DR. FRANK A DIFAZIO M.D.
NPI 1518073972
Orthopaedic Surgery in Charleston, SC

NPI Status: Active since August 21, 2006

Contact Information

3424 SHELBY RAY CT
CHARLESTON, SC
ZIP 29414
Phone: (843) 402-6834

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

Individual
Male
Orthopaedic Surgery
Accepts Insurance
PECOS Enrolled

About FRANK DIFAZIO

This page provides the complete NPI Profile along with additional information for Frank Difazio, a provider established in Charleston, South Carolina with a medical specialization in Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1518073972 assigned on August 2006. The practitioner's primary taxonomy code is 207X00000X with license number 87400 (SC). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI: 1518073972
Provider Name: DR. FRANK A DIFAZIO M.D.
Gender: Male
Entity Type: Individual
Location Address: 3424 SHELBY RAY CT CHARLESTON, SC 29414
Location Phone: (843) 402-6834
Mailing Address: PO BOX 749306 ATLANTA, GA 30374
Is Sole Proprietor?: No
Enumeration Date: 08-21-2006
Last Update Date: 11-11-2024
Code Navigator

Location Map

Secondary Locations

8050 W Judge Perez Dr
Chalmette, LA 70043
(504) 826-9600
1014 Saint Andrews Blvd
Charleston, SC 29407
(843) 556-5585
1290 Summer St SUITE 4400
Stamford, CT 06905
(203) 323-7331

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: Orthopaedic Surgery
Taxonomy Code: 207X00000X
Type: Allopathic & Osteopathic Physicians
License No.: 87400
License State: SC
Taxonomy Description: An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

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	207X00000X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	321517 (LA)
2	207XX0005X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery Sports Medicine	38363 (CT)
3	207XX0801X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery Orthopaedic Trauma	038363 (CT)

Insurance Plans Accepted

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

Molina Healthcare

Gold 1 - HMO
Gold 1 with Adult Vision Services - HMO
Gold 8 - HMO
Silver 1 - HMO
Silver 1 with Adult Vision Services - HMO
Silver 12 - HMO
Silver 8 - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Frank Difazio 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

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.

Established patient office or other outpatient visit, 20-29 minutes

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 29414 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 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.

NPI Validation Check Digit Calculation

The following table explains the step by step 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.
1	5	1	8	0	7	3	9	7	2
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	5	2	8	0	7	6	9	14
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 2 + 8 + 0 + 7 + 6 + 9 + 1 + 4 + 24 = 68
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 68 = 2									2

The NPI number 1518073972 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.