DR. MICHAEL SANDERS CRAPANZANO SR. M.D.
NPI 1811996184
Pediatrics - Pediatric Cardiology in Baton Rouge, LA

NPI Status: Active since July 19, 2005

Contact Information

8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA
ZIP 70809
Phone: (225) 767-6700
Fax: (225) 767-6721

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  • Individual
  • Male
  • Years of Experience 38
  • Pediatrics
  • Pediatric Cardiology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MICHAEL CRAPANZANO

This page provides the complete NPI Profile along with additional information for Michael Crapanzano, a pediatrician established in Baton Rouge, Louisiana with a medical specialization in Pediatrics, focusing in pediatric cardiology and more than 38 years of experience. He graduated from Medical College Of Georgia School Of Medicine in 1988. The healthcare provider is registered in the NPI registry with number 1811996184 assigned on July 2005. The practitioner's primary taxonomy code is 2080P0202X with license number 019862 (LA). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1811996184
Provider Name
DR. MICHAEL SANDERS CRAPANZANO SR. M.D.
Gender
Male
Entity Type
Individual
Location Address
8200 CONSTANTIN BLVD STE 200 BATON ROUGE, LA 70809
Location Phone
(225) 767-6700
Location Fax
(225) 767-6721
Mailing Address
8200 CONSTANTIN BLVD STE 200 BATON ROUGE, LA 70809
Mailing Phone
(225) 709-8633
Mailing Fax
(225) 767-6721
Medical School Name
MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduation Year
1988
Is Sole Proprietor?
Yes
Enumeration Date
07-19-2005
Last Update Date
11-06-2024
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A pediatrician like Michael Crapanzano 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

Secondary Locations

  • 433