JOSEPH LOUGHRAN M.D.
NPI 1659358232
Internal Medicine in Wilmington, DE
NPI Status: Active since December 27, 2005
Contact Information
3411 SILVERSIDE RD
WEBSTER BUILDING, SUITE 103
WILMINGTON, DE
ZIP 19810
Phone: (302) 479-8464
Fax: (302) 479-8463
- Individual
- Male
- Internal Medicine
- Accepts Insurance
- PECOS Enrolled
About JOSEPH LOUGHRAN
This page provides the complete NPI Profile along with additional information for Joseph Loughran, an internist established in Wilmington, Delaware with a medical specialization in Internal Medicine. The healthcare provider is registered in the NPI registry with number 1659358232 assigned on December 2005. The practitioner's primary taxonomy code is 207R00000X with license number C10002436 (DE). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1659358232
- Provider Name
- JOSEPH LOUGHRAN M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3411 SILVERSIDE RD WEBSTER BUILDING, SUITE 103 WILMINGTON, DE 19810
- Location Phone
- (302) 479-8464
- Location Fax
- (302) 479-8463
- Mailing Address
- 292 LONGVIEW LN KENNETT SQUARE, PA 19348
- Mailing Phone
- (302) 479-8464
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-27-2005
- Last Update Date
- 04-04-2008
- Code Navigator
An internist like Joseph Loughran is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, 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
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- C10002436
- License State
- DE
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
- AmeriHealth Caritas Next Gold Premier + No Referrals - HMO
- AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
- AmeriHealth Caritas Next Silver Essential + No Referrals - HMO
- AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
- AmeriHealth Caritas Next Silver Signature + No Referrals - 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 |
|---|---|---|---|
| G02723I16 | MEDICARE PIN (08) | DE |
Medicare Participation & PECOS Enrollment Status
Joseph Loughran 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
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.
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
New patient office or other outpatient visit, 45-59 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 12 times for 12 patientsThis 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 315 times for 244 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 49 times for 24 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 40 times for 28 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 142 times for 142 patientsPhysician Visit Costs
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 19810 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $131.15
- Minimum New Patient Price $57.12
- Maximum New Patient Price $173.08
- Average New Patient Copayment $32.78
- Minimum New Patient Copayment $14.28
- Maximum New Patient Copayment $43.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.68
- Minimum Established Patient Price $18.36
- Maximum Established Patient Price $141.05
- Average Established Patient Copayment $25.17
- Minimum Established Patient Copayment $4.59
- Maximum Established Patient Copayment $35.26
* 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 1659358232, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
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 68 is 70. 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.
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
WILMINGTON, DE 19810
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1659358232, enumerated as an "individual" on December 27, 2005.
The provider is located at 3411 SILVERSIDE RD WEBSTER BUILDING, SUITE 103 WILMINGTON, DE 19810 and the phone number is (302) 479-8464.
Internal Medicine with taxonomy code 207R00000X.
The provider might be accepting Accepts: AmeriHealth Caritas Next, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
