DR. BENEDICTO M ESTOESTA M.D.
NPI 1649451071
Family Medicine - Adult Medicine in Valley Springs, CA

NPI Status: Active since November 14, 2007

Contact Information

55 S HIGHWAY 26 STE 1
VALLEY SPRINGS, CA
ZIP 95252
Phone: (209) 772-8906
Fax: (209) 772-8950

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  • Individual
  • Male
  • Years of Experience 43
  • Family Medicine
  • Adult Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting
  • CLIA Number: 05D1013542
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-10-2027

About BENEDICTO ESTOESTA

This page provides the complete NPI Profile along with additional information for Benedicto Estoesta, a primary care provider established in Valley Springs, California with a medical specialization in Family Medicine, focusing in adult medicine and more than 43 years of experience. The healthcare provider is registered in the NPI registry with number 1649451071 assigned on November 2007. The practitioner's primary taxonomy code is 207QA0505X with license number A49318 (CA). The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI
1649451071
Provider Name
DR. BENEDICTO M ESTOESTA M.D.
Gender
Male
Entity Type
Individual
Location Address
55 S HIGHWAY 26 STE 1 VALLEY SPRINGS, CA 95252
Location Phone
(209) 772-8906
Location Fax
(209) 772-8950
Mailing Address
55 S HIGHWAY 26 STE 1 VALLEY SPRINGS, CA 95252
Mailing Phone
(209) 772-8906
Mailing Fax
(209) 772-8950
Medical School Name
OTHER
Graduation Year
1983
Is Sole Proprietor?
No
Enumeration Date
11-14-2007
Last Update Date
11-14-2007
Code Navigator

A primary care provider (PCP) like Benedicto Estoesta 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

Family Medicine Adult Medicine

Taxonomy Code
207QA0505X
Type
Allopathic & Osteopathic Physicians
License No.
A49318
License State
CA
Taxonomy Description
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

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)
1171100000XOther Service Providers

Acupuncturist

A49318 (CA)

Insurance Plans Accepted

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

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
00A493183MEDICARE PIN (08)CA 

Medicare Participation & PECOS Enrollment Status

Benedicto Estoesta 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.

Benedicto Estoesta 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: 1456244995

    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: I20040206000621

    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 43 Medicare Claims 106 Services Paid

  • DME-Other DME (DE000N)

    Normal, low and high calibrator solution / chips (HCPCS:A4256)

    2 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    2 DME suppliers used 12 Medicare Claims 28 Services Paid

  • DME-Other DME (DE001N)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    7 DME suppliers used 23 Medicare Claims 23 Services Paid

  • DME-Other DME (DE000N)

    Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)

    2 DME suppliers used 12 Medicare Claims 24 Services Paid

  • DME-Other DME (DE001N)

    Full face mask used with positive airway pressure device, each (HCPCS:A7030)

    6 DME suppliers used 18 Medicare Claims 18 Services Paid

  • DME-Other DME (DE001N)

    Face mask interface, replacement for full face mask, each (HCPCS:A7031)

    6 DME suppliers used 20 Medicare Claims 54 Services Paid

  • DME-Other DME (DE001N)

    Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

    6 DME suppliers used 20 Medicare Claims 112 Services Paid

  • DME-Other DME (DE001N)

    Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)

    6 DME suppliers used 17 Medicare Claims 96 Services Paid

  • DME-Other DME (DE001N)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    7 DME suppliers used 41 Medicare Claims 41 Services Paid

  • DME-Other DME (DE001N)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    8 DME suppliers used 33 Medicare Claims 33 Services Paid

  • DME-Other DME (DE001N)

    Tubing used with positive airway pressure device (HCPCS:A7037)

    5 DME suppliers used 36 Medicare Claims 36 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    8 DME suppliers used 52 Medicare Claims 308 Services Paid

  • DME-Other DME (DE001N)

    Filter, non disposable, used with positive airway pressure device (HCPCS:A7039)

    5 DME suppliers used 23 Medicare Claims 23 Services Paid

  • DME-Other DME (DE001N)

    Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)

    7 DME suppliers used 21 Medicare Claims 21 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    3 DME suppliers used 55 Medicare Claims 57 Services Paid

  • DME-Other DME (DE005N)

    Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) (HCPCS:E0466)

    3 DME suppliers used 68 Medicare Claims 68 Services Paid

  • DME-Other DME (DE000N)

    High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each (HCPCS:E0483)

