MEGAN MEDINA
NPI 1801263454
Counselor in West Frankfort, IL

NPI Status: Active since August 31, 2015

Contact Information

902 W MAIN ST
WEST FRANKFORT, IL
ZIP 62896
Phone: (610) 937-6483
Fax: (618) 937-1440

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Counselor
Accepts Insurance
Opted-Out Medicare

About MEGAN MEDINA

This page provides the complete NPI Profile along with additional information for Megan Medina, a provider established in West Frankfort, Illinois with a medical specialization in Counselor. The healthcare provider is registered in the NPI registry with number 1801263454 assigned on August 2015. The practitioner's primary taxonomy code is 101Y00000X. The provider is registered as an individual and her NPI record was last updated 11 years ago.

NPI: 1801263454
Provider Name: MEGAN MEDINA
Gender: Female
Entity Type: Individual
Location Address: 902 W MAIN ST WEST FRANKFORT, IL 62896
Location Phone: (610) 937-6483
Location Fax: (618) 937-1440
Mailing Address: 902 W MAIN ST WEST FRANKFORT, IL 62896
Mailing Phone: (610) 937-6483
Mailing Fax: (618) 937-1440
Is Sole Proprietor?: No
Enumeration Date: 08-31-2015
Last Update Date: 08-31-2015
Code Navigator

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Megan Medina opted out of Medicare effective on 05-02-2023 until 05-02-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.

Location Map

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
Taxonomy Code: 101Y00000X
Type: Behavioral Health & Social Service Providers
Taxonomy Description: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Insurance Plans Accepted

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

UnitedHealthcare

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 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, $5 Tier 2 Rx, No Referrals) - HMO
UHC Gold Standard (No Referrals) - HMO
UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
UHC Silver Standard (No Referrals) - HMO
UHC Silver Value ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - HMO
UHC Silver Value+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, 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

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.

Opted-Out of Medicare? Yes
Opt-Out Effective Date: 05-02-2023
Opt-Out End Date: 05-02-2027
Eligible to Order and Refer? No

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 1801263454, 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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 0

Pos 4

Unchanged

Pos 5

Doubled → 4

Pos 6

Unchanged

Pos 7

Doubled → 6

Pos 8

Unchanged

Pos 9

Doubled → 10 → 1 + 0

Check

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 0 → 0 2 → 4 3 → 6 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 0 + 1 + 4 + 6 + 6 + 4 + 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 1801263454.