MS. ELS SINCEBAUGH PAC
NPI 1629124136
Physician Assistant in Rangeley, ME

NPI Status: Active since January 26, 2007

Contact Information

42 DALLAS HILL RD
RANGELEY, ME
ZIP 04970
Phone: (207) 864-3303
Fax: (207) 864-2969

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 27
Physician Assistant
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About ELS SINCEBAUGH

This page provides the complete NPI Profile along with additional information for Els Sincebaugh, a primary care provider established in Rangeley, Maine with a medical specialization in Physician Assistant and more than 27 years of experience. The healthcare provider is registered in the NPI registry with number 1629124136 assigned on January 2007. The practitioner's primary taxonomy code is 363A00000X with license number 25MP00054600 (NJ). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI: 1629124136
Provider Name: MS. ELS SINCEBAUGH PAC
Gender: Female
Entity Type: Individual
Location Address: 42 DALLAS HILL RD RANGELEY, ME 04970
Location Phone: (207) 864-3303
Location Fax: (207) 864-2969
Mailing Address: PO BOX 727 WATERVILLE, ME 04903
Mailing Phone: (207) 864-3303
Mailing Fax: (207) 864-2969
Medical School Name: OTHER
Graduation Year: 1999
Is Sole Proprietor?: No
Enumeration Date: 01-26-2007
Last Update Date: 03-11-2022
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A primary care provider (PCP) like Els Sincebaugh 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
License No.: 25MP00054600
License State: NJ
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:

Anthem Blue Cross and Blue Shield

Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 3000/0%/7500 RxD - HMO
Anthem Gold Access Blue New England HMO 500/30%/9000 - HMO
Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
Anthem Silver Access Blue New England HMO 2500/30%/10000 Value - HMO
Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
Anthem Silver Access Blue New England HMO 3500/20%/10000 - HMO
Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
Anthem Silver Access Blue New England HMO 4000/0%/9000 - HMO
Anthem Silver Access Blue New England HMO 4000/0%/9000 RxD - HMO
Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO

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

Medicare Participation & PECOS Enrollment Status

Els Sincebaugh 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.

Els Sincebaugh 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: 2567615164
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: I20211201000993
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-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
1 DME suppliers used 15 Medicare Claims 16 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.

Automated urinalysis test
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza
Hemoglobin a1c level

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $20.64 for a new patient copayment and $16.68 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 04970 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $82.58
Minimum New Patient Price $53.26
Maximum New Patient Price $162.77

Average New Patient Copayment $20.64
Minimum New Patient Copayment $13.31
Maximum New Patient Copayment $40.69

Established Patients Visit Costs *

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

Average Established Patient Price $66.74
Minimum Established Patient Price $16.9
Maximum Established Patient Price $132.79

Average Established Patient Copayment $16.68
Minimum Established Patient Copayment $4.22
Maximum Established Patient Copayment $33.19

* 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.

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 1629124136, 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 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 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 → 4

Pos 4

Unchanged

Pos 5

Doubled → 2

Pos 6

Unchanged

Pos 7

Doubled → 8

Pos 8

Unchanged

Pos 9

Doubled → 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 2 → 4 1 → 2 4 → 8 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 4 + 9 + 2 + 2 + 8 + 1 + 6 + 24 = 64

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

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6

This NPI is valid

The calculated check digit is 6, which matches the last digit of 1629124136.