    2 DME suppliers used 22 Medicare Claims 22 Services Paid

  • DME-Other DME (DE000N)

    Nebulizer, with compressor (HCPCS:E0570)

    2 DME suppliers used 20 Medicare Claims 20 Services Paid

  • DME-Other DME (DE001N)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    1 DME suppliers used 15 Medicare Claims 15 Services Paid

  • 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)

    4 DME suppliers used 87 Medicare Claims 89 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    2 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Wheelchairs (DD021N)

    Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Other DME (DE000N)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    6 DME suppliers used 45 Medicare Claims 45 Services Paid

Drugs Administered Through DME

  • DME-Drugs Administered Through DME (DG006N)

    Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms (HCPCS:J7606)

    3 DME suppliers used 28 Medicare Claims 1500 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram (HCPCS:J7677)

    3 DME suppliers used 15 Medicare Claims 78750 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.

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 153 times for 153 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 969 times for 272 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 1,117 times for 290 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 88 times for 64 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.58 for a new patient copayment and $25.84 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 95252 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $90.32
  • Minimum New Patient Price $58.87
  • Maximum New Patient Price $176.6
  • Average New Patient Copayment $22.58
  • Minimum New Patient Copayment $14.71
  • Maximum New Patient Copayment $44.15

Established Patients Visit Costs *

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

  • Average Established Patient Price $103.36
  • Minimum Established Patient Price $19.28
  • Maximum Established Patient Price $144.6
  • Average Established Patient Copayment $25.84
  • Minimum Established Patient Copayment $4.82
  • Maximum Established Patient Copayment $36.15

* 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
Advance Care PlanningYesN/A
Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning.
Annual registration in the Prescription Drug Monitoring ProgramYesN/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Breast Cancer Screening 63% 359
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Consultation of the Prescription Drug Monitoring ProgramYesN/A
Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance.
Diabetes: Medical Attention for Nephropathy 57% 130
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Documentation of Current Medications in the Medical Record 77% 6033
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Engagement of patients through implementation of improvements in patient portalYesN/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
e-Prescribing 88% 14301
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Immunization Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Implementation of an ASPYesN/A
Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance
Implementation of fall screening and assessment programsYesN/A
Implementation of fall screening and assessment programs to identify patients at risk for falls and address modifiable risk factors (e.g., Clinical decision support/prompts in the electronic health record that help manage the use of medications, such as benzodiazepines, that increase fall risk).
Implementation of medication management practice improvementsYesN/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.
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet 96% 151
Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active diagnosis of ischemic vascular disease (IVD) during the measurement period, and who had documentation of use of aspirin or another antiplatelet during the measurement period
Medication Reconciliation 100% 137
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 100% 1200
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 100% 1200
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology.
Secure Messaging 1% 1200
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 AnalysisYesN/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.
Tobacco useYesN/A
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence.
Use of certified EHR to capture patient reported outcomesYesN/A
In support of improving patient access, performing additional activities that enable capture of patient reported outcomes (e.g., home blood pressure, blood glucose logs, food diaries, at-risk health factors such as tobacco or alcohol use, etc.) or patient activation measures through use of certified EHR technology, containing this data in a separate queue for clinician recognition and review.

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D1013542
Facility Type
Physician Office
Certificate Effective Date
June 11, 2025
Certificate Expiration Date
June 10, 2027
Laboratory Director
BENEDICTO M. ESTOESTA MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Benedicto Estoesta to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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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 1649451071, we treat the final digit (1) 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 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).

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
4
Doubled → 8
Pos 4
9
Unchanged
Pos 5
4
Doubled → 8
Pos 6
5
Unchanged
Pos 7
1
Doubled → 2
Pos 8
0
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
1
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 4 → 8 4 → 8 1 → 2 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 8 + 9 + 8 + 5 + 2 + 0 + 1 + 4 + 24 = 69

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

The next multiple of ten after 69 is 70. The difference is the calculated check digit.

70 - 69 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1649451071.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Family Medicine
55 S HIGHWAY 26 STE 1
VALLEY SPRINGS, CA 95252
Chiropractor
55 S HIGHWAY 26 STE 1
VALLEY SPRINGS, CA 95252

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1649451071, enumerated as an "individual" on November 14, 2007.

The provider is located at 55 S HIGHWAY 26 STE 1 VALLEY SPRINGS, CA 95252 and the phone number is (209) 772-8906.

Family Medicine with taxonomy code 207QA0505X and a focus in Adult Medicine.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.