DR. JONATHAN E EFRON M.D.
NPI 1538144647
Surgery in Baltimore, MD

NPI Status: Active since December 12, 2005

Contact Information

4940 EASTERN AVE
BALTIMORE, MD
ZIP 21224
Phone: (410) 550-0100

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  • Individual
  • Male
  • Surgery
  • Accepts Insurance
  • PECOS Enrolled

About JONATHAN EFRON

This page provides the complete NPI Profile along with additional information for Jonathan Efron, a provider established in Baltimore, Maryland with a medical specialization in Surgery. The healthcare provider is registered in the NPI registry with number 1538144647 assigned on December 2005. The practitioner's primary taxonomy code is 208600000X with license number D69531 (MD). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1538144647
Provider Name
DR. JONATHAN E EFRON M.D.
Gender
Male
Entity Type
Individual
Location Address
4940 EASTERN AVE BALTIMORE, MD 21224
Location Phone
(410) 550-0100
Mailing Address
PO BOX 64563 BALTIMORE, MD 21264
Is Sole Proprietor?
No
Enumeration Date
12-12-2005
Last Update Date
02-10-2014
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A surgeon like Jonathan Efron treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.

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

Surgery

Taxonomy Code
208600000X
Type
Allopathic & Osteopathic Physicians
License No.
D69531
License State
MD
Taxonomy Description
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

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)
1208C00000XAllopathic & Osteopathic Physicians

Colon & Rectal Surgery

33553 (AZ)

Insurance Plans Accepted

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

  • MyBlue Health Bronze? 402 - HMO
  • MyBlue Health Bronze? Standard - HMO
  • MyBlue Health Gold? 403 - HMO
  • MyBlue Health Gold? Standard - HMO
  • MyBlue Health Silver? 405 - HMO
  • MyBlue Health Silver? Standard - 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
P00217762OTHER (01)AZRAILROAD MEDICARE
G98083MEDICARE UPIN (02) 
Z101327MEDICARE PIN (08)AZ 
418309600MEDICAID (05)MD 
912742MEDICAID (05)AZ 
165254YVEMEDICARE PIN (08)MD 
86080015085259A982OTHER (01)AZTRIWEST

Medicare Participation & PECOS Enrollment Status

Jonathan Efron 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.

Orthotic Devices

  • DME-Orthotic Devices (DF010N)

    Skin barrier; solid, 4 x 4 or equivalent; each (HCPCS:A4362)

    4 DME suppliers used 33 Medicare Claims 940 Services Paid

  • DME-Orthotic Devices (DF010N)

    Ostomy belt, each (HCPCS:A4367)

    3 DME suppliers used 12 Medicare Claims 24 Services Paid

  • DME-Orthotic Devices (DF010N)

    Ostomy skin barrier, powder, per oz (HCPCS:A4371)

    4 DME suppliers used 18 Medicare Claims 31 Services Paid

  • DME-Orthotic Devices (DF010N)

    Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each (HCPCS:A4385)

    5 DME suppliers used 35 Medicare Claims 1300 Services Paid

  • DME-Orthotic Devices (DF010N)

    Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce (HCPCS:A4394)

    7 DME suppliers used 44 Medicare Claims 1025 Services Paid

  • DME-Orthotic Devices (DF010N)

    Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4407)

    7 DME suppliers used 80 Medicare Claims 2670 Services Paid

  • DME-Orthotic Devices (DF010N)

    Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4409)

    4 DME suppliers used 11 Medicare Claims 460 Services Paid

  • DME-Orthotic Devices (DF010N)

    Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each (HCPCS:A4419)

    8 DME suppliers used 49 Medicare Claims 4860 Services Paid

  • DME-Orthotic Devices (DF010N)

    Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each (HCPCS:A4425)

    3 DME suppliers used 21 Medicare Claims 1080 Services Paid

  • DME-Orthotic Devices (DF010N)

    Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each (HCPCS:A5056)

    4 DME suppliers used 12 Medicare Claims 200 Services Paid

  • DME-Orthotic Devices (DF010N)

    Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each (HCPCS:A5057)

