DR. JOSEPH J. MELVIN DO
NPI 1609829936
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Philadelphia, PA

NPI Status: Active since May 18, 2006

Contact Information

160 E ERIE AVE
ST CHRISTOPHER'S HOSPITAL FOR CHILDREN NEUROLOGY
PHILADELPHIA, PA
ZIP 19134
Phone: (215) 427-5470
Fax: (215) 427-4393

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  • Individual
  • Male
  • Years of Experience 36
  • Psychiatry & Neurology
  • Neurology with Special Qualifications in...
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JOSEPH MELVIN

This page provides the complete NPI Profile along with additional information for Joseph Melvin, a provider established in Philadelphia, Pennsylvania with a medical specialization in Psychiatry & Neurology, focusing in neurology with special qualifications in child neurology and more than 36 years of experience. He graduated from Philadelphia College Of Osteopathic Medicine in 1990. The healthcare provider is registered in the NPI registry with number 1609829936 assigned on May 2006. The practitioner's primary taxonomy code is 2084N0402X with license number OS008444L (PA). The provider is registered as an individual and his NPI record was last updated 10 years ago.

NPI
1609829936
Provider Name
DR. JOSEPH J. MELVIN DO
Gender
Male
Entity Type
Individual
Location Address
160 E ERIE AVE ST CHRISTOPHER'S HOSPITAL FOR CHILDREN NEUROLOGY PHILADELPHIA, PA 19134
Location Phone
(215) 427-5470
Location Fax
(215) 427-4393
Mailing Address
160 EAST ERIE AVE ST CHRISTOPHER'S HOSPITAL FOR CHILDREN NEUROLOGY PHILADELPHIA, PA 19134
Mailing Phone
(215) 427-5470
Mailing Fax
(215) 427-4393
Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year
1990
Is Sole Proprietor?
No
Enumeration Date
05-18-2006
Last Update Date
09-07-2016
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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

Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology

Taxonomy Code
2084N0402X
Type
Allopathic & Osteopathic Physicians
License No.
OS008444L
License State
PA
Taxonomy Description
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.

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
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - 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
G48112MEDICARE UPIN (02)PA 
0013624130003MEDICAID (05)PA 

Medicare Participation & PECOS Enrollment Status

Joseph Melvin 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.

Joseph Melvin 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: 1456252006

    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: I20040116000217

    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: $34.29 for a new patient copayment and $26.3 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 19134 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $137.17
  • Minimum New Patient Price $59.88
  • Maximum New Patient Price $180.99
  • Average New Patient Copayment $34.29
  • Minimum New Patient Copayment $14.97
  • Maximum New Patient Copayment $45.24

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $105.21
  • Minimum Established Patient Price $19.3
  • Maximum Established Patient Price $147.29
  • Average Established Patient Copayment $26.3
  • Minimum Established Patient Copayment $4.82
  • Maximum Established Patient Copayment $36.82

* 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 1609829936, 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 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 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
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
0
Doubled → 0
Pos 4
9
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
9
Unchanged
Pos 9
3
Doubled → 6
Check
6
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 8 → 16 → 7 9 → 18 → 9 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 + 1 + 6 + 2 + 1 + 8 + 9 + 6 + 24 = 74

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

The next multiple of ten after 74 is 80. The difference is the calculated check digit.

80 - 74 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1609829936.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
160 E ERIE AVE, PULMONARY
PHILADELPHIA, PA 19134
Nurse Practitioner (Pediatrics)
160 E ERIE AVE
PHILADELPHIA, PA 19134
Pediatrics (Pediatric Critical Care Medicine)
160 E ERIE AVE
PHILADELPHIA, PA 19134
Dietitian, Registered
160 E ERIE AVE
PHILADELPHIA, PA 19134
Social Worker
160 E ERIE AVE
PHILADELPHIA, PA 19134
Pediatrics (Pediatric Cardiology)
160 E ERIE AVE
PHILADELPHIA, PA 19134
Pediatrics (Pediatric Cardiology)
160 E ERIE AVE
PHILADELPHIA, PA 19134
Pediatrics
160 E ERIE AVE
PHILADELPHIA, PA 19134
Pediatrics
160 E ERIE AVE
PHILADELPHIA, PA 19134
Pediatrics
160 E ERIE AVE
PHILADELPHIA, PA 19134
Pediatrics
160 E ERIE AVE
PHILADELPHIA, PA 19134
General Acute Care Hospital (Children)
160 E ERIE AVE
PHILADELPHIA, PA 19134
Pediatrics
160 E ERIE AVE
PHILADELPHIA, PA 19134
Pediatrics
160 E ERIE AVE
PHILADELPHIA, PA 19134
Pediatrics
160 E ERIE AVE
PHILADELPHIA, PA 19134
Psychologist (Clinical)
160 E ERIE AVE, ST. CHRISTOPHER'S HOSPITAL
PHILADELPHIA, PA 19134
Nurse Practitioner (Pediatrics)
160 E ERIE AVE
PHILADELPHIA, PA 19134
Nurse Practitioner (Primary Care)
160 E ERIE AVE
PHILADELPHIA, PA 19134
Pediatrics (Pediatric Cardiology)
160 E ERIE AVE
PHILADELPHIA, PA 19134
Radiology (Diagnostic Neuroimaging)
160 E ERIE AVE
PHILADELPHIA, PA 19134

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609829936, enumerated as an "individual" on May 18, 2006.

The provider is located at 160 E ERIE AVE ST CHRISTOPHER'S HOSPITAL FOR CHILDREN NEUROLOGY PHILADELPHIA, PA 19134 and the phone number is (215) 427-5470.

Psychiatry & Neurology with taxonomy code 2084N0402X and a focus in Neurology with Special Qualifications in Child Neurology.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter. Please consult your insurance carrier or call the provider to verify.