GARY F STONES DPM
NPI 1811965080
Podiatrist in Massapequa, NY

NPI Status: Active since March 14, 2006

Contact Information

566 BROADWAY
MASSAPEQUA, NY
ZIP 11758
Phone: (516) 799-6616
Fax: (516) 799-6472

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  • Individual
  • Male
  • Years of Experience 42
  • Podiatrist
  • May Accept Medicare Approved Payment
  • PECOS Enrolled

About GARY STONES

This page provides the complete NPI Profile along with additional information for Gary Stones, a provider established in Massapequa, New York with a medical specialization in Podiatrist and more than 42 years of experience. He graduated from New York College Of Podiatric Medicine in 1984. The healthcare provider is registered in the NPI registry with number 1811965080 assigned on March 2006. The practitioner's primary taxonomy code is 213E00000X with license number N0038101 (NY). The provider is registered as an individual and his NPI record was last updated 14 years ago.

NPI
1811965080
Provider Name
GARY F STONES DPM
Gender
Male
Entity Type
Individual
Location Address
566 BROADWAY MASSAPEQUA, NY 11758
Location Phone
(516) 799-6616
Location Fax
(516) 799-6472
Mailing Address
566 BROADWAY MASSAPEQUA, NY 11758
Mailing Phone
(516) 799-6616
Mailing Fax
(516) 799-6472
Medical School Name
NEW YORK COLLEGE OF PODIATRIC MEDICINE
Graduation Year
1984
Is Sole Proprietor?
Yes
Enumeration Date
03-14-2006
Last Update Date
11-14-2012
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A podiatrist like Gary Stones provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.

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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

Taxonomy Code
213E00000X
Type
Podiatric Medicine & Surgery Service Providers
License No.
N0038101
License State
NY
Taxonomy Description
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

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.

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.

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
P41361MEDICARE ID-TYPE UNSPECIFIED (04) 
2C6354OTHER (01)HEALTHNET
DR6940OTHER (01)OXFORD HEALTH PLANS
N003810N13OTHER (01)NYHEALTH FIRST
00924290MEDICAID (05)NY 
0458381OTHER (01)AETNA
T51286MEDICARE UPIN (02) 
0021049OTHER (01)NYGHI
P4136OTHER (01)NYEMPIRE BCBS
4245910001MEDICARE NSC (07)NY 
480004311OTHER (01)MEDICARE RAILROAD

Medicare Participation & PECOS Enrollment Status

Gary Stones is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Gary Stones 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: 1759593874

    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: I20101014000177

    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? Maybe

    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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Orthotic Devices

  • DME-Orthotic Devices (DF000N)

    For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe (HCPCS:A5500)

    2 DME suppliers used 17 Medicare Claims 32 Services Paid

  • DME-Orthotic Devices (DF000N)

    For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each (HCPCS:A5512)

    2 DME suppliers used 15 Medicare Claims 78 Services Paid

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.

Destruction of skin growth, 1-14 growths

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

This service was performed 103 times for 24 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 422 times for 132 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 27 times for 27 patients

Removal of fingernails or toenails, 1-5 nails

This procedure involves the careful removal of 1-5 nails from fingers or toes. It's typically done to treat conditions like ingrown nails, fungal infections, or damaged nails. Local anesthesia is used for comfort, and the area heals over time with appropriate care.

This service was performed 56 times for 22 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 788 times for 220 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 293 times for 84 patients

Removal of noncancer thickened skin growth, more than 4 growths

This procedure involves the removal of more than four noncancerous, thickened skin growths. It's a simple process where a healthcare professional uses a specialized tool to carefully remove these growths, promoting healthier skin.

This service was performed 93 times for 23 patients

Removal of tissue from wound, 20.0 sq cm or less

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

This service was performed 26 times for 12 patients

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 11758 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $105.06
  • Minimum New Patient Price $67.4
  • Maximum New Patient Price $203.53
  • Average New Patient Copayment $26.26
  • Minimum New Patient Copayment $16.85
  • Maximum New Patient Copayment $50.88

Established Patients Visit Costs *

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

  • Average Established Patient Price $83.44
  • Minimum Established Patient Price $21.66
  • Maximum Established Patient Price $164.45
  • Average Established Patient Copayment $20.86
  • Minimum Established Patient Copayment $5.41
  • Maximum Established Patient Copayment $41.11

* 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 1811965080, 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 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
8
Unchanged
Pos 3
1
Doubled → 2
Pos 4
1
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
6
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
0
Unchanged
Pos 9
8
Doubled → 16 → 1 + 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 1 → 2 9 → 18 → 9 5 → 10 → 1 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 2 + 1 + 1 + 8 + 6 + 1 + 0 + 0 + 1 + 6 + 24 = 60

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

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

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1811965080.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Physical Medicine & Rehabilitation
566 BROADWAY
MASSAPEQUA, NY 11758
Internal Medicine (Rheumatology)
566 BROADWAY
MASSAPEQUA, NY 11758
Durable Medical Equipment & Medical Supplies
566 BROADWAY
MASSAPEQUA, NY 11758
Internal Medicine (Rheumatology)
566 BROADWAY
MASSAPEQUA, NY 11758
Internal Medicine (Rheumatology)
566 BROADWAY
MASSAPEQUA, NY 11758

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811965080, enumerated as an "individual" on March 14, 2006.

The provider is located at 566 BROADWAY MASSAPEQUA, NY 11758 and the phone number is (516) 799-6616.

Podiatrist with taxonomy code 213E00000X.

The provider might be accepting Accepts: Medicare, Medicaid, Oxford Health Plans, Aetna,. Please consult your insurance carrier or call the provider to verify.