SUSANNE M GAINES CRNP
NPI 1538520150
Nurse Practitioner - Acute Care in Baltimore, MD
NPI Status: Active since March 09, 2016
Contact Information
22 S GREENE ST
BALTIMORE, MD
ZIP 21201
Phone: (410) 328-8000
- Individual
- Female
- Nurse Practitioner
- Acute Care
- PECOS Enrolled
About SUSANNE GAINES
This page provides the complete NPI Profile along with additional information for Susanne Gaines, a provider established in Baltimore, Maryland with a medical specialization in Nurse Practitioner, focusing in acute care . The healthcare provider is registered in the NPI registry with number 1538520150 assigned on March 2016. The practitioner's primary taxonomy code is 363LA2100X with license number R166135 (MD). The provider is registered as an individual and her NPI record was last updated 8 years ago.
- NPI
- 1538520150
- Provider Name
- SUSANNE M GAINES CRNP
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 22 S GREENE ST BALTIMORE, MD 21201
- Location Phone
- (410) 328-8000
- Mailing Address
- PO BOX 64442 BALTIMORE, MD 21264
- Mailing Phone
- (410) 328-8040
- Mailing Fax
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 03-09-2016
- Last Update Date
- 02-28-2018
- Code Navigator
A nurse practitioner (NP) like Susanne Gaines is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
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
Nurse Practitioner Acute Care
- Taxonomy Code
- 363LA2100X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- R166135
- License State
- MD
Medicare Participation & PECOS Enrollment Status
Susanne Gaines 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.
Unknown
Treatment-Chemotherapy (RH002N)
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg (HCPCS:J7503)
1 DME suppliers used 38 Medicare Claims 22680 Services Paid
Treatment-Treatment - Miscellaneous (RX029N)
Tacrolimus, immediate release, oral, 1 mg (HCPCS:J7507)
1 DME suppliers used 13 Medicare Claims 3300 Services Paid
Treatment-Treatment - Miscellaneous (RX029N)
Prednisone, immediate release or delayed release, oral, 1 mg (HCPCS:J7512)
1 DME suppliers used 35 Medicare Claims 52100 Services Paid
Treatment-Treatment - Miscellaneous (RX029N)
Mycophenolic acid, oral, 180 mg (HCPCS:J7518)
1 DME suppliers used 25 Medicare Claims 5220 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant (HCPCS:Q0510)
1 DME suppliers used 23 Medicare Claims 23 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period (HCPCS:Q0511)
1 DME suppliers used 32 Medicare Claims 32 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period (HCPCS:Q0512)
1 DME suppliers used 65 Medicare Claims 66 Services Paid
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 21201 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 99214
- Average Established Patient Price $106.59
- Minimum Established Patient Price $19.6
- Maximum Established Patient Price $149.17
- Average Established Patient Copayment $26.64
- 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.
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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 1538520150, we treat the final digit (0) 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 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
BALTIMORE, MD 21201
BALTIMORE, MD 21201
BALTIMORE, MD 21201
BALTIMORE, MD 21201
BALTIMORE, MD 21201
BALTIMORE, MD 21201
BALTIMORE, MD 21201
BALTIMORE, MD 21201
BALTIMORE, MD 21201
BALTIMORE, MD 21201
BALTIMORE, MD 21201
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1538520150, enumerated as an "individual" on March 09, 2016.
The provider is located at 22 S GREENE ST BALTIMORE, MD 21201 and the phone number is (410) 328-8000.
Nurse Practitioner with taxonomy code 363LA2100X and a focus in Acute Care.
