DR. EDWARD M BAYNHAM JR. DPM
NPI 1790913630
Podiatrist - Foot & Ankle Surgery in Columbus, OH

NPI Status: Active since June 30, 2009

Contact Information

1570 FISHINGER RD
COLUMBUS, OH
ZIP 43221
Phone: (614) 451-7033
Fax: (614) 451-7080

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  • Individual
  • Male
  • Years of Experience 17
  • Podiatrist
  • Foot & Ankle Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About EDWARD BAYNHAM

This page provides the complete NPI Profile along with additional information for Edward Baynham, a provider established in Columbus, Ohio with a medical specialization in Podiatrist, focusing in foot & ankle surgery and more than 17 years of experience. He graduated from Kent State University College Of Podiatric Medicine in 2009. The healthcare provider is registered in the NPI registry with number 1790913630 assigned on June 2009. The practitioner's primary taxonomy code is 213ES0103X with license number 003618 (OH). The provider is registered as an individual and his NPI record was last updated 14 years ago.

NPI
1790913630
Provider Name
DR. EDWARD M BAYNHAM JR. DPM
Gender
Male
Entity Type
Individual
Location Address
1570 FISHINGER RD COLUMBUS, OH 43221
Location Phone
(614) 451-7033
Location Fax
(614) 451-7080
Mailing Address
1570 FISHINGER RD COLUMBUS, OH 43221
Mailing Phone
(989) 621-3607
Mailing Fax
(614) 451-7080
Medical School Name
KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduation Year
2009
Is Sole Proprietor?
No
Enumeration Date
06-30-2009
Last Update Date
07-20-2012
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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

Podiatrist Foot & Ankle Surgery

Taxonomy Code
213ES0103X
Type
Podiatric Medicine & Surgery Service Providers
License No.
003618
License State
OH

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1213ES0103XPodiatric Medicine & Surgery Service Providers

Podiatrist
Foot & Ankle Surgery

SC006106 (PA)

Insurance Plans Accepted

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

  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Gold Standard+ (Dental + Vision, No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Silver Standard (No Referrals) - HMO
  • UHC Silver Standard+ (Dental + Vision, No Referrals) - HMO

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

Medicare Participation & PECOS Enrollment Status

Edward Baynham 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.

Edward Baynham 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) and a Home Health Agency (HHA).

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: 2961668116

    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: I20120717000325

    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: No

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 custodial care facility, group care, or assisted living visit, typically 15 minutes

This is a routine 15-minute visit for patients residing in care facilities like nursing homes or assisted living. During this visit, healthcare providers review the patient's health, manage medications, and address any concerns or changes in condition. It ensures continuous, quality care.

This service was performed 30 times for 17 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 181 times for 72 patients

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 144 times for 63 patients

Lower limb (leg) arthroscopy (minimally invasive joint repair)

Lower limb arthroscopy is a minimally invasive procedure that allows doctors to examine and repair issues in your leg joints. It involves making small incisions through which a tiny camera and instruments are inserted. This technique can help diagnose and treat various joint problems with less pain and quicker recovery time.

This service was performed for 1-10 patients

New patient office or other outpatient visit, 15-29 minutes

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

This service was performed 15 times for 15 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 28 times for 28 patients

Removal of fingernails or toenails, 6 or more nails

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

This service was performed 209 times for 75 patients

Removal of noncancer thickened skin growth, 1 growth

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

This service was performed 31 times for 19 patients

Removal of noncancer thickened skin growth, 2-4 growths

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

This service was performed 102 times for 33 patients

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
Annual registration in the Prescription Drug Monitoring ProgramYesN/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Care transition documentation practice improvementsYesN/A
Implementation of practices/processes for care transition that include documentation of how a MIPS eligible clinician or group carried out a patient-centered action plan for first 30 days following a discharge (e.g., staff involved, phone calls conducted in support of transition, accompaniments, navigation actions, home visits, patient information access, etc.).
Documentation of Current Medications in the Medical Record 100% 984
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing 100% 91
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Evidenced-based techniques to promote self-management into usual careYesN/A
Incorporate evidence-based techniques to promote self-management into usual care, using techniques such as goal setting with structured follow-up, Teach Back, action planning or motivational interviewing.
Integration of patient coaching practices between visitsYesN/A
Provide coaching between visits with follow-up on care plan and goals.
Medication Reconciliation 100% 194
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 100% 357
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Pneumococcal Vaccination Status for Older Adults 46% 229
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Practice Improvements for Bilateral Exchange of Patient InformationYesN/A
Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: • Participate in a Health Information Exchange if available; and/or • Use structured referral notes.
Preventive Care and Screening: Influenza Immunization 54% 227
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Provide Patient Access 59% 357
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Use of High-Risk Medications in the Elderly 0% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
229
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication

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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 1790913630, we treat the final digit (0) 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 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

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
9
Doubled → 18 → 1 + 8
Pos 6
1
Unchanged
Pos 7
3
Doubled → 6
Pos 8
6
Unchanged
Pos 9
3
Doubled → 6
Check
0
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 9 → 18 → 9 3 → 6 3 → 6

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 + 8 + 1 + 6 + 6 + 6 + 24 = 70

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

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1790913630.

Other Providers at the Same Location


The following 12 providers are registered at the same or a nearby location.

Psychologist (Clinical)
1570 FISHINGER RD
COLUMBUS, OH 43221
Social Worker (Clinical)
1570 FISHINGER RD
COLUMBUS, OH 43221
Psychologist
1570 FISHINGER RD
COLUMBUS, OH 43221
Psychologist (Clinical)
1570 FISHINGER RD
UPPER ARLINGTON, OH 43221
Podiatrist (Foot & Ankle Surgery)
1570 FISHINGER RD
COLUMBUS, OH 43221
Podiatrist (Foot & Ankle Surgery)
1570 FISHINGER RD
COLUMBUS, OH 43221
Hearing Instrument Specialist
1570 FISHINGER RD, SUITE E
COLUMBUS, OH 43221
Audiologist
1570 FISHINGER RD, STE E
COLUMBUS, OH 43221
Dentist (Endodontics)
1570 FISHINGER RD
COLUMBUS, OH 43221
Psychologist
1570 FISHINGER RD
COLUMBUS, OH 43221
Psychologist
1570 FISHINGER RD
COLUMBUS, OH 43221
Psychologist (Counseling)
1570 FISHINGER RD
COLUMBUS, OH 43221

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790913630, enumerated as an "individual" on June 30, 2009.

The provider is located at 1570 FISHINGER RD COLUMBUS, OH 43221 and the phone number is (614) 451-7033.

Podiatrist with taxonomy code 213ES0103X and a focus in Foot & Ankle Surgery.

The provider might be accepting Accepts: UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.