DR. JUSTIN EARL JONES MD
NPI 1760547699
Family Medicine in Provo, UT

PECOS Enrollment and Medicare Participation Status

Justin Jones 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: 7517042385

  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: I20100624000156

  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

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

• Other DME (D1E)

  Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

  11 DME suppliers used 30 Medicare Claims 81 Services Paid

• Oxygen and supplies (D1C)

  Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

  4 DME suppliers used 29 Medicare Claims 29 Services Paid

• Wheelchairs (D1D)

  Standard wheelchair (HCPCS:K0001)

  1 DME suppliers used 20 Medicare Claims 20 Services Paid

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 84604 ZIP code area.

* 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.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

• 509

  Insertion of needle into vein for collection of blood sample (HCPCS:36415)

• 329

  Blood test, comprehensive group of blood chemicals (HCPCS:80053)

• 320

  Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS:85025)

• 221

  Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

• 201

  Hemoglobin a1c level (HCPCS:83036)

• 112

  Administration of influenza virus vaccine (HCPCS:G0008)

• 68

  Vaccine for influenza for injection into muscle (HCPCS:90662)

• 60

  Automated urinalysis test (HCPCS:81003)

• 49

  Administration of pneumococcal vaccine (HCPCS:G0009)

• 26

  Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)

• 17

  Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem (HCPCS:G0180)

• 12

  Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

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NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

The NPI number 1760547699 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

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Frequently Asked Questions