DR. ALEX JUAN CARLOS JR. MD
NPI 1770147225
Internal Medicine - Nephrology in Waipahu, HI

NPI Status: Active since April 30, 2019

Contact Information

94-229 WAIPAHU DEPOT ST STE 101
WAIPAHU, HI
ZIP 96797
Phone: (808) 206-9849
Fax: (808) 206-9850

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 12
Internal Medicine
Nephrology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About ALEX CARLOS

This page provides the complete NPI Profile along with additional information for Alex Carlos, an internist established in Waipahu, Hawaii with a medical specialization in Internal Medicine, focusing in nephrology and more than 12 years of experience. The healthcare provider is registered in the NPI registry with number 1770147225 assigned on April 2019. The practitioner's primary taxonomy code is 207RN0300X with license number MD-23920-0 (HI). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI: 1770147225
Provider Name: DR. ALEX JUAN CARLOS JR. MD
Gender: Male
Entity Type: Individual
Location Address: 94-229 WAIPAHU DEPOT ST STE 101 WAIPAHU, HI 96797
Location Phone: (808) 206-9849
Location Fax: (808) 206-9850
Mailing Address: 94-229 WAIPAHU DEPOT ST STE 101 WAIPAHU, HI 96797
Mailing Phone: (808) 206-9849
Mailing Fax: (808) 206-9850
Medical School Name: OTHER
Graduation Year: 2014
Is Sole Proprietor?: No
Enumeration Date: 04-30-2019
Last Update Date: 07-16-2024
Code Navigator

An internist like Alex Carlos 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

Secondary Locations

75-184 Hualalai Rd Ste 202
Kailua Kona, HI 96740
(808) 329-8251

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 Nephrology
Taxonomy Code: 207RN0300X
Type: Allopathic & Osteopathic Physicians
License No.: MD-23920-0
License State: HI
Taxonomy Description: An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Insurance Plans Accepted

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

HMSA

HMSA Bronze PPO I - PPO
HMSA Bronze PPO II HSA - PPO
HMSA Catastrophic Plan - PPO
HMSA Gold PPO I - PPO
HMSA Gold PPO II - PPO
HMSA Platinum PPO - PPO
HMSA Silver PPO - PPO

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

Medicare Participation & PECOS Enrollment Status

Alex Carlos 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.

Alex Carlos 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: 840666400
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: I20240610003954
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

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $34.17 for a new patient copayment and $26.41 for an established patient copayment.

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 96797 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $136.68
Minimum New Patient Price $60.53
Maximum New Patient Price $180.05

Average New Patient Copayment $34.17
Minimum New Patient Copayment $15.13
Maximum New Patient Copayment $45.01

Established Patients Visit Costs *

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

Average Established Patient Price $105.65
Minimum Established Patient Price $20.09
Maximum Established Patient Price $147.56

Average Established Patient Copayment $26.41
Minimum Established Patient Copayment $5.02
Maximum Established Patient Copayment $36.89

* 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.

NPI Validation Check Digit Calculation

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

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	7	7	0	1	4	7	2	2	5
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	14	0	2	4	14	2	4
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 4 + 0 + 2 + 4 + 1 + 4 + 2 + 4 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 5									5

The NPI number 1770147225 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.