EDIFEL N MACATUNO M.D.
NPI 1649219585
Pediatrics - Adolescent Medicine in Spartanburg, SC
NPI Status: Active since June 06, 2006
Contact Information
101 E WOOD ST
SPARTANBURG, SC
ZIP 29303
Phone: (864) 560-6287
Fax: (864) 560-7091
- Individual
- Male
- Pediatrics
- Adolescent Medicine
- Accepts Insurance
- PECOS Enrolled
About EDIFEL MACATUNO
This page provides the complete NPI Profile along with additional information for Edifel Macatuno, a pediatrician established in Spartanburg, South Carolina with a medical specialization in Pediatrics, focusing in adolescent medicine . The healthcare provider is registered in the NPI registry with number 1649219585 assigned on June 2006. The practitioner's primary taxonomy code is 2080A0000X with license number 23575 (SC). The provider is registered as an individual and his NPI record was last updated 5 years ago.
- NPI
- 1649219585
- Provider Name
- EDIFEL N MACATUNO M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 101 E WOOD ST SPARTANBURG, SC 29303
- Location Phone
- (864) 560-6287
- Location Fax
- (864) 560-7091
- Mailing Address
- PO BOX 743070 ATLANTA, GA 30374
- Mailing Phone
- (864) 560-4304
- Mailing Fax
- (864) 560-7091
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-06-2006
- Last Update Date
- 02-04-2021
- Code Navigator
A pediatrician like Edifel Macatuno is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, 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
Pediatrics Adolescent Medicine
- Taxonomy Code
- 2080A0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 23575
- License State
- SC
- Taxonomy Description
- A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
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 | 2080A0000X | Allopathic & Osteopathic Physicians | Pediatrics | M23575 (SC) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Gold - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - 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
- First Choice Next Bronze Essential - HMO
- First Choice Next Bronze Premier - HMO
- First Choice Next Bronze Signature - HMO
- First Choice Next Gold Premier - HMO
- First Choice Next Gold Signature - HMO
- First Choice Next Silver Essential - HMO
- First Choice Next Silver Premier - HMO
- First Choice Next Silver Signature - HMO
- InHealth Basic 1 - HMO
- InHealth Basic 1 + Adult Vision - HMO
- InHealth Basic 2 - HMO
- InHealth Basic Plus Standard - HMO
- InHealth Basic Standard - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Core 1640 Plus with Adult Vision - HMO
- Molina Gold Standard - HMO
- Molina Gold Value - HMO
- Molina Gold Value Plus with Adult Dental and Vision - HMO
- Molina Gold Value Plus with Adult Vision - HMO
- Molina Silver Core - HMO
- Molina Silver Core Plus with Adult Dental and Vision - HMO
- Molina Silver Core Plus with Adult Vision - 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 |
|---|---|---|---|
| 235757 | MEDICAID (05) | SC | |
| SCC508J577 | OTHER (01) | SC | MEDICARE PIN |
| SCC508H895 | OTHER (01) | SC | MEDICARE PIN |
| SCC5085019 | OTHER (01) | SC | MEDICARE PIN |
Medicare Participation & PECOS Enrollment Status
Edifel Macatuno 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
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
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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 1649219585, we treat the final digit (5) 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 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).
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 75 is 80. 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.
SPARTANBURG, SC 29303
SPARTANBURG, SC 29303
SPARTANBURG, SC 29303
SPARTANBURG, SC 29303
SPARTANBURG, SC 29303
SPARTANBURG, SC 29303
SPARTANBURG, SC 29303
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1649219585, enumerated as an "individual" on June 06, 2006.
The provider is located at 101 E WOOD ST SPARTANBURG, SC 29303 and the phone number is (864) 560-6287.
Pediatrics with taxonomy code 2080A0000X and a focus in Adolescent Medicine.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.
