JOHN EDWARD SHEFFEL RN, FNP-C
NPI 1760475735
General Practice in Victoria, TX

NPI Status: Active since August 25, 2005

Contact Information

115 MEDICAL DR STE 101
VICTORIA, TX
ZIP 77904
Phone: (361) 355-8202
Fax: (361) 355-8204

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  • Individual
  • Male
  • Years of Experience 21
  • General Practice
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JOHN SHEFFEL

This page provides the complete NPI Profile along with additional information for John Sheffel, a primary care provider established in Victoria, Texas with a medical specialization in General Practice and more than 21 years of experience. The healthcare provider is registered in the NPI registry with number 1760475735 assigned on August 2005. The practitioner's primary taxonomy code is 208D00000X with license number 666326 (TX). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1760475735
Provider Name
JOHN EDWARD SHEFFEL RN, FNP-C
Gender
Male
Entity Type
Individual
Location Address
115 MEDICAL DR STE 101 VICTORIA, TX 77904
Location Phone
(361) 355-8202
Location Fax
(361) 355-8204
Mailing Address
115 MEDICAL DR STE 101 VICTORIA, TX 77904
Mailing Phone
(361) 355-8202
Mailing Fax
(361) 355-8204
Medical School Name
OTHER
Graduation Year
2005
Is Sole Proprietor?
No
Enumeration Date
08-25-2005
Last Update Date
09-19-2024
Code Navigator

A primary care provider (PCP) like John Sheffel 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

General Practice

Taxonomy Code
208D00000X
Type
Allopathic & Osteopathic Physicians
License No.
666326
License State
TX
Taxonomy Description
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1171400000XOther Service Providers

Health and Wellness Coach

666326 (TX)
2202D00000XAllopathic & Osteopathic Physicians

Integrative Medicine

666326 (TX)
3207QA0000XAllopathic & Osteopathic Physicians

Family Medicine
Adolescent Medicine

666326 (TX)
4207QB0002XAllopathic & Osteopathic Physicians

Family Medicine
Obesity Medicine

666326 (TX)
52083B0002XAllopathic & Osteopathic Physicians

Preventive Medicine
Obesity Medicine

666326 (TX)
6363L00000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner

666326 (TX)
7363LF0000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Family

666326 (TX)
8363LP2300XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Primary Care

666326 (TX)

Insurance Plans Accepted

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

  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Standard - HMO
  • UHC Bronze Standard+ (Dental + Vision) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
  • UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Gold Standard - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Silver Standard - HMO
  • UHC Silver Value ($0 Virtual Urgent Care) - HMO
  • UHC Silver Value+ ($0 Virtual Urgent Care, Dental + Vision) - HMO

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

Medicare Participation & PECOS Enrollment Status

John Sheffel 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.

John Sheffel 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: 8729136916

    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: I20090427000557

    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

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

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. John Sheffel is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
DE TAR HOSPITAL NAVARRO506 E SAN ANTONIO ST
VICTORIA, TX 77901
(361) 575-7441Acute Care Hospitals

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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 1760475735, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

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
6
Doubled → 12 → 1 + 2
Pos 4
0
Unchanged
Pos 5
4
Doubled → 8
Pos 6
7
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
7
Unchanged
Pos 9
3
Doubled → 6
Check
5
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 6 → 12 → 3 4 → 8 5 → 10 → 1 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 7 + 1 + 2 + 0 + 8 + 7 + 1 + 0 + 7 + 6 + 24 = 65

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

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1760475735.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Clinic/Center (Primary Care)
115 MEDICAL DR STE 101
VICTORIA, TX 77904
Clinic/Center
115 MEDICAL DR STE 101
VICTORIA, TX 77904
Nurse Practitioner (Family)
115 MEDICAL DR STE 101
VICTORIA, TX 77904

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1760475735, enumerated as an "individual" on August 25, 2005.

The provider is located at 115 MEDICAL DR STE 101 VICTORIA, TX 77904 and the phone number is (361) 355-8202.

General Practice with taxonomy code 208D00000X.

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

John Sheffel is affiliated with: DE TAR HOSPITAL NAVARRO.