REBECCA SWOFFORD PA-C
NPI 1609220086
Physician Assistant in Varnville, SC

NPI Status: Active since April 21, 2016

Contact Information

1000 PINE ST W
VARNVILLE, SC
ZIP 29944
Phone: (803) 943-5228

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Durable Medical Equipment
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 10
Physician Assistant
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About REBECCA SWOFFORD

This page provides the complete NPI Profile along with additional information for Rebecca Swofford, a primary care provider established in Varnville, South Carolina with a medical specialization in Physician Assistant and more than 10 years of experience. The healthcare provider is registered in the NPI registry with number 1609220086 assigned on April 2016. The practitioner's primary taxonomy code is 363A00000X. The provider is registered as an individual and her NPI record was last updated 7 years ago.

NPI: 1609220086
Provider Name: REBECCA SWOFFORD PA-C
Other Name: REBECCA KOGER
Other Name Type: Former Name (1)
Gender: Female
Entity Type: Individual
Location Address: 1000 PINE ST W VARNVILLE, SC 29944
Location Phone: (803) 943-5228
Mailing Address: 1000 PINE ST W VARNVILLE, SC 29944
Mailing Phone: (803) 943-5228
Medical School Name: OTHER
Graduation Year: 2016
Is Sole Proprietor?: No
Enumeration Date: 04-21-2016
Last Update Date: 10-10-2019
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A primary care provider (PCP) like Rebecca Swofford 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
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:

BlueCross BlueShield of South Carolina

Blue Beaufort Bronze 1 - HMO
Blue Beaufort Bronze 2 - HMO
Blue Beaufort Gold 1 - HMO
Blue Beaufort Silver 1 - HMO
Blue Beaufort Silver 2 - HMO
Blue Beaufort Silver 2 + Adult Vision - HMO
Blue Beaufort Standard Expanded Bronze - HMO
Blue Beaufort Standard Gold - HMO
Blue Beaufort Standard Silver - HMO
Blue Direction Bronze 1 - POS
Blue Direction Silver 1 - POS
Blue Direction Silver 1 + Adult Vision - POS
Blue Direction Silver 2 - POS
Blue Direction Standard Expanded Bronze - POS
Blue Direction Standard Gold - POS
Blue Direction Standard Silver - POS
Blue VirtuConnect Bronze 1 - EPO
Blue VirtuConnect Gold 1 - EPO
Blue VirtuConnect Silver 1 - EPO
BlueEssentials Bronze 4 - EPO

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded - HMO
UHC Bronze Copay Focus+ $0 Indiv Med Ded (Dental + Vision) - HMO
UHC Bronze Essential - HMO
UHC Bronze Essential- - HMO
UHC Bronze Standard - HMO
UHC Bronze Standard Plus Chiro - HMO
UHC Gold Advantage - HMO
UHC Gold Advantage+ (Dental + Vision) - HMO
UHC Gold Copay Focus $0 Indiv Med Ded - HMO
UHC Gold Standard - HMO
UHC Gold Standard Plus Chiro - HMO
UHC Silver Advantage - HMO
UHC Silver Advantage+ (Dental + Vision) - HMO
UHC Silver Copay Focus $0 Indiv Med Ded - HMO
UHC Silver Standard - HMO
UHC Silver Standard- - HMO
UHC Silver Standard Plus Chiro - HMO

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

Medicare Participation & PECOS Enrollment Status

Rebecca Swofford 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.

Rebecca Swofford 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: 648544965
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: I20170925002047
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

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.

Durable Medical Equipment

DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
5 DME suppliers used 25 Medicare Claims 52 Services Paid
DME-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
3 DME suppliers used 16 Medicare Claims 16 Services Paid
DME-Other DME (DE001N)
Full face mask used with positive airway pressure device, each (HCPCS:A7030)
4 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE001N)
Face mask interface, replacement for full face mask, each (HCPCS:A7031)
4 DME suppliers used 13 Medicare Claims 32 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
3 DME suppliers used 19 Medicare Claims 114 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
1 DME suppliers used 31 Medicare Claims 31 Services Paid
DME-Wheelchairs (DD000N)
Standard hemi (low seat) wheelchair (HCPCS:K0002)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Wheelchairs (DD021N)
Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
2 DME suppliers used 12 Medicare Claims 12 Services Paid

Unknown

Other-Enteral and Parenteral (OB006N)
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4034)
1 DME suppliers used 11 Medicare Claims 341 Services Paid

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $20.79 for a new patient copayment and $16.78 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 29944 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $83.18
Minimum New Patient Price $53.57
Maximum New Patient Price $163.84

Average New Patient Copayment $20.79
Minimum New Patient Copayment $13.39
Maximum New Patient Copayment $40.96

Established Patients Visit Costs *

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

Average Established Patient Price $67.12
Minimum Established Patient Price $16.96
Maximum Established Patient Price $133.52

Average Established Patient Copayment $16.78
Minimum Established Patient Copayment $4.24
Maximum Established Patient Copayment $33.38

* 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.

Quality 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
e-Prescribing	95%	3839
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange	55%	229
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
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.
Patient-Specific Education	41%	59
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access	36%	59
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	14%	59
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
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.

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. Rebecca Swofford is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type
BEAUFORT COUNTY MEMORIAL HOSPITAL	955 RIBAUT RD BEAUFORT, SC 29902	(843) 522-5200	Acute Care Hospitals
HAMPTON REGIONAL MEDICAL CENTER	595 WEST CAROLINA AVENUE VARNVILLE, SC 29944	(803) 943-2771	Acute Care Hospitals
ALLENDALE COUNTY HOSPITAL	1787 ALLENDALE FAIRFAX RD FAIRFAX, SC 29827	(803) 632-3311	Critical Access Hospitals

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 1609220086, 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 0

Pos 4

Unchanged

Pos 5

Doubled → 4

Pos 6

Unchanged

Pos 7

Doubled → 0

Pos 8

Unchanged

Pos 9

Doubled → 16 → 1 + 6

Check

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 0 → 0 8 → 16 → 7

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 + 2 + 0 + 0 + 1 + 6 + 24 = 54

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

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6

This NPI is valid

The calculated check digit is 6, which matches the last digit of 1609220086.