DR. EDWARD A APICELLA MD
NPI 1528051869
Pain Medicine - Interventional Pain Medicine in Albany, NY

NPI Status: Active since August 23, 2005

Contact Information

12 CORPORATE WOODS BLVD
ALBANY, NY
ZIP 12211
Phone: (518) 463-0171
Fax: (518) 463-0174

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  • Individual
  • Male
  • Pain Medicine
  • Interventional Pain Medicine
  • PECOS Enrolled

About EDWARD APICELLA

This page provides the complete NPI Profile along with additional information for Edward Apicella, a provider established in Albany, New York with a medical specialization in Pain Medicine, focusing in interventional pain medicine . The healthcare provider is registered in the NPI registry with number 1528051869 assigned on August 2005. The practitioner's primary taxonomy code is 208VP0014X with license number 191595 (NY). The provider is registered as an individual and his NPI record was last updated 16 years ago.

NPI
1528051869
Provider Name
DR. EDWARD A APICELLA MD
Gender
Male
Entity Type
Individual
Location Address
12 CORPORATE WOODS BLVD ALBANY, NY 12211
Location Phone
(518) 463-0171
Location Fax
(518) 463-0174
Mailing Address
12 CORPORATE WOODS BLVD ALBANY, NY 12211
Mailing Phone
(518) 463-0171
Mailing Fax
(518) 463-0174
Is Sole Proprietor?
No
Enumeration Date
08-23-2005
Last Update Date
10-28-2010
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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

Pain Medicine Interventional Pain Medicine

Taxonomy Code
208VP0014X
Type
Allopathic & Osteopathic Physicians
License No.
191595
License State
NY
Taxonomy Description
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

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)
1207LP2900XAllopathic & Osteopathic Physicians

Anesthesiology
Pain Medicine

191595 (NY)
2208VP0000XAllopathic & Osteopathic Physicians

Pain Medicine
Pain Medicine

191595 (NY)

Insurance Plans Accepted

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

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
5508704OTHER (01)NYGHI PPO GROUP NUMBER
141806863OTHER (01)NYUNITED HEALTH CARE
050078269OTHER (01)NYRAIL ROAD MEDICARE
5301566OTHER (01)NYGHI PPO DR. APICELLA'S #
AA0505MEDICARE ID-TYPE UNSPECIFIED (04)NYGROUP # FOR ACPM
4868OTHER (01)NYCDPHP GROUP #
5403572OTHER (01)NYAETNA
10000049OTHER (01)NYCDPHP
110586100OTHER (01)NYDEPT OF LABOR/POSTAL WORK
G04192MEDICARE UPIN (02)NY 
01565035MEDICAID (05)NY 
000405461007OTHER (01)NYBSNENY
EA03087930OTHER (01)NYEMPIRE/ BLUE CHOICE
05641OTHER (01)NYMVP
CC0430MEDICARE ID-TYPE UNSPECIFIED (04)NYDR. APICELLA'S NUMBER

Medicare Participation & PECOS Enrollment Status

Edward Apicella 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

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 68 times for 49 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 165 times for 93 patients

Telephone medical discussion with physician, 11-20 minutes

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

This service was performed 54 times for 45 patients

Telephone medical discussion with physician, 21-30 minutes

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

This service was performed 11 times for 11 patients

Telephone medical discussion with physician, 5-10 minutes

A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.

This service was performed 13 times for 11 patients

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 12211 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $126.4
  • Minimum New Patient Price $54.87
  • Maximum New Patient Price $166.88
  • Average New Patient Copayment $31.6
  • Minimum New Patient Copayment $13.71
  • Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

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

  • Average Established Patient Price $97.08
  • Minimum Established Patient Price $17.54
  • Maximum Established Patient Price $136.14
  • Average Established Patient Copayment $24.27
  • Minimum Established Patient Copayment $4.38
  • Maximum Established Patient Copayment $34.03

* 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.

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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 1528051869, 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
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
2
Doubled → 4
Pos 4
8
Unchanged
Pos 5
0
Doubled → 0
Pos 6
5
Unchanged
Pos 7
1
Doubled → 2
Pos 8
8
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
9
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 2 → 4 0 → 0 1 → 2 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

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

2 + 5 + 4 + 8 + 0 + 5 + 2 + 8 + 1 + 2 + 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 1528051869.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Physical Therapy Assistant
12 CORPORATE WOODS BLVD
ALBANY, NY 12211
Optometrist
12 CORPORATE WOODS BLVD, LASIKPLUS
ALBANY, NY 12211
Clinic/Center (Ophthalmologic Surgery)
12 CORPORATE WOODS BLVD
ALBANY, NY 12211

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1528051869, enumerated as an "individual" on August 23, 2005.

The provider is located at 12 CORPORATE WOODS BLVD ALBANY, NY 12211 and the phone number is (518) 463-0171.

Pain Medicine with taxonomy code 208VP0014X and a focus in Interventional Pain Medicine.

The provider might be accepting Accepts: Medicare, Medicaid and Aetna. Please consult your insurance carrier or call the provider to verify.