DR. EDWARD P RAINES MD
NPI 1568414258
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Norfolk, NE
NPI Status: Active since May 17, 2006
Contact Information
110 N 29TH ST
STE 302
NORFOLK, NE
ZIP 68701
Phone: (402) 844-8242
Fax: (402) 844-8233
- Individual
- Male
- Thoracic Surgery (Cardiothoracic Vascula...
- Accepts Insurance
- PECOS Enrolled
About EDWARD RAINES
This page provides the complete NPI Profile along with additional information for Edward Raines, a provider established in Norfolk, Nebraska with a medical specialization in Thoracic Surgery (cardiothoracic Vascular Surgery). The healthcare provider is registered in the NPI registry with number 1568414258 assigned on May 2006. The practitioner's primary taxonomy code is 208G00000X with license number 18481 (NE). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1568414258
- Provider Name
- DR. EDWARD P RAINES MD
- Other Name
- DR. EDWARD P RAINES M.D.
- Other Name Type
- Professional Name (2)
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 110 N 29TH ST STE 302 NORFOLK, NE 68701
- Location Phone
- (402) 844-8242
- Location Fax
- (402) 844-8233
- Mailing Address
- 5348 WILDCAT CT MORRISON, CO 80465
- Mailing Phone
- (402) 730-9232
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-17-2006
- Last Update Date
- 02-20-2017
- Code Navigator
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
Thoracic Surgery (Cardiothoracic Vascular Surgery)
- Taxonomy Code
- 208G00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 18481
- License State
- NE
- Taxonomy Description
- A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
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) |
|---|---|---|---|---|
| 1 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | 18481 (NE) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze PPO? 202 - PPO
- Blue Advantage Bronze PPO? 203 - PPO
- Blue Advantage Bronze PPO? Standard - PPO
- Blue Advantage Gold PPO? 309 - PPO
- Blue Advantage Gold PPO? 604 - PPO
- Blue Advantage Gold PPO? Standard - PPO
- Blue Advantage Silver PPO? 204 - PPO
- Blue Advantage Silver PPO? 501 - PPO
- Blue Advantage Silver PPO? Standard - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? Standard - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Edward Raines 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
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 68701 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $160.21
- Minimum New Patient Price $52.69
- Maximum New Patient Price $160.21
- Average New Patient Copayment $40.05
- Minimum New Patient Copayment $13.17
- Maximum New Patient Copayment $40.05
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66
- Minimum Established Patient Price $16.9
- Maximum Established Patient Price $131.25
- Average Established Patient Copayment $16.5
- Minimum Established Patient Copayment $4.22
- Maximum Established Patient Copayment $32.81
* 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 1568414258, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
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 62 is 70. 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.
NORFOLK, NE 68701
NORFOLK, NE 68701
NORFOLK, NE 68701
NORFOLK, NE 68701
NORFOLK, NE 68701
NORFOLK, NE 68701
NORFOLK, NE 68701
NORFOLK, NE 68701
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568414258, enumerated as an "individual" on May 17, 2006.
The provider is located at 110 N 29TH ST STE 302 NORFOLK, NE 68701 and the phone number is (402) 844-8242.
Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Oklahoma. Please consult your insurance carrier or call the provider to verify.
