KETTLIE JOSEPH DANIELS MD
NPI 1790775054
Specialist in Toledo, OH

NPI Status: Active since October 26, 2005

Contact Information

980 SOUTH BYRNE ROAD
TOLEDO, OH
ZIP 43609
Phone: (419) 842-0140
Fax: (419) 842-0142

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  • Individual
  • Female
  • Years of Experience 39
  • Specialist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About KETTLIE DANIELS

This page provides the complete NPI Profile along with additional information for Kettlie Daniels, a provider established in Toledo, Ohio with a medical specialization in Specialist and more than 39 years of experience. She graduated from University Of Toledo College Of Medicine in 1987. The healthcare provider is registered in the NPI registry with number 1790775054 assigned on October 2005. The practitioner's primary taxonomy code is 174400000X with license number OH35057621 (OH). The provider is registered as an individual and her NPI record was last updated 14 years ago.

NPI
1790775054
Provider Name
KETTLIE JOSEPH DANIELS MD
Gender
Female
Entity Type
Individual
Location Address
980 SOUTH BYRNE ROAD TOLEDO, OH 43609
Location Phone
(419) 842-0140
Location Fax
(419) 842-0142
Mailing Address
980 S BYRNE RD SUITE 250 TOLEDO, OH 43609
Mailing Phone
(419) 842-0140
Mailing Fax
(419) 842-0142
Medical School Name
UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE
Graduation Year
1987
Is Sole Proprietor?
Yes
Enumeration Date
10-26-2005
Last Update Date
11-05-2012
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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

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
OH35057621
License State
OH
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Insurance Plans Accepted

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

  • Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 8500 for HSA - HMO
  • Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Bronze Pathway 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Silver Pathway 5000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 4000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 5500 for HSA - HMO
  • Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Bronze $8,300 w/ Adult Dental ON-EX - HMO
  • Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
  • Bronze HSA $7,300 ON-EX - HMO
  • Bronze Standard w/ Virtual & Wellness - HMO
  • Gold $1,000 w/ Adult Dental ON-EX - HMO
  • Gold $1,000 w/ Virtual & Wellness ON-EX - HMO
  • Gold $500 w/ Virtual & Wellness ON-EX - HMO
  • Gold Standard w/ Virtual & Wellness - HMO
  • Silver $5,000 w/ Adult Dental ON-EX - HMO
  • Silver $5,000 w/ Virtual & Wellness ON-EX - HMO
  • Silver $5,800 w/ Virtual & Wellness ON-EX - HMO
  • Silver Standard w/ Virtual & Wellness - HMO
  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO

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
0678303MEDICARE ID-TYPE UNSPECIFIED (04)OH 

Medicare Participation & PECOS Enrollment Status

Kettlie Daniels 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.

Kettlie Daniels 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: 4688636368

    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: I20041104000000

    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

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.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 151 times for 72 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 99 times for 57 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 57 times for 30 patients

Psychiatric services complicated by communication factor

Psychiatric services complicated by communication factors involve mental health care for individuals who have challenges with communication. This can include language barriers, speech disorders, or cognitive impairments. The process involves tailored strategies to ensure effective communication and appropriate mental health care.

This service was performed 82 times for 26 patients

Psychotherapy with evaluation and management visit, 30 minutes

Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.

This service was performed 309 times for 98 patients

Psychotherapy, 1 hour

Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.

This service was performed 83 times for 15 patients

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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 1790775054, we treat the final digit (4) 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 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

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
9
Doubled → 18 → 1 + 8
Pos 4
0
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
7
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
0
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
4
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 9 → 18 → 9 7 → 14 → 5 5 → 10 → 1 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 7 + 1 + 8 + 0 + 1 + 4 + 7 + 1 + 0 + 0 + 1 + 0 + 24 = 56

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

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1790775054.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790775054, enumerated as an "individual" on October 26, 2005.

The provider is located at 980 SOUTH BYRNE ROAD TOLEDO, OH 43609 and the phone number is (419) 842-0140.

Specialist with taxonomy code 174400000X.

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