PETE CAPLES M.D.
NPI 1720065766
Internal Medicine - Cardiovascular Disease in Cincinnati, OH
NPI Status: Active since December 30, 2005
Contact Information
10506 MONTGOMERY RD
SUITE 504
CINCINNATI, OH
ZIP 45242
Phone: (513) 792-7800
Fax: (513) 792-7807
- Individual
- Male
- Internal Medicine
- Cardiovascular Disease
- PECOS Enrolled
- Medicare Quality Reporting
About PETE CAPLES
This page provides the complete NPI Profile along with additional information for Pete Caples, an internist established in Cincinnati, Ohio with a medical specialization in Internal Medicine, focusing in cardiovascular disease . The healthcare provider is registered in the NPI registry with number 1720065766 assigned on December 2005. The practitioner's primary taxonomy code is 207RC0000X with license number 35039198 (OH). The provider is registered as an individual and his NPI record was last updated 12 years ago.
- NPI
- 1720065766
- Provider Name
- PETE CAPLES M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 10506 MONTGOMERY RD SUITE 504 CINCINNATI, OH 45242
- Location Phone
- (513) 792-7800
- Location Fax
- (513) 792-7807
- Mailing Address
- 237 WILLIAM HOWARD TAFT RD 2ND FLOOR, CBO 2-3 CINCINNATI, OH 45219
- Mailing Phone
- (513) 792-7800
- Mailing Fax
- (513) 792-7807
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-30-2005
- Last Update Date
- 11-17-2014
- Code Navigator
An internist like Pete Caples 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 Cardiovascular Disease
- Taxonomy Code
- 207RC0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 35039198
- License State
- OH
- Taxonomy Description
- An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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.
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.
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 |
|---|---|---|---|
| 25-20406 | OTHER (01) | UNITED HEALTHCARE | |
| 0392089 | MEDICAID (05) | OH | |
| 64769607 | MEDICAID (05) | KY | |
| 0896402 | MEDICARE PIN (08) | OH | |
| 000000019724 | OTHER (01) | OH | ANTHEM |
| 110061528 | OTHER (01) | OH | RR MEDICARE |
| 0896409 | MEDICARE PIN (08) | OH | |
| 06003202 | OTHER (01) | RAILROAD MEDICARE | |
| 0641442 | OTHER (01) | OH | AETNA |
| 311438871076 | OTHER (01) | OH | CARESOURCE MEDICAID OH |
| 100335950 | MEDICAID (05) | IN | |
| 0426466 | MEDICARE PIN (08) | OH | |
| 283761 | OTHER (01) | OH | AMERIGROUP MEDICAID OH |
| 39198-14 | OTHER (01) | OH | HUMANA |
| A75696 | MEDICARE UPIN (02) |
Medicare Participation & PECOS Enrollment Status
Pete Caples 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 45242 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.12
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.65
- Average New Patient Copayment $31.53
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.66
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 $17.1
- 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 |
|---|---|---|
| Care Plan | 3% | 535 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| Pneumococcal Vaccination Status for Older Adults | 48% | 535 |
| 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 | 21% | 551 |
| 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 | ||
Reviews for PETE CAPLES M.D.
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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 1720065766, we treat the final digit (6) 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
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 54 is 60. 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.
CINCINNATI, OH 45242
CINCINNATI, OH 45242
CINCINNATI, OH 45242
CINCINNATI, OH 45242
CINCINNATI, OH 45242
CINCINNATI, OH 45242
CINCINNATI, OH 45242
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720065766, enumerated as an "individual" on December 30, 2005.
The provider is located at 10506 MONTGOMERY RD SUITE 504 CINCINNATI, OH 45242 and the phone number is (513) 792-7800.
Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.
The provider might be accepting Accepts: Medicare, Medicaid, Anthem Blue Cross, Railroad. Please consult your insurance carrier or call the provider to verify.
