KAREN MACLEAN NPI 1518313964
Physical Therapist in Gainesville, VA

About KAREN MACLEAN

Karen Maclean is a provider established in Gainesville, Virginia and her medical specialization is Physical Therapist with more than 28 years of experience. The NPI number of this provider is 1518313964 and was assigned on May 2016. The practitioner's primary taxonomy code is 225100000X with license number 2307001227 (VA). The provider is registered as an individual and her NPI record was last updated 7 years ago.

NPI
1518313964
Provider Name KAREN MACLEAN
Location Address6856 PIEDMONT CENTER PLZ #C-4 GAINESVILLE, VA 20155
Location Phone(703) 754-6955
Mailing Address2445 CENTREVILLE RD HERNDON, VA 20171
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1995
Is Sole Proprietor?No
Enumeration Date05-04-2016
Last Update Date05-04-2016

Karen Maclean 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.

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.59 for a new patient copayment and $18.37 for an established patient copayment.



Primary Taxonomy

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.

Taxonomy Code225100000X
ClassificationPhysical Therapist
TypeRespiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.2307001227
License StateVA
Taxonomy DescriptionPhysical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Business Address

6856 PIEDMONT CENTER PLZ
#C-4
GAINESVILLE, VA
ZIP 20155
Phone: (703) 754-6955
Fax: (703) 754-6956

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Mailing Address

2445 CENTREVILLE RD
HERNDON, VA
ZIP 20171
Phone: (703) 793-4851
Fax: (703) 793-4853


Location Map

PECOS Enrollment and Medicare Participation Status

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.

PECOS PAC ID8325331333
PECOS Enrollment IDI20160728001932
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.

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 20155 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$58.76 $178.23 $90.36
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.69 $44.55 $22.59
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
$18.32 $145.63 $73.51
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.58 $36.4 $18.37

* 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.

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.
1518313964
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2528616912
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 2 + 8 + 6 + 1 + 6 + 9 + 1 + 2 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1518313964 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1023352242 SABA SHAPOURI PT, DPT
Individual
Physical Therapist6856 PIEDMONT CENTER PLZ #C-4
GAINESVILLE, VA 20155
(703) 754-6955

Frequently Asked Questions

What is Karen Maclean NPI number?

The NPI number assigned to this healthcare provider is 1518313964, registered as an "individual" on May 04, 2016

Where is Karen Maclean located?

The provider is located at 6856 Piedmont Center Plz #c-4 Gainesville, Va 20155 and the phone number is (703) 754-6955

Which is Karen Maclean specialty?

The provider's speciality is Physical Therapist

How many years of experience does Karen Maclean have?

The provider has more than 28 years of experience.

How much is a visit to Karen Maclean ?

Medicare beneficiaries should expect a typical cost of $90.36 with an average copayment of $22.59 for new patient appointments. Established patients should expect a typical charge of $73.51 and an average copayment of 18.37. Please review your insurance plan or contact the provider directly to determine your specific costs.

How do I update my NPI information?

The NPI record of Karen Maclean was last updated on May 04, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
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