DR. HOLLY KAI BREEDEN MD
NPI 1669961918
Pediatrics - Pediatric Gastroenterology in Austin, TX

NPI Status: Active since May 02, 2018

Contact Information

9835 N LAKE CREEK PKWY
AUSTIN, TX
ZIP 78717
Phone: (737) 229-2000

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

Individual
Female
Pediatrics
Pediatric Gastroenterology
Accepts Insurance
PECOS Enrolled

About HOLLY BREEDEN

This page provides the complete NPI Profile along with additional information for Holly Breeden, a pediatrician established in Austin, Texas with a medical specialization in Pediatrics, focusing in pediatric gastroenterology . The healthcare provider is registered in the NPI registry with number 1669961918 assigned on May 2018. The practitioner's primary taxonomy code is 2080P0206X with license number V2443 (TX). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI: 1669961918
Provider Name: DR. HOLLY KAI BREEDEN MD
Gender: Female
Entity Type: Individual
Location Address: 9835 N LAKE CREEK PKWY AUSTIN, TX 78717
Location Phone: (737) 229-2000
Mailing Address: 9835 N LAKE CREEK PKWY AUSTIN, TX 78717
Is Sole Proprietor?: No
Enumeration Date: 05-02-2018
Last Update Date: 07-08-2024
Code Navigator

A pediatrician like Holly Breeden 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 Pediatric Gastroenterology
Taxonomy Code: 2080P0206X
Type: Allopathic & Osteopathic Physicians
License No.: V2443
License State: TX
Taxonomy Description: A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.

Insurance Plans Accepted

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

Baylor Scott and White Health Plan

BSW Diabetes Care Gold HMO 014 - HMO
BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
BSW Elite Gold HMO 004 - HMO
BSW Elite Gold HMO 012 - HMO
BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
BSW Prime Silver HMO 008 - HMO
BSW Prime Silver HMO 005 - HMO
BSW Savers Bronze HMO H S A 006 - HMO
BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
BSW Savers Bronze HMO H S A 009 - HMO

Blue Cross and Blue Shield of Louisiana

Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible - PPO
Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits - PPO
Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits - PPO
Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible - PPO
Blue Max Copay (PCP) 60/40 $6000 Standardized - PPO
Blue Max Copay (PCP) 75/55 $2000 Standardized - PPO
Blue Saver 60/40 $6100 - PPO
Blue Saver 90/70 $3400 - PPO

HMO Louisiana

Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits - POS
Precision Blue 80/60 $3200 with 2 $0 PCP Virtual Visits (BR) - POS
Precision Blue 80/60 $3200 with 2 $0 PCP Virtual Visits (M) - POS
Precision Blue 90/70 $9900 with 2 $0 PCP Virtual Visits (M) HSA Eligible - POS

Moda Health Plan, Inc.

Moda Select Alaska Bronze 6500 - PPO
Moda Select Alaska Bronze HDHP 5500 - PPO
Moda Select Alaska Gold 1500 - PPO
Moda Select Alaska Silver 4500 - PPO
Moda Select Alaska Standard Bronze - PPO
Moda Select Alaska Standard Gold - PPO
Moda Select Alaska Standard Silver - PPO
Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
Moda Select Texas Bronze HDHP 7500 - EPO
Moda Select Texas Standard Bronze - EPO

Molina Healthcare

Molina Gold Standard - HMO
Molina Silver Standard - HMO

Sendero Health Plans, Local Nonprofit

Sendero Health Austin512 Silver / $40 PCP / $75 Specialist / $15 Generic Drugs / $0 Deductible - HMO
Sendero Health Capital Silver / $40 PCP / $80 Specialist / $20 Generic Drugs - HMO
Sendero Health Hill Country Gold / $30 PCP / $60 Specialist / $15 Generic Drugs - HMO
Sendero Health Original Silver / $20 PCP + 2 $0 PCP Visits / $10 Generic Drugs - HMO
Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs - HMO
Sendero Health Quality Care Bronze High Deductible / $50 PCP / $25 Generic Drugs / $100 Specialist - HMO
Sendero Health Real Gold / $350 Deductible - HMO

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

Medicare Participation & PECOS Enrollment Status

Holly Breeden 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

Physician 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 78717 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $126.4
Minimum New Patient Price $54.84
Maximum New Patient Price $166.88

Average New Patient Copayment $31.6
Minimum New Patient Copayment $13.71
Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

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

Average Established Patient Price $97.05
Minimum Established Patient Price $17.52
Maximum Established Patient Price $136.11

Average Established Patient Copayment $24.26
Minimum Established Patient Copayment $4.38
Maximum Established Patient Copayment $34.02

* 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 1669961918, we treat the final digit (8) 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 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).

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 → 12 → 1 + 2

Pos 4

Unchanged

Pos 5

Doubled → 18 → 1 + 8

Pos 6

Unchanged

Pos 7

Doubled → 2

Pos 8

Unchanged

Pos 9

Doubled → 2

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 6 → 12 → 3 9 → 18 → 9 1 → 2 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 1 + 2 + 9 + 1 + 8 + 6 + 2 + 9 + 2 + 24 = 72

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

The next multiple of ten after 72 is 80. The difference is the calculated check digit.

80 - 72 = 8

This NPI is valid

The calculated check digit is 8, which matches the last digit of 1669961918.