SHARON BETH GANTMAN LICSW
NPI 1780624924
Counselor - Mental Health in Newburyport, MA

NPI Status: Active since June 07, 2006

Contact Information

10 PRINCE PL 107
NEWBURYPORT, MA
ZIP 01950
Phone: (978) 465-5033
Fax: (978) 465-5034

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  • Individual
  • Female
  • Years of Experience 36
  • Counselor
  • Mental Health
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About SHARON GANTMAN

This page provides the complete NPI Profile along with additional information for Sharon Gantman, a provider established in Newburyport, Massachusetts with a medical specialization in Counselor, focusing in mental health and more than 36 years of experience. The healthcare provider is registered in the NPI registry with number 1780624924 assigned on June 2006. The practitioner's primary taxonomy code is 101YM0800X with license number 1023367 (MA). The provider is registered as an individual and her NPI record was last updated 10 years ago.

NPI
1780624924
Provider Name
SHARON BETH GANTMAN LICSW
Gender
Female
Entity Type
Individual
Location Address
10 PRINCE PL 107 NEWBURYPORT, MA 01950
Location Phone
(978) 465-5033
Location Fax
(978) 465-5034
Mailing Address
PO BOX 276 NEWBURYPORT, MA 01950
Mailing Phone
(978) 609-5226
Mailing Fax
(978) 465-5034
Medical School Name
OTHER
Graduation Year
1990
Is Sole Proprietor?
Yes
Enumeration Date
06-07-2006
Last Update Date
09-03-2015
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A mental health counselor like Sharon Gantman provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.

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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

Counselor Mental Health

Taxonomy Code
101YM0800X
Type
Behavioral Health & Social Service Providers
License No.
1023367
License State
MA

Insurance Plans Accepted

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

  • Anthem Bronze Preferred Blue PPO 5000/10%/8000 w/HSA - PPO
  • Anthem Bronze Preferred Blue PPO 5000/20%/8000 w/HSA - PPO
  • Anthem Bronze Preferred Blue PPO 6500/30%/9200 Value - PPO
  • Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
  • Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
  • Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
  • Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
  • Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
  • Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
  • Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO
  • Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
  • Anthem Bronze Pathway X Enhanced 6500/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
  • Anthem Catastrophic Pathway X Enhanced 9200/0% - HMO
  • Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Gold Pathway X Enhanced 1500/25% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
  • Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Bronze Pathway X Enhanced 6000/30% ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
  • NH Local Choice HMO Bronze 8000 - HMO
  • NH Local Choice HMO Gold - HMO
  • NH Local Choice HMO Gold 1400 - HMO
  • NH Local Choice HMO HSA Bronze 6000 - HMO
  • NH Local Choice HMO Silver 3500 - HMO
  • NH Local Choice HMO Silver 5000 - HMO
  • NH Local HMO Bronze 7500 Standard - HMO
  • NH Local HMO Gold 1500 Standard - HMO
  • NH Local HMO Silver 5000 Standard - HMO

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
P30008MEDICARE ID-TYPE UNSPECIFIED (04)MA 
P07782OTHER (01)MABCBS

Medicare Participation & PECOS Enrollment Status

Sharon Gantman 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.

Sharon Gantman 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 and Durable Medical Equipment (DME).

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: 4880646397

    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: I20050217000098

    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): No

  • Eligible to Order or Refer Power Mobility Devices: No

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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.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1780624924
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27160122894
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 6 + 0 + 1 + 2 + 2 + 8 + 9 + 4 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1780624924 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780624924, enumerated as an "individual" on June 07, 2006.

The provider is located at 10 PRINCE PL 107 NEWBURYPORT, MA 01950 and the phone number is (978) 465-5033.

Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

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