ERIKA N MCCOMBS PT
NPI 1780845081
Physical Therapist in Newburgh, IN

NPI Status: Active since June 19, 2008

Contact Information

4199 GATEWAY BLVD
SUITE 3500
NEWBURGH, IN
ZIP 47630
Phone: (812) 858-5950
Fax: (812) 858-5955

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  • Individual
  • Female
  • Years of Experience 23
  • Physical Therapist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About ERIKA MCCOMBS

This page provides the complete NPI Profile along with additional information for Erika Mccombs, a provider established in Newburgh, Indiana with a medical specialization in Physical Therapist and more than 23 years of experience. The healthcare provider is registered in the NPI registry with number 1780845081 assigned on June 2008. The practitioner's primary taxonomy code is 225100000X with license number 05008155A (IN). The provider is registered as an individual and her NPI record was last updated 7 years ago.

NPI
1780845081
Provider Name
ERIKA N MCCOMBS PT
Gender
Female
Entity Type
Individual
Location Address
4199 GATEWAY BLVD SUITE 3500 NEWBURGH, IN 47630
Location Phone
(812) 858-5950
Location Fax
(812) 858-5955
Mailing Address
4199 GATEWAY BLVD SUITE 3500 NEWBURGH, IN 47630
Mailing Phone
(812) 858-5950
Mailing Fax
(812) 858-5955
Medical School Name
OTHER
Graduation Year
2003
Is Sole Proprietor?
No
Enumeration Date
06-19-2008
Last Update Date
06-18-2019
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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

Physical Therapist

Taxonomy Code
225100000X
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.
05008155A
License State
IN
Taxonomy Description
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Insurance Plans Accepted

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

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - 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.

*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
201003570MEDICAID (05)IN 

Medicare Participation & PECOS Enrollment Status

Erika Mccombs 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.

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.

  • PECOS PAC ID: 4486932175

    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: I20161101000476

    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.

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Evaluation for physical therapy, typically 30 minutes

An evaluation for physical therapy is a 30-minute session where a physical therapist assesses your current physical condition. They'll examine your strength, flexibility, balance, and mobility to identify areas needing improvement. This helps tailor a therapy plan to your specific needs.

This service was performed 32 times for 32 patients

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes

This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.

This service was performed 305 times for 46 patients

Therapy procedure using manual technique, each 15 minutes

This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.

This service was performed 124 times for 12 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.51 for a new patient copayment and $16.62 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 47630 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.04
  • Minimum New Patient Price $53.07
  • Maximum New Patient Price $161.76
  • Average New Patient Copayment $20.51
  • Minimum New Patient Copayment $13.26
  • Maximum New Patient Copayment $40.44

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $66.48
  • Minimum Established Patient Price $16.93
  • Maximum Established Patient Price $132.22
  • Average Established Patient Copayment $16.62
  • Minimum Established Patient Copayment $4.23
  • Maximum Established Patient Copayment $33.05

* 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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 97% 63
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2

Reviews for ERIKA N MCCOMBS PT

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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 1780845081, we treat the final digit (1) 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 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

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
8
Doubled → 16 → 1 + 6
Pos 4
0
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
4
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
0
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
1
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 8 → 16 → 7 8 → 16 → 7 5 → 10 → 1 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

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

2 + 7 + 1 + 6 + 0 + 1 + 6 + 4 + 1 + 0 + 0 + 1 + 6 + 24 = 59

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

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1780845081.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Obstetrics & Gynecology
4199 GATEWAY BLVD, STE 2400
NEWBURGH, IN 47630
Obstetrics & Gynecology
4199 GATEWAY BLVD, STE 2400
NEWBURGH, IN 47630
Obstetrics & Gynecology
4199 GATEWAY BLVD, STE 2300
NEWBURGH, IN 47630
Obstetrics & Gynecology
4199 GATEWAY BLVD, STE 2300
NEWBURGH, IN 47630
Obstetrics & Gynecology (Gynecology)
4199 GATEWAY BLVD, SUITE 2300
NEWBURGH, IN 47630
Obstetrics & Gynecology
4199 GATEWAY BLVD, SUITE 2300
NEWBURGH, IN 47630
Anesthesiology
4199 GATEWAY BLVD, THE WOMENS HOSPITAL
NEWBURGH, IN 47630
Anesthesiology
4199 GATEWAY BLVD, THE WOMENS HOSPITAL
NEWBURGH, IN 47630
Obstetrics & Gynecology (Reproductive Endocrinology)
4199 GATEWAY BLVD, SUITE 2900
NEWBURGH, IN 47630
Pediatrics (Neonatal-Perinatal Medicine)
4199 GATEWAY BLVD
NEWBURGH, IN 47630
Radiology (Diagnostic Radiology)
4199 GATEWAY BLVD, SUITE 3000
NEWBURGH, IN 47630
Durable Medical Equipment & Medical Supplies
4199 GATEWAY BLVD, SUITE 3000
NEWBURGH, IN 47630
Obstetrics & Gynecology (Reproductive Endocrinology)
4199 GATEWAY BLVD, SUITE 2900
NEWBURGH, IN 47630
Physical Therapy Assistant
4199 GATEWAY BLVD, STE 3800
NEWBURGH, IN 47630
Occupational Therapist
4199 GATEWAY BLVD, STE. 3800
NEWBURGH, IN 47630
Obstetrics & Gynecology (Maternal & Fetal Medicine)
4199 GATEWAY BLVD, STE 2600
NEWBURGH, IN 47630
Durable Medical Equipment & Medical Supplies
4199 GATEWAY BLVD, SUITE 2000
NEWBURGH, IN 47630
Obstetrics & Gynecology (Reproductive Endocrinology)
4199 GATEWAY BLVD, SUITE 2900
NEWBURGH, IN 47630
Obstetrics & Gynecology (Reproductive Endocrinology)
4199 GATEWAY BLVD, SUITE 2600
NEWBURGH, IN 47630
Clinical Nurse Specialist (Perinatal)
4199 GATEWAY BLVD, SUITE 3100
NEWBURGH, IN 47630

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780845081, enumerated as an "individual" on June 19, 2008.

The provider is located at 4199 GATEWAY BLVD SUITE 3500 NEWBURGH, IN 47630 and the phone number is (812) 858-5950.

Physical Therapist with taxonomy code 225100000X.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.