 88% | 257 |
| Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period | ||
| Documentation of Current Medications in the Medical Record | 100% | 2813 |
| 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 | ||
| Falls: Screening for Future Fall Risk | 79% | 364 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Pneumococcal Vaccination Status for Older Adults | 49% | 364 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 49% | 400 |
| 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: Screening for Depression and Follow-Up Plan | 51% | 307 |
| Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen | ||
| Provide Patient Access | 62% | 436 |
| 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. | ||
| 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. | ||
| Use of High-Risk Medications in the Elderly | 18% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 364 |
| 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 | ||
Reviews for STEPHEN MARK THOMAS M.D.
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
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 1508956673, we treat the final digit (3) 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
MOUNT PLEASANT, SC 29464
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1508956673, enumerated as an "individual" on October 12, 2006.
The provider is located at 1204 PALMETTO PENINSULA DR MOUNT PLEASANT, SC 29464 and the phone number is (843) 901-2386.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: First Choice Next, Medicare, Medicaid and Railroad. Please consult your insurance carrier or call the provider to verify.
