DONALD A CAMPBELL JR.
NPI 1740281997
Family Medicine in Warren, MI

NPI Status: Active since August 09, 2005

Contact Information

11270 E 13 MILE RD
SUITE 4
WARREN, MI
ZIP 48093
Phone: (586) 574-0630
Fax: (586) 574-0636

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  • Individual
  • Male
  • Family Medicine
  • PECOS Enrolled
  • Medicare Quality Reporting

About DONALD CAMPBELL

This page provides the complete NPI Profile along with additional information for Donald Campbell, a primary care provider established in Warren, Michigan with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1740281997 assigned on August 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 4301046758 (MI). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1740281997
Provider Name
DONALD A CAMPBELL JR.
Gender
Male
Entity Type
Individual
Location Address
11270 E 13 MILE RD SUITE 4 WARREN, MI 48093
Location Phone
(586) 574-0630
Location Fax
(586) 574-0636
Mailing Address
11270 E 13 MILE RD SUITE 4 WARREN, MI 48093
Mailing Phone
(586) 574-0630
Mailing Fax
(586) 574-0636
Is Sole Proprietor?
No
Enumeration Date
08-09-2005
Last Update Date
04-30-2014
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A primary care provider (PCP) like Donald Campbell 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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
4301046758
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:

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
700E031610OTHER (01)MIBCBSM GROUP NUMBER
MI3971052MEDICARE PIN (08)MI 
A73511MEDICARE UPIN (02) 
0500014OTHER (01)MNBCBSM PIN

Medicare Participation & PECOS Enrollment Status

Donald Campbell 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 48093 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $90.76
  • Minimum New Patient Price $58.04
  • Maximum New Patient Price $177.36
  • Average New Patient Copayment $22.69
  • Minimum New Patient Copayment $14.51
  • Maximum New Patient Copayment $44.34

Established Patients Visit Costs *

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

  • Average Established Patient Price $102.35
  • Minimum Established Patient Price $18.32
  • Maximum Established Patient Price $143.49
  • Average Established Patient Copayment $25.58
  • Minimum Established Patient Copayment $4.58
  • Maximum Established Patient Copayment $35.87

* 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
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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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 1740281997, 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 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 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
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
4
Doubled → 8
Pos 4
0
Unchanged
Pos 5
2
Doubled → 4
Pos 6
8
Unchanged
Pos 7
1
Doubled → 2
Pos 8
9
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
7
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 4 → 8 2 → 4 1 → 2 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

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

2 + 7 + 8 + 0 + 4 + 8 + 2 + 9 + 1 + 8 + 24 = 73

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

The next multiple of ten after 73 is 80. The difference is the calculated check digit.

80 - 73 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1740281997.

Other Providers at the Same Location


The following 9 providers are registered at the same or a nearby location.

Dentist (General Practice)
11270 E 13 MILE RD, SUITE #1A
WARREN, MI 48093
Dentist (General Practice)
11270 E 13 MILE RD, SUITE 3A
WARREN, MI 48093
Nurse Practitioner (Family)
11270 E 13 MILE RD, SUITE 4
WARREN, MI 48093
Family Medicine
11270 E 13 MILE RD, SUITE 4
WARREN, MI 48093
Social Worker (Clinical)
11270 E 13 MILE RD
WARREN, MI 48093
Social Worker (Clinical)
11270 E 13 MILE RD
WARREN, MI 48093
Social Worker (Clinical)
11270 E 13 MILE RD, STE 200
WARREN, MI 48093
Counselor (Professional)
11270 E 13 MILE RD
WARREN, MI 48093
Social Worker (Clinical)
11270 E 13 MILE RD
WARREN, MI 48093

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1740281997, enumerated as an "individual" on August 09, 2005.

The provider is located at 11270 E 13 MILE RD SUITE 4 WARREN, MI 48093 and the phone number is (586) 574-0630.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.