ABBY SAUNDERS PA
NPI 1811068042
Physician Assistant in Berkeley Heights, NJ

NPI Status: Active since November 10, 2006

Contact Information

1 DIAMOND HILL RD
SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ
ZIP 07922
Phone: (908) 273-4300
Fax: (908) 673-7132

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  • Individual
  • Female
  • Years of Experience 29
  • Physician Assistant
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ABBY SAUNDERS

This page provides the complete NPI Profile along with additional information for Abby Saunders, a primary care provider established in Berkeley Heights, New Jersey with a medical specialization in Physician Assistant and more than 29 years of experience. The healthcare provider is registered in the NPI registry with number 1811068042 assigned on November 2006. The practitioner's primary taxonomy code is 363A00000X with license number 25MP00031500 (NJ). The provider is registered as an individual and her NPI record was last updated 18 years ago.

NPI
1811068042
Provider Name
ABBY SAUNDERS PA
Gender
Female
Entity Type
Individual
Location Address
1 DIAMOND HILL RD SUMMIT MEDICAL GROUP BERKELEY HEIGHTS, NJ 07922
Location Phone
(908) 273-4300
Location Fax
(908) 673-7132
Mailing Address
1 DIAMOND HILL RD SUMMIT MEDICAL GROUP BERKELEY HEIGHTS, NJ 07922
Mailing Phone
(908) 273-4300
Mailing Fax
(908) 673-7132
Medical School Name
OTHER
Graduation Year
1997
Is Sole Proprietor?
No
Enumeration Date
11-10-2006
Last Update Date
03-28-2008
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A primary care provider (PCP) like Abby Saunders sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
25MP00031500
License State
NJ
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

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

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
P71968MEDICARE UPIN (02)NJ 
064154MEDICARE ID-TYPE UNSPECIFIED (04)NJ 

Medicare Participation & PECOS Enrollment Status

Abby Saunders 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.

Abby Saunders 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: 5597951020

    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: I20101123001020

    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.

Bacterial colony count, urine

A bacterial colony count, urine, is a laboratory test that checks a urine sample for bacteria. It helps to identify if an infection is present in the urinary system. High numbers of bacteria in the urine can indicate a urinary tract infection (UTI).

This service was performed 15 times for 15 patients

Bacterial culture, any other source except urine, blood or stool, aerobic

A bacterial culture is a test that helps identify harmful bacteria in your body. In this case, a sample from any part other than urine, blood or stool is collected. The sample is placed in a special environment to promote bacteria growth. It helps in diagnosing infections and determining the best treatment.

This service was performed 32 times for 32 patients

Bacterial urine culture

A bacterial urine culture is a laboratory test that checks for bacteria in your urine. It helps identify the type of bacteria causing an infection, enabling the selection of the most effective treatment. The test involves collecting a urine sample in a sterile container.

This service was performed 16 times for 16 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

This service was performed 76 times for 76 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

This service was performed 51 times for 50 patients

Detection test by immunoassay with direct visual observation for influenza virus

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

This service was performed 60 times for 30 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

This service was performed 36 times for 36 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 129 times for 122 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 26 times for 26 patients

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution

This process checks how well certain drugs, like antibiotics, can fight against infections. It involves mixing the drug with a microbe (like bacteria or a virus) in a lab. By observing how the microbe reacts, it helps determine the best drug to treat your infection.

This service was performed 12 times for 11 patients

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within

This is a test to detect the COVID-19 virus. It uses a technique that amplifies the virus's genetic material (DNA or RNA) for detection. High throughput technologies are used for rapid and large-scale testing. The procedure is completed within a set time frame.

This service was performed 27 times for 26 patients

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r

This is a test for COVID-19. It uses high-tech methods to find the virus's genetic material in your body. The amplified probe technique helps detect the virus even in small amounts. This is crucial for early detection and effective treatment.

This service was performed 32 times for 31 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 36 times for 36 patients

Urinalysis, manual test

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

This service was performed 17 times for 16 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $24.52 for a new patient copayment and $19.77 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 07922 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $98.09
  • Minimum New Patient Price $63.84
  • Maximum New Patient Price $190.92
  • Average New Patient Copayment $24.52
  • Minimum New Patient Copayment $15.96
  • Maximum New Patient Copayment $47.73

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $79.09
  • Minimum Established Patient Price $20.97
  • Maximum Established Patient Price $155.92
  • Average Established Patient Copayment $19.77
  • Minimum Established Patient Copayment $5.24
  • Maximum Established Patient Copayment $38.98

* 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 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 1811068042, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

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
8
Unchanged
Pos 3
1
Doubled → 2
Pos 4
1
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
0
Unchanged
Pos 9
4
Doubled → 8
Check
2
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 1 → 2 0 → 0 8 → 16 → 7 4 → 8

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 2 + 1 + 0 + 6 + 1 + 6 + 0 + 8 + 24 = 58

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

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1811068042.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine (Nephrology)
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Internal Medicine (Gastroenterology)
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Psychiatry & Neurology (Neurology)
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Orthopaedic Surgery
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Internal Medicine (Cardiovascular Disease)
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Internal Medicine (Gastroenterology)
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Internal Medicine (Nephrology)
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Plastic Surgery
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Ophthalmology
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Dermatology
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Surgery (Surgical Oncology)
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Otolaryngology
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Otolaryngology
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Internal Medicine (Rheumatology)
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Physical Therapist
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Dietitian, Registered
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Physical Therapist
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Emergency Medicine
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Orthopaedic Surgery
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Internal Medicine (Infectious Disease)
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811068042, enumerated as an "individual" on November 10, 2006.

The provider is located at 1 DIAMOND HILL RD SUMMIT MEDICAL GROUP BERKELEY HEIGHTS, NJ 07922 and the phone number is (908) 273-4300.

Physician Assistant with taxonomy code 363A00000X.

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