DR. DOUGLAS S APPEL D.P.M.
NPI 1609213537
Podiatrist - Foot & Ankle Surgery in Willingboro, NJ

NPI Status: Active since June 01, 2013

Contact Information

320 BEVERLY RANCOCAS RD STE 3M
WILLINGBORO, NJ
ZIP 08046
Phone: (609) 835-2676

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  • Individual
  • Male
  • Years of Experience 13
  • Podiatrist
  • Foot & Ankle Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About DOUGLAS APPEL

This page provides the complete NPI Profile along with additional information for Douglas Appel, a provider established in Willingboro, New Jersey with a medical specialization in Podiatrist, focusing in foot & ankle surgery and more than 13 years of experience. He graduated from Temple University School Of Podiatric Medicine in 2013. The healthcare provider is registered in the NPI registry with number 1609213537 assigned on June 2013. The practitioner's primary taxonomy code is 213ES0103X with license number 25MD00329200 (NJ). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1609213537
Provider Name
DR. DOUGLAS S APPEL D.P.M.
Gender
Male
Entity Type
Individual
Location Address
320 BEVERLY RANCOCAS RD STE 3M WILLINGBORO, NJ 08046
Location Phone
(609) 835-2676
Mailing Address
320 BEVERLY RANCOCAS RD STE 3M WILLINGBORO, NJ 08046
Mailing Phone
(609) 835-2676
Medical School Name
TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduation Year
2013
Is Sole Proprietor?
No
Enumeration Date
06-01-2013
Last Update Date
05-12-2023
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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

Podiatrist Foot & Ankle Surgery

Taxonomy Code
213ES0103X
Type
Podiatric Medicine & Surgery Service Providers
License No.
25MD00329200
License State
NJ

Insurance Plans Accepted

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

  • AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
  • AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
  • AmeriHealth Caritas Next Gold Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Essential + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Signature + No Referrals - HMO

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

Medicare Participation & PECOS Enrollment Status

Douglas Appel 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.

Douglas Appel 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) and a Home Health Agency (HHA).

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: 4082919071

    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: I20160301000509

    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: No

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.

Orthotic Devices

  • DME-Orthotic Devices (DF000N)

    For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe (HCPCS:A5500)

    1 DME suppliers used 15 Medicare Claims 30 Services Paid

  • DME-Orthotic Devices (DF000N)

    For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each (HCPCS:A5512)

    1 DME suppliers used 15 Medicare Claims 78 Services Paid

Durable Medical Equipment

  • DME-Medical/Surgical Supplies (DA023N)

    Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6446)

    2 DME suppliers used 11 Medicare Claims 1446 Services Paid

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.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 24 times for 11 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 116 times for 57 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 185 times for 185 patients

Removal of fingernails or toenails, 1-5 nails

This procedure involves the careful removal of 1-5 nails from fingers or toes. It's typically done to treat conditions like ingrown nails, fungal infections, or damaged nails. Local anesthesia is used for comfort, and the area heals over time with appropriate care.

This service was performed 133 times for 42 patients

Removal of fingernails or toenails, 6 or more nails

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

This service was performed 277 times for 103 patients

Removal of noncancer thickened skin growth, 1 growth

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

This service was performed 49 times for 25 patients

Removal of noncancer thickened skin growth, 2-4 growths

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

This service was performed 49 times for 21 patients

Trimming of fingernails or toenails

Trimming of fingernails or toenails is a simple procedure for maintaining hygiene and preventing nail-related issues. It involves cutting the nails straight across, then smoothing any sharp edges with a file. Regular nail care can help prevent infections and discomfort.

This service was performed 124 times for 39 patients

X-ray of foot, minimum of 3 views

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

This service was performed 45 times for 25 patients

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. Douglas Appel is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
DEBORAH HEART AND LUNG CENTER200 TRENTON ROAD
BROWNS MILLS, NJ 08015
(609) 893-6611Acute Care 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 1609213537, we treat the final digit (7) 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 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).

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
6
Unchanged
Pos 3
0
Doubled → 0
Pos 4
9
Unchanged
Pos 5
2
Doubled → 4
Pos 6
1
Unchanged
Pos 7
3
Doubled → 6
Pos 8
5
Unchanged
Pos 9
3
Doubled → 6
Check
7
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 0 → 0 2 → 4 3 → 6 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 0 + 9 + 4 + 1 + 6 + 5 + 6 + 24 = 63

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

The next multiple of ten after 63 is 70. The difference is the calculated check digit.

70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1609213537.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Podiatrist (Foot & Ankle Surgery)
320 BEVERLY RANCOCAS RD STE 3M
WILLINGBORO, NJ 08046

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609213537, enumerated as an "individual" on June 01, 2013.

The provider is located at 320 BEVERLY RANCOCAS RD STE 3M WILLINGBORO, NJ 08046 and the phone number is (609) 835-2676.

Podiatrist with taxonomy code 213ES0103X and a focus in Foot & Ankle Surgery.

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

Douglas Appel is affiliated with: DEBORAH HEART AND LUNG CENTER.