SCOTT H BERGER DPT
NPI 1801191275
Physical Therapist in Marion, IN
About Scott H Berger Dpt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SCOTT H BERGER DPT (NPI 1801191275) is a physical therapist provider in Marion, Indiana, licensed in Indiana (05009679A) and active in the NPI registry since January 2011. He maintains a secondary practice location in Hartford City and is a graduate of Other (2008).Information from the official NPPES registry record, last updated September 18, 2023.
NPPES Registry Identity
★ Primary Specialty
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… Show more
Also on File with NPPES
Hartford City, IN 47348-1382
Phone (765) 348-4197
129137500 (Other, IN, Us Department Of Labor)
Medicare Participation & PECOS Enrollment Status
Scott Berger 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: 5991159204
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: I20230920002036
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.
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 46953 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.
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Other Providers at the Same Location
The following 12 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1801191275, enumerated as an "individual" on January 17, 2011.
The provider is located at 4411 S ADAMS ST MARION, IN 46953 and the phone number is (765) 674-4455.
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.