DR. PABLO ALABANZA MERCED M.D. NPI 1770633182
Family Medicine in Jackson, KY
About DR. PABLO ALABANZA MERCED M.D.
Pablo Merced is a primary care provider established in Jackson, Kentucky and his medical specialization is Family Medicine with more than 54 years of experience. The NPI number of this provider is 1770633182 and was assigned on January 2007. The practitioner's primary taxonomy code is 207Q00000X with license number KY24420 (KY). The provider is registered as an individual and his NPI record was last updated 12 years ago.
| NPI | 1770633182 |
| Provider Name | DR. PABLO ALABANZA MERCED M.D. |
| Location Address | 1389 HIGHWAY 15 N JACKSON, KY 41339 |
| Location Phone | (606) 666-4011 |
| Mailing Address | PO BOX 606 JACKSON, KY 41339 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 1969 |
| Is Sole Proprietor? | Yes |
| Enumeration Date | 01-11-2007 |
| Last Update Date | 01-26-2011 |
A primary care provider (PCP) like Pablo Merced 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 Pablo Merced 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.
Pablo Merced is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with .
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.18 for a new patient copayment and $24.51 for an established patient copayment.
Primary Taxonomy
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 207Q00000X |
| Classification | Family Medicine |
| Type | Allopathic & Osteopathic Physicians |
| License No. | KY24420 |
| License State | KY |
| 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. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
1389 HIGHWAY 15 N
JACKSON, KY
ZIP 41339
Phone: (606) 666-4011
Fax: (606) 666-5801
Mailing Address
PO BOX 606
JACKSON, KY
ZIP 41339
Phone: (606) 666-4011
Fax: (606) 666-5801
Location Map
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 4486827060 |
| PECOS Enrollment ID | I20111026000527 |
| 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 order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 41339 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99203 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $54.72 | $168.41 | $84.75 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $13.68 | $42.1 | $21.18 |
| Established Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for established patients office visits: 99214 | ||
| Minimum Established Patient Pricing | Maximum Established Patient Pricing | Typical Established Patient Pricing |
| $16.65 | $137.34 | $98.06 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.16 | $34.33 | $24.51 |
* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1439702 | OTHER (01) | KY | MEDICARE PTAN NUMBER |
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 | 6 | 3 | 3 | 1 | 8 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 14 | 0 | 12 | 3 | 6 | 1 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 4 + 0 + 1 + 2 + 3 + 6 + 1 + 1 + 6 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1770633182 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1336375294 | WOLFE COUNTY CLINICS Organization | Internal Medicine (Cardiovascular Disease) | 1389 HIGHWAY 15 N JACKSON, KY 41339 (606) 668-3925 |
| 1972974186 | MOTHER OF GOOD COUNSEL Organization | Counselor | 1389 HIGHWAY 15 N JACKSON, KY 41339 (606) 666-4011 |
| 1992357321 | REBECCA LYNN FRYMAN Individual | Case Manager/Care Coordinator | 1389 HIGHWAY 15 N JACKSON, KY 41339 (606) 666-4011 |
| 1720630155 | ANNA MARIA VANOVER Individual | Case Manager/Care Coordinator | 1389 HIGHWAY 15 N JACKSON, KY 41339 (606) 666-4011 |
| 1821640251 | PETER ANTHONY MERCED Individual | Case Manager/Care Coordinator | 1389 HIGHWAY 15 N JACKSON, KY 41339 (606) 666-4011 |
Frequently Asked Questions
What is Dr. Pablo Merced M.D. NPI number?
The NPI number assigned to this healthcare provider is 1770633182, registered as an "individual" on January 11, 2007
Where is Dr. Pablo Merced M.D. located?
The provider is located at 1389 Highway 15 N Jackson, Ky 41339 and the phone number is (606) 666-4011
Which is Dr. Pablo Merced M.D. specialty?
The provider's speciality is Family Medicine
How many years of experience does Dr. Pablo Merced M.D. have?
The provider has more than 54 years of experience.
What insurance does Dr. Pablo Merced M.D. accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Dr. Pablo Merced M.D. registered in PECOS?
Yes, as of May 11, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary 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.
How much is a visit to Dr. Pablo Merced M.D.?
Medicare beneficiaries should expect a typical cost of $84.75 with an average copayment of $21.18 for new patient appointments. Established patients should expect a typical charge of $98.06 and an average copayment of 24.51. Please review your insurance plan or contact the provider directly to determine your specific costs.
How do I update my NPI information?
The NPI record of Dr. Pablo Merced M.D. was last updated on January 11, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
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