NORTHCOAST HEALTH CARE MANAGEMENT SERVICES
NPI 1710206917
Exclusive Provider Organization in Richfield, OH

NPI Status: Active since May 27, 2010

Contact Information

4199 KINROSS LAKES PKWY STE 220
RICHFIELD, OH
ZIP 44286
Phone: (440) 212-8828

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Authorized Official
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Exclusive Provider Organization
Accepts Insurance

About NORTHCOAST HEALTH CARE MANAGEMENT SERVICES

This page provides the complete NPI Profile along with additional information for Northcoast Health Care Management Services, a provider established in Richfield, Ohio operating as a Exclusive Provider Organization. The healthcare provider is registered in the NPI registry with number 1710206917 assigned on May 2010. The practitioner's primary taxonomy code is 302F00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Amy Marie Konopka (Evp Business Development)

NPI: 1710206917
Provider Name: NORTHCOAST HEALTH CARE MANAGEMENT SERVICES
Entity Type: Organization
Location Address: 4199 KINROSS LAKES PKWY STE 220 RICHFIELD, OH 44286
Location Phone: (440) 212-8828
Mailing Address: 4199 KINROSS LAKES PKWY STE 220 RICHFIELD, OH 44286
Mailing Phone: (440) 212-8828
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 05-27-2010
Last Update Date: 12-01-2021
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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: Exclusive Provider Organization
Taxonomy Code: 302F00000X
Type: Managed Care Organizations
Taxonomy Description: (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.

Insurance Plans Accepted

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

Anthem Blue Cross and Blue Shield

Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway 8500 for HSA - HMO
Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Heart Healthy Bronze Pathway 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Heart Healthy Silver Pathway 5000 ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Silver Pathway 4000 ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Silver Pathway 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Silver Pathway 5500 for HSA - HMO
Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO

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

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: AMY MARIE KONOPKA
Authorized Official Title: EVP BUSINESS DEVELOPMENT
Authorized Official Phone: (216) 591-2000

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 1710206917, we treat the final digit (7) 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

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 → 2

Pos 4

Unchanged

Pos 5

Doubled → 4

Pos 6

Unchanged

Pos 7

Doubled → 12 → 1 + 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 1 → 2 2 → 4 6 → 12 → 3 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 7 + 2 + 0 + 4 + 0 + 1 + 2 + 9 + 2 + 24 = 53

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

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7

This NPI is valid

The calculated check digit is 7, which matches the last digit of 1710206917.