DANIELLE BROOKE LANCASTER PHYSICIAN ASSISTANT
NPI 1538791926
Physician Assistant in Grantsville, WV

NPI Status: Active since February 04, 2020

Contact Information

186 HOSPITAL DR
GRANTSVILLE, WV
ZIP 26147
Phone: (304) 354-9244

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  • Individual
  • Female
  • Years of Experience 7
  • Physician Assistant
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About DANIELLE LANCASTER

This page provides the complete NPI Profile along with additional information for Danielle Lancaster, a primary care provider established in Grantsville, West Virginia with a medical specialization in Physician Assistant and more than 7 years of experience. The healthcare provider is registered in the NPI registry with number 1538791926 assigned on February 2020. The practitioner's primary taxonomy code is 363A00000X with license number 2487 (WV). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1538791926
Provider Name
DANIELLE BROOKE LANCASTER PHYSICIAN ASSISTANT
Gender
Female
Entity Type
Individual
Location Address
186 HOSPITAL DR GRANTSVILLE, WV 26147
Location Phone
(304) 354-9244
Mailing Address
122 CENTER ST CLAY, WV 25043
Medical School Name
OTHER
Graduation Year
2020
Is Sole Proprietor?
No
Enumeration Date
02-04-2020
Last Update Date
01-24-2024
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A primary care provider (PCP) like Danielle Lancaster sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
2487
License State
WV
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

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

  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Low Deductible Silver 5000 $3 Generic Drugs - HMO
  • Low Deductible Silver 5000 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Platinum Zero $5 Generic Drugs - HMO
  • Platinum Zero $5 Generic Drugs + Adult Vision & Fitness - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Danielle Lancaster 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.

Danielle Lancaster 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: 3870999386

    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: I20210909000243

    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.

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

This service was performed 18 times for 18 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

This service was performed 17 times for 17 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.87 for a new patient copayment and $16.71 for an established patient copayment.

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 26147 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $83.49
  • Minimum New Patient Price $53.2
  • Maximum New Patient Price $164.59
  • Average New Patient Copayment $20.87
  • Minimum New Patient Copayment $13.3
  • Maximum New Patient Copayment $41.14

Established Patients Visit Costs *

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

  • Average Established Patient Price $66.84
  • Minimum Established Patient Price $16.47
  • Maximum Established Patient Price $133.29
  • Average Established Patient Copayment $16.71
  • Minimum Established Patient Copayment $4.11
  • Maximum Established Patient Copayment $33.32

* 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.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Adult Major Depressive Disorder (MDD): Suicide Risk Assessment 0% 48
Appropriate Treatment for Upper Respiratory Infection (URI) 30% 27
Breast Cancer Screening 64% 102
Cervical Cancer Screening 72% 191
Chlamydia Screening for Women 4% 98
Closing the Referral Loop: Receipt of Specialist Report 50% 121
Colorectal Cancer Screening 56% 234
Controlling High Blood Pressure 90% 206
Diabetes: Eye Exam 80% 92
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) 13% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
92
Documentation of Current Medications in the Medical Record 100% 814
Falls: Screening for Future Fall Risk 76% 107
HIV Screening 61% 509
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 100% 544
Preventive Care and Screening: Screening for Depression and Follow-Up Plan 95% 388
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented 39% 509
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 99% 481
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 99% 184
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 100% 481
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 81% 147
Use of High-Risk Medications in Older Adults 0% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
110
Use of High-Risk Medications in Older Adults 12% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
112
Use of High-Risk Medications in Older Adults 12% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
112

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Danielle Lancaster is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
MINNIE HAMILTON HEALTH SYSTEM186 HOSPITAL DRIVE
GRANTSVILLE, WV 26147
(304) 354-9244Critical Access Hospitals
ROANE GENERAL HOSPITAL200 HOSPITAL DRIVE
SPENCER, WV 25276
(304) 927-4444Critical Access Hospitals

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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 1538791926, we treat the final digit (6) 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 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 6).

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
7
Doubled → 14 → 1 + 4
Pos 6
9
Unchanged
Pos 7
1
Doubled → 2
Pos 8
9
Unchanged
Pos 9
2
Doubled → 4
Check
6
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 7 → 14 → 5 1 → 2 2 → 4

Step 2: Add all digits plus the NPI constant

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

2 + 5 + 6 + 8 + 1 + 4 + 9 + 2 + 9 + 4 + 24 = 74

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

The next multiple of ten after 74 is 80. The difference is the calculated check digit.

80 - 74 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1538791926.

Other Providers at the Same Location


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

Emergency Medicine
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Internal Medicine
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Nurse Practitioner
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Nurse Practitioner (Family)
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Physician Assistant
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Pharmacist
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Emergency Medicine
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Nurse Practitioner (Family)
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Physician Assistant
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Dentist (General Practice)
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Physical Therapist
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Pediatrics
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Nurse Practitioner (Family)
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Dentist (General Practice)
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Pharmacy (Institutional Pharmacy)
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Physical Therapist
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Nurse Practitioner (Family)
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Psychologist (Clinical)
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Nurse Practitioner (Family)
186 HOSPITAL DR
GRANTSVILLE, WV 26147
Registered Nurse
186 HOSPITAL DR
GRANTSVILLE, WV 26147

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1538791926, enumerated as an "individual" on February 04, 2020.

The provider is located at 186 HOSPITAL DR GRANTSVILLE, WV 26147 and the phone number is (304) 354-9244.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: CareSource. Please consult your insurance carrier or call the provider to verify.

Danielle Lancaster is affiliated with: MINNIE HAMILTON HEALTH SYSTEM and ROANE GENERAL HOSPITAL.