    4 DME suppliers used 27 Medicare Claims 610 Services Paid

  • DME-Orthotic Devices (DF010N)

    Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each (HCPCS:A5063)

    3 DME suppliers used 27 Medicare Claims 820 Services Paid

  • DME-Orthotic Devices (DF010N)

    Skin barrier, wipes or swabs, each (HCPCS:A5120)

    10 DME suppliers used 61 Medicare Claims 3162 Services Paid

Durable Medical Equipment

  • DME-Medical/Surgical Supplies (DA000N)

    Tape, waterproof, per 18 square inches (HCPCS:A4452)

    1 DME suppliers used 11 Medicare Claims 690 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Adhesive remover or solvent (for tape, cement or other adhesive), per ounce (HCPCS:A4455)

    4 DME suppliers used 13 Medicare Claims 55 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Adhesive remover, wipes, any type, each (HCPCS:A4456)

    10 DME suppliers used 53 Medicare Claims 3655 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.

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 62 times for 43 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 22 times for 22 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 21224 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $94.08
  • Minimum New Patient Price $60.73
  • Maximum New Patient Price $183.44
  • Average New Patient Copayment $23.52
  • Minimum New Patient Copayment $15.18
  • Maximum New Patient Copayment $45.86

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $75.47
  • Minimum Established Patient Price $19.6
  • Maximum Established Patient Price $149.17
  • Average Established Patient Copayment $18.86
  • Minimum Established Patient Copayment $4.9
  • Maximum Established Patient Copayment $37.29

* 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.

Reviews for DR. JONATHAN E EFRON M.D.

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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 1538144647, we treat the final digit (7) 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 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).

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
4
Unchanged
Pos 7
4
Doubled → 8
Pos 8
6
Unchanged
Pos 9
4
Doubled → 8
Check
7
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 4 → 8 4 → 8

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 + 4 + 8 + 6 + 8 + 24 = 73

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

The next multiple of ten after 73 is 80. The difference is the calculated check digit.

80 - 73 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1538144647.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Urology
4940 EASTERN AVE
BALTIMORE, MD 21224
Physician Assistant
4940 EASTERN AVE
BALTIMORE, MD 21224
Internal Medicine (Nephrology)
4940 EASTERN AVE
BALTIMORE, MD 21224
Physician Assistant
4940 EASTERN AVE
BALTIMORE, MD 21224
Physician Assistant
4940 EASTERN AVE
BALTIMORE, MD 21224
Psychiatry & Neurology (Psychiatry)
4940 EASTERN AVE
BALTIMORE, MD 21224
Psychologist
4940 EASTERN AVE
BALTIMORE, MD 21224
Emergency Medicine
4940 EASTERN AVE
BALTIMORE, MD 21224
Nurse Anesthetist, Certified Registered
4940 EASTERN AVE
BALTIMORE, MD 21224
Internal Medicine
4940 EASTERN AVE
BALTIMORE, MD 21224
Nurse Anesthetist, Certified Registered
4940 EASTERN AVE
BALTIMORE, MD 21224
Psychologist (Clinical)
4940 EASTERN AVE
BALTIMORE, MD 21224
Orthopaedic Surgery
4940 EASTERN AVE
BALTIMORE, MD 21224
Surgery
4940 EASTERN AVE
BALTIMORE, MD 21224
Obstetrics & Gynecology
4940 EASTERN AVE
BALTIMORE, MD 21224
Physician Assistant
4940 EASTERN AVE
BALTIMORE, MD 21224
Psychiatry & Neurology (Psychiatry)
4940 EASTERN AVE
BALTIMORE, MD 21224
Pediatrics
4940 EASTERN AVE
BALTIMORE, MD 21224
Internal Medicine
4940 EASTERN AVE
BALTIMORE, MD 21224
Psychiatry & Neurology (Psychiatry)
4940 EASTERN AVE
BALTIMORE, MD 21224

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1538144647, enumerated as an "individual" on December 12, 2005.

The provider is located at 4940 EASTERN AVE BALTIMORE, MD 21224 and the phone number is (410) 550-0100.

Surgery with taxonomy code 208600000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Railroad. Please consult your insurance carrier or call the provider to verify.