DR. ROY ODEM MEARS DO
NPI 1679733695
Family Medicine in Grand Jct, CO

NPI Status: Active since June 12, 2008

Contact Information

743 HORIZON CT STE 100
GRAND JCT, CO
ZIP 81506
Phone: (970) 241-7600
Fax: (970) 245-9094

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  • Individual
  • Male
  • Years of Experience 17
  • Family Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About ROY MEARS

Roy Mears is a primary care provider established in Grand Jct, Colorado and his medical specialization is Family Medicine with more than 17 years of experience. The healthcare provider is registered in the NPI registry with number 1679733695 assigned on June 2008. The practitioner's primary taxonomy code is 207Q00000X with license number 5101017759 (MI). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1679733695
Provider Name
DR. ROY ODEM MEARS DO
Gender
Male
Entity Type
Individual
Location Address
743 HORIZON CT STE 100 GRAND JCT, CO 81506
Location Phone
(970) 241-7600
Location Fax
(970) 245-9094
Mailing Address
PO BOX 1727 GRAND JUNCTION, CO 81502
Mailing Phone
(970) 241-7600
Mailing Fax
(970) 245-9094
Medical School Name
OTHER
Graduation Year
2008
Is Sole Proprietor?
No
Enumeration Date
06-12-2008
Last Update Date
11-24-2021
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A primary care provider (PCP) like Roy Mears 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

Roy Mears 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.

The typical physician office visit costs for Medicare beneficiaries in this area are: $23.01 for a new patient copayment and $26.58 for an established patient copayment.

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

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
5101017759
License State
MI
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

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

  • Molina Healthcare

    • Gold 1 - HMO
    • Gold 1 with Adult Vision Services - HMO
    • Gold 8 - HMO
    • Silver 1 - HMO
    • Silver 1 250 - HMO
    • Silver 1 250 with Adult Vision Services - HMO
    • Silver 1 with Adult Vision Services - HMO
    • Silver 12 - HMO
    • Silver 12 250 with First 4 Primary Care Visits Free - HMO
    • Silver 12 with First 4 Primary Care Visits Free - HMO
    • Silver 3 250 - HMO
    • Silver 8 - HMO
    • Silver 8 250 - HMO
  • University of Utah Health Plans

    • Healthy Premier Bronze HSA - EPO
    • Healthy Premier Bronze w.3 Copays - EPO
    • Healthy Premier Expanded Bronze - EPO
    • Healthy Premier Expanded Bronze Standard - EPO
    • Healthy Premier Expanded Bronze Standard Choice - EPO
    • Healthy Premier Gold Copay - EPO
    • Healthy Premier Gold Standard - EPO
    • Healthy Premier Silver Copay - EPO
    • Healthy Premier Silver Standard - EPO
  • Medicare

  • Medicaid


*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
50421OTHER (01)COSTATE MEDICAL LICENSE
99830248MEDICAID (05)CO 

PECOS Enrollment and Medicare Participation Status

Roy Mears 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: 6800044009

    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: I20120913000075

    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

  • Other DME (D1E)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    5 DME suppliers used 11 Medicare Claims 38 Services Paid

  • Other DME (D1E)

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

    4 DME suppliers used 12 Medicare Claims 61 Services Paid

  • Oxygen and supplies (D1C)

    Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing (HCPCS:E0434)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Oxygen and supplies (D1C)

    Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing (HCPCS:E0439)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Other DME (D1E)

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

    4 DME suppliers used 28 Medicare Claims 28 Services Paid

  • Oxygen and supplies (D1C)

    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 29 Medicare Claims 29 Services Paid

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 81506 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $92.04
  • Minimum New Patient Price $60.06
  • Maximum New Patient Price $181
  • Average New Patient Copayment $23.01
  • Minimum New Patient Copayment $15.01
  • Maximum New Patient Copayment $45.25

Established Patients Visit Costs *

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

  • Average Established Patient Price $106.32
  • Minimum Established Patient Price $18.98
  • Maximum Established Patient Price $148.2
  • Average Established Patient Copayment $26.58
  • Minimum Established Patient Copayment $4.74
  • Maximum Established Patient Copayment $37.05

* 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.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 52

    Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

  • 40

    Hemoglobin a1c level (HCPCS:83036)

  • 38

    Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Roy Mears is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ST MARYS MEDICAL CENTER2635 N 7TH ST
GRAND JUNCTION, CO 81501
(970) 298-1950Acute Care Hospitals
COMMUNITY HOSPITAL2351 'G' RD
GRAND JUNCTION, CO 81505
(970) 644-3020Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1679733695
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
261491436618
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 4 + 9 + 1 + 4 + 3 + 6 + 6 + 1 + 8 + 24 = 75
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 75 = 55

The NPI number 1679733695 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1790906261 MELISSA A SCHMALZ DO
Individual
Family Medicine743 HORIZON CT STE 100
GRAND JCT, CO 81506
(970) 241-7600
1720736937GRAND VALLEY ORTHOPEDICS
Organization
Specialist743 HORIZON CT STE 100
GRAND JCT, CO 81506
(970) 644-4010
1336807932WESTERN MEDICAL ASSOCIATES, P.C.
Organization
Clinic/Center (Multi-Specialty)743 HORIZON CT STE 100
GRAND JUNCTION, CO 81506
(970) 256-8504
1629858857COMMUNITY MEDICAL GROUP
Organization
Family Medicine743 HORIZON CT STE 100
GRAND JCT, CO 81506
(970) 241-7600

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1679733695, enumerated in the NPI registry as an "individual" on June 12, 2008

The provider is located at 743 Horizon Ct Ste 100 Grand Jct, Co 81506 and the phone number is (970) 241-7600

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 17 years of experience.

The provider might be accepting Accepts: Molina Healthcare, University of Utah Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of July 02, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

Medicare beneficiaries should expect a typical cost of $92.04 with an average copayment of $23.01 for new patient appointments. Established patients should expect a typical charge of $106.32 and an average copayment of 26.58. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Hemoglobin a1c level and Injection beneath the skin or into muscle for therapy, diagnosis, or prevention.

The practitioner is affiliated to the following hospital(s): ST MARYS MEDICAL CENTER and COMMUNITY HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 12, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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