LACEY CAROLINE GARDNER PA-C
NPI 1679758254
Physician Assistant in Mount Pleasant, MI

NPI Status: Active since January 02, 2008

Contact Information

1970 ASHLAND DR
MOUNT PLEASANT, MI
ZIP 48858
Phone: (989) 779-5262
Fax: (989) 772-6784

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  • Individual
  • Female
  • Physician Assistant
  • Accepts Insurance
  • PECOS Enrolled
  • Medicare Quality Reporting

About LACEY GARDNER

This page provides the complete NPI Profile along with additional information for Lacey Gardner, a primary care provider established in Mount Pleasant, Michigan with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1679758254 assigned on January 2008. The practitioner's primary taxonomy code is 363A00000X with license number 5601005080 (MI). The provider is registered as an individual and her NPI record was last updated 13 years ago.

NPI
1679758254
Provider Name
LACEY CAROLINE GARDNER PA-C
Gender
Female
Entity Type
Individual
Location Address
1970 ASHLAND DR MOUNT PLEASANT, MI 48858
Location Phone
(989) 779-5262
Location Fax
(989) 772-6784
Mailing Address
1970 ASHLAND DR MOUNT PLEASANT, MI 48858
Mailing Phone
(989) 779-5262
Mailing Fax
(989) 772-6784
Is Sole Proprietor?
No
Enumeration Date
01-02-2008
Last Update Date
02-27-2013
Code Navigator

A primary care provider (PCP) like Lacey Gardner 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

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
5601005080
License State
MI
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

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

  • Blue Cross� Preferred HMO Bronze Extra - HMO
  • Blue Cross� Preferred HMO Bronze Saver HSA - HMO
  • Blue Cross� Preferred HMO Bronze Secure - HMO
  • Blue Cross� Preferred HMO Gold - HMO
  • Blue Cross� Preferred HMO Gold Extra - HMO
  • Blue Cross� Preferred HMO Silver - HMO
  • Blue Cross� Preferred HMO Silver Extra - HMO
  • Blue Cross� Preferred HMO Silver Saver - HMO
  • Blue Cross� Preferred HMO Value - HMO
  • Blue Cross� Select HMO Bronze Extra - HMO
  • Blue Cross� Premier PPO Bronze Extra - PPO
  • Blue Cross� Premier PPO Bronze Saver HSA - PPO
  • Blue Cross� Premier PPO Bronze Secure - PPO
  • Blue Cross� Premier PPO Gold - PPO
  • Blue Cross� Premier PPO Gold Extra - PPO
  • Blue Cross� Premier PPO Silver - PPO
  • Blue Cross� Premier PPO Silver Extra - PPO
  • Blue Cross� Premier PPO Silver Saver HSA - PPO
  • Blue Cross� Premier PPO Value - PPO
  • MHP Bronze - HMO
  • MHP Bronze Saver (Expanded) - HMO
  • MHP Expanded Bronze Standard - HMO
  • MHP Gold - HMO
  • MHP Gold Standard - HMO
  • MHP Silver Exchange - HMO
  • MHP Silver Exchange Rewards - HMO
  • MHP Silver Standard - HMO
  • MHP Young Adult/Catastrophic - HMO
  • MyPriority Balanced Silver - HMO
  • MyPriority Premier Silver - HMO
  • MyPriority Standard Bronze - HMO
  • MyPriority Standard Bronze - Travel - HMO
  • MyPriority Standard Gold - HMO
  • MyPriority Standard Silver - HMO
  • MyPriority Standard Silver - Travel - HMO
  • MyPriority Value Bronze - HMO
  • MyPriority Value Bronze HSA - 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.

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
Z96017093MEDICARE PIN (08)MI 
080B610040OTHER (01)MIBCBS
MI1118002MEDICARE PIN (08)MI 
010Z960170OTHER (01)MIBLUE CROSS BLUE SHIELD
0Z96017OTHER (01)MIMEDICARE PTAN
0Z96017OTHER (01)MIMEDICARE GROUP
MI1118OTHER (01)MIMEDICARE GROUP NUMBER
0P43930OTHER (01)MIMEDICARE GROUP NUMBER
P43930004MEDICARE PIN (08)MI 

Medicare Participation & PECOS Enrollment Status

Lacey Gardner 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

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)

    6 DME suppliers used 12 Medicare Claims 52 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.

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 12 times for 12 patients

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 48858 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $84.74
  • Minimum New Patient Price $54.34
  • Maximum New Patient Price $166.68
  • Average New Patient Copayment $21.18
  • Minimum New Patient Copayment $13.58
  • Maximum New Patient Copayment $41.67

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $68.07
  • Minimum Established Patient Price $17.09
  • Maximum Established Patient Price $135.4
  • Average Established Patient Copayment $17.01
  • Minimum Established Patient Copayment $4.27
  • Maximum Established Patient Copayment $33.85

* 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
Closing the Referral Loop: Receipt of Specialist Report 69% 210
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
Diabetes: Foot Exam 58% 135
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
Documentation of Current Medications in the Medical Record 91% 1984
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
Falls: Screening for Future Fall Risk 53% 157
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Pneumococcal Vaccination Status for Older Adults 85% 157
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 81% 914
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Influenza Immunization 45% 652
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Preventive Care and Screening: Screening for Depression and Follow-Up Plan 80% 540
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 40% 761
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Use of High-Risk Medications in the Elderly 6% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
157
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication

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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 1679758254, we treat the final digit (4) 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 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

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
7
Doubled → 14 → 1 + 4
Pos 4
9
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
5
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
2
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
4
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 7 → 14 → 5 7 → 14 → 5 8 → 16 → 7 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 1 + 4 + 9 + 1 + 4 + 5 + 1 + 6 + 2 + 1 + 0 + 24 = 66

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

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1679758254.

Other Providers at the Same Location


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

Pediatrics
1970 ASHLAND DR
MT PLEASANT, MI 48858
Physician Assistant
1970 ASHLAND DR
MT PLEASANT, MI 48858
Nurse Practitioner (Primary Care)
1970 ASHLAND DR
MOUNT PLEASANT, MI 48858
Obstetrics & Gynecology
1970 ASHLAND DR
MT PLEASANT, MI 48858

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1679758254, enumerated as an "individual" on January 02, 2008.

The provider is located at 1970 ASHLAND DR MOUNT PLEASANT, MI 48858 and the phone number is (989) 779-5262.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.