DR. MARK GETTLEMAN M.D.
NPI 1801989611
Pediatrics in Gilbert, AZ
NPI Status: Active since October 02, 2006
Contact Information
1790 E BOSTON ST
GILBERT, AZ
ZIP 85295
Phone: (602) 933-3549
- Individual
- Male
- Pediatrics
- Accepts Insurance
- PECOS Enrolled
About MARK GETTLEMAN
This page provides the complete NPI Profile along with additional information for Mark Gettleman, a pediatrician established in Gilbert, Arizona with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1801989611 assigned on October 2006. The practitioner's primary taxonomy code is 208000000X with license number 23947 (AZ). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1801989611
- Provider Name
- DR. MARK GETTLEMAN M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1790 E BOSTON ST GILBERT, AZ 85295
- Location Phone
- (602) 933-3549
- Mailing Address
- 2108 E THOMAS RD STE 130 PHOENIX, AZ 85016
- Mailing Phone
- (029) 331-8136
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-02-2006
- Last Update Date
- 03-08-2023
- Code Navigator
A pediatrician like Mark Gettleman is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
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
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 23947
- License State
- AZ
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
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) |
|---|---|---|---|---|
| 1 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | MD60622294 (WA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue AdvanceHealth Bronze - MaricopaFocus Network - HMO
- Blue AdvanceHealth Gold - MaricopaFocus Network - HMO
- Blue AdvanceHealth Silver - MaricopaFocus Network - HMO
- Blue EverydayHealth Gold - MaricopaFocus Network - HMO
- Blue EverydayHealth Silver - MaricopaFocus Network - HMO
- Blue Portfolio HSA Bronze - MaricopaFocus Network - HMO
- Blue Portfolio HSA Gold - Statewide PPO Network - PPO
- Blue PPO PremierHealth Silver - Statewide PPO Network - PPO
- Blue PPO PremierHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Silver - Statewide PPO Network - PPO
- Blue StandardHealth Bronze - MaricopaFocus Network - HMO
- Blue StandardHealth Gold - MaricopaFocus Network - HMO
- Blue StandardHealth Silver - MaricopaFocus Network - HMO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - EPO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - EPO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - EPO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - EPO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - EPO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - EPO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - EPO
- Medica Individual Choice Silver Standard - HMO
- Bronze Classic 4700 - PPO
- Bronze Classic Standard - PPO
- Bronze Elite + PCP Saver Plus - PPO
- Gold Classic Standard - PPO
- Secure - PPO
- Silver Classic Standard - PPO
- Silver Elite Saver Plus - PPO
- Silver Simple Breathe Easy with Enhanced COPD Benefits - PPO
- Silver Simple Diabetes - PPO
- Silver Simple PCP Saver - PPO
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 |
|---|---|---|---|
| 2055783 | MEDICAID (05) | WA |
Medicare Participation & PECOS Enrollment Status
Mark Gettleman 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
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
Physician Visit Costs
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 85295 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.89
- Minimum New Patient Price $55.44
- Maximum New Patient Price $168.6
- Average New Patient Copayment $21.47
- Minimum New Patient Copayment $13.86
- Maximum New Patient Copayment $42.15
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $98
- Minimum Established Patient Price $17.72
- Maximum Established Patient Price $137.41
- Average Established Patient Copayment $24.5
- Minimum Established Patient Copayment $4.43
- Maximum Established Patient Copayment $34.35
* 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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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 8 | 0 | 1 | 9 | 8 | 9 | 6 | 1 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 0 | 1 | 18 | 8 | 18 | 6 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 0 + 1 + 1 + 8 + 8 + 1 + 8 + 6 + 2 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1801989611 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1801989611, enumerated as an "individual" on October 02, 2006.
The provider is located at 1790 E BOSTON ST GILBERT, AZ 85295 and the phone number is (602) 933-3549.
Pediatrics with taxonomy code 208000000X.
The provider might be accepting Accepts: Blue Cross Blue Shield of Arizona, Medica, Oscar. Please consult your insurance carrier or call the provider to verify.
