ROY A SCHMIDT M. D.
NPI 1538109855
Specialist in Jackson, TN

NPI Status: Active since June 07, 2006

Contact Information

15 STONEBRIDGE BLVD
JACKSON, TN
ZIP 38305
Phone: (731) 660-2056
Fax: (731) 661-9092

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  • Individual
  • Male
  • Years of Experience 43
  • Specialist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ROY SCHMIDT

This page provides the complete NPI Profile along with additional information for Roy Schmidt, a provider established in Jackson, Tennessee with a medical specialization in Specialist and more than 43 years of experience. He graduated from Loma Linda University School Of Medicine in 1984. The healthcare provider is registered in the NPI registry with number 1538109855 assigned on June 2006. The practitioner's primary taxonomy code is 174400000X with license number 22099 (TN). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1538109855
Provider Name
ROY A SCHMIDT M. D.
Gender
Male
Entity Type
Individual
Location Address
15 STONEBRIDGE BLVD JACKSON, TN 38305
Location Phone
(731) 660-2056
Location Fax
(731) 661-9092
Mailing Address
15 STONEBRIDGE BLVD JACKSON, TN 38305
Mailing Phone
(731) 660-2056
Mailing Fax
(731) 661-9092
Medical School Name
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
1984
Is Sole Proprietor?
No
Enumeration Date
06-07-2006
Last Update Date
04-18-2019
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Location Map

Secondary Locations

  • 205 Hospital Dr Ste A
    Mc Kenzie, TN 38201
    (731) 352-7907

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

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
22099
License State
TN
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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)
1207L00000XAllopathic & Osteopathic Physicians

Anesthesiology

MD22099 (TN)
2207LP2900XAllopathic & Osteopathic Physicians

Anesthesiology
Pain Medicine

MD22099 (TN)

Insurance Plans Accepted

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

  • BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Essential (No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Gold Advantage (Virtual Urgent Care, No Referrals) - EPO
  • UHC Gold Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO
  • UHC Silver Advantage (Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Silver Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Standard (No Referrals) - EPO

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
030670000OTHER (01)KYBLACK LUNG
C20829OTHER (01)KYCUMBERLAND HEALTHCARE INC
50007501OTHER (01)KYPASSPORT HEALTH PLAN
64095367MEDICAID (05)KY 
000000378004OTHER (01)KYANTHEM
3380640MEDICAID (05)TN 

Medicare Participation & PECOS Enrollment Status

Roy Schmidt is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Roy Schmidt 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

  • PECOS PAC ID: 4385693746

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20061026000665

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • 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.

  • 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.

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint

This procedure involves using imaging technology to locate and treat nerves in your lower spine or sacral area that may be causing pain. Each additional facet joint refers to treating more than one spinal nerve. It's a non-invasive way to manage chronic back pain.

This service was performed 53 times for 26 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 34 times for 26 patients

Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming

This procedure involves electronically analyzing an implanted neurostimulator. This device sends electrical pulses to your spinal cord or peripheral nerves to manage pain. The programming is complex, requiring expert analysis to ensure proper functioning.

This service was performed 17 times for 16 patients

Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming

This procedure involves electronically analyzing an implanted neurostimulator. This device sends electrical pulses to your spinal cord or peripheral nerves to manage pain. The programming is complex, requiring expert analysis to ensure proper functioning.

This service was performed 40 times for 23 patients

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 262 times for 152 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 86 times for 55 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 14 times for 12 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

This service was performed 56 times for 33 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 57 times for 33 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 91 times for 76 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 22 times for 16 patients

Injection, methylprednisolone acetate, 80 mg

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

This service was performed 136 times for 107 patients

Insertion of spinal neurostimulator electrode array through skin

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

This service was performed 23 times for 11 patients

Insertion of spinal neurostimulator electrode array through skin

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

This service was performed 22 times for 11 patients

Insertion of spinal neurostimulator generator or receiver

The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.

This service was performed 15 times for 15 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 33 times for 33 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 37 times for 37 patients

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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 1538109855, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

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
3
Doubled → 6
Pos 4
8
Unchanged
Pos 5
1
Doubled → 2
Pos 6
0
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
8
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
5
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 3 → 6 1 → 2 9 → 18 → 9 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 5 + 6 + 8 + 2 + 0 + 1 + 8 + 8 + 1 + 0 + 24 = 65

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

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1538109855.

Other Providers at the Same Location


The following 9 providers are registered at the same or a nearby location.

Physician Assistant
15 STONEBRIDGE BLVD
JACKSON, TN 38305
Nurse Practitioner
15 STONEBRIDGE BLVD
JACKSON, TN 38305
Anesthesiology (Pain Medicine)
15 STONEBRIDGE BLVD
JACKSON, TN 38305
Internal Medicine
15 STONEBRIDGE BLVD
JACKSON, TN 38305
Durable Medical Equipment & Medical Supplies
15 STONEBRIDGE BLVD
JACKSON, TN 38305
Nurse Practitioner (Family)
15 STONEBRIDGE BLVD
JACKSON, TN 38305
Nurse Practitioner (Family)
15 STONEBRIDGE BLVD
JACKSON, TN 38305
Nurse Practitioner (Family)
15 STONEBRIDGE BLVD
JACKSON, TN 38305
Nurse Practitioner (Family)
15 STONEBRIDGE BLVD
JACKSON, TN 38305

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1538109855, enumerated as an "individual" on June 07, 2006.

The provider is located at 15 STONEBRIDGE BLVD JACKSON, TN 38305 and the phone number is (731) 660-2056.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: BlueCross BlueShield of Tennessee,. Please consult your insurance carrier or call the provider to verify.