NELSON HERNANDO DURAN PA
NPI 1588092571
Physician Assistant - Medical in Parrish, FL
NPI Status: Active since October 29, 2013
Contact Information
12271 US HIGHWAY 301 N
PARRISH, FL
ZIP 34219
Phone: (941) 776-4000
Fax: (941) 776-4013
- Individual
- Male
- Years of Experience 13
- Physician Assistant
- Medical
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About NELSON DURAN
This page provides the complete NPI Profile along with additional information for Nelson Duran, a primary care provider established in Parrish, Florida with a medical specialization in Physician Assistant, focusing in medical and more than 13 years of experience. The healthcare provider is registered in the NPI registry with number 1588092571 assigned on October 2013. The practitioner's primary taxonomy code is 363AM0700X with license number PA 9107523 (FL). The provider is registered as an individual and his NPI record was last updated 7 years ago.
- NPI
- 1588092571
- Provider Name
- NELSON HERNANDO DURAN PA
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 12271 US HIGHWAY 301 N PARRISH, FL 34219
- Location Phone
- (941) 776-4000
- Location Fax
- (941) 776-4013
- Mailing Address
- 280 S DECATUR BLVD LAS VEGAS, NV 89107
- Mailing Phone
- (702) 759-1238
- Medical School Name
- OTHER
- Graduation Year
- 2013
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-29-2013
- Last Update Date
- 10-24-2019
- Code Navigator
A primary care provider (PCP) like Nelson Duran 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 Medical
- Taxonomy Code
- 363AM0700X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA 9107523
- License State
- FL
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 | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | PA1898 (NV) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Nelson Duran is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Nelson Duran 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: 1456578491
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: I20190306001304
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? Maybe
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.
Injection of drug or substance under skin or into muscle
Injection, penicillin g benzathine, 100,000 units
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
This service was performed 30 times for 13 patientsPenicillin G Benzathine is an antibiotic injection used to treat or prevent a variety of bacterial infections. The 100,000 units denote the dosage. This medication works by stopping the growth of bacteria, helping your body to fight off the infection.
This service was performed 672 times for 12 patientsQuality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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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 1588092571, we treat the final digit (1) 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 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
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 69 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.
PARRISH, FL 34219
PARRISH, FL 34219
PARRISH, FL 34219
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1588092571, enumerated as an "individual" on October 29, 2013.
The provider is located at 12271 US HIGHWAY 301 N PARRISH, FL 34219 and the phone number is (941) 776-4000.
Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.
The provider might be accepting Accepts: Ambetter from Arizona Complete Health. Please consult your insurance carrier or call the provider to verify.