SALVATORE PAOLILLO M.D.
NPI 1588051916
Obstetrics & Gynecology in Johnson City, TN
NPI Status: Active since April 23, 2015
Contact Information
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 439-7272
- Individual
- Male
- Years of Experience 11
- Obstetrics & Gynecology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About SALVATORE PAOLILLO
This page provides the complete NPI Profile along with additional information for Salvatore Paolillo, a women's health care provider established in Johnson City, Tennessee with a medical specialization in Obstetrics & Gynecology and more than 11 years of experience. The healthcare provider is registered in the NPI registry with number 1588051916 assigned on April 2015. The practitioner's primary taxonomy code is 207V00000X with license number 71792 (TN). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1588051916
- Provider Name
- SALVATORE PAOLILLO M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 325 N STATE OF FRANKLIN RD FL 1 JOHNSON CITY, TN 37604
- Location Phone
- (423) 439-7272
- Mailing Address
- PO BOX 699 MOUNTAIN HOME, TN 37684
- Medical School Name
- OTHER
- Graduation Year
- 2015
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-23-2015
- Last Update Date
- 09-23-2024
- Code Navigator
Women's health care providers like Salvatore Paolillo treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
Location Map
Secondary Locations
- 1505 W Elk Ave Ste 1
Elizabethton, TN 37643
(423) 543-7919
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
Obstetrics & Gynecology
- Taxonomy Code
- 207V00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 71792
- License State
- TN
- Taxonomy Description
- An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Silver Pathway/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - 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.
*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 |
---|---|---|---|
Q096089 | MEDICAID (05) | TN |
Medicare Participation & PECOS Enrollment Status
Salvatore Paolillo 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.
Salvatore Paolillo 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: 2466855648
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: I20241021004349
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
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $30.45 for a new patient copayment and $16.5 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 37604 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $121.8
- Minimum New Patient Price $52.64
- Maximum New Patient Price $160.89
- Average New Patient Copayment $30.45
- Minimum New Patient Copayment $13.16
- Maximum New Patient Copayment $40.22
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.01
- Minimum Established Patient Price $16.72
- Maximum Established Patient Price $131.41
- Average Established Patient Copayment $16.5
- Minimum Established Patient Copayment $4.18
- Maximum Established Patient Copayment $32.85
* 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 Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 5 | 8 | 8 | 0 | 5 | 1 | 9 | 1 | 6 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 5 | 16 | 8 | 0 | 5 | 2 | 9 | 2 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 5 + 1 + 6 + 8 + 0 + 5 + 2 + 9 + 2 + 24 = 64 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 64 = 6 | 6 |
The NPI number 1588051916 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
DR. HANA EL ADO MIKDACHI M.D.
Obstetrics & Gynecology
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
GINGER WILLIAMS CARTER MD
Obstetrics & Gynecology
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
ELIZABETH A LANE R.D.
Dietitian, Registered
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
ADITYA NITIN THAKKAR MD
Student in an Organized Health Care Education/Training Program
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
ANDREA NICOLE HETHERINGTON FNPC
Nurse Practitioner
(Obstetrics & Gynecology)
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
KARA BETH WEISHAAR MD
Obstetrics & Gynecology
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
DR. DONALD CLINTON WILLIS M.D.
Obstetrics & Gynecology
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
DR. KAREN SUZANNE BALLARD D.O.
Obstetrics & Gynecology
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
DR. ALEKSANDR M. FUKS M.D.
Obstetrics & Gynecology
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
ANN MARIA GEBKA ROUSE MD
Obstetrics & Gynecology
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
JACQUELINE VICTORIA HEFLIN WHNP-BC
Nurse Practitioner
(Women's Health)
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
MARTIN E. OLSEN M.D.
Obstetrics & Gynecology
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
DR. MOLLY TALCOTT HEINZEN OXFORD M.D.
Obstetrics & Gynecology
(Obstetrics)
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
BETHANY LOVEN REYNOLDS M.D.
Obstetrics & Gynecology
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
MRS. STEPHANIE SHADDEN ROARK RD
Dietitian, Registered
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
TARA VICK MD
Obstetrics & Gynecology
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
CRYSTAL ANN YATES APRN
Nurse Practitioner
(Family)
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
DR. JESSICA HOLT TURNER PHD
Psychologist
(Clinical)
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
SHERI LYNN HOLMES MD
Obstetrics & Gynecology
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
GLORIA M DUDNEY RN
Registered Nurse
(Lactation Consultant)
325 N STATE OF FRANKLIN RD FL 1
JOHNSON CITY, TN
ZIP 37604
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1588051916, enumerated as an "individual" on April 23, 2015.
The provider is located at 325 N STATE OF FRANKLIN RD FL 1 JOHNSON CITY, TN 37604 and the phone number is (423) 439-7272.
Obstetrics & Gynecology with taxonomy code 207V00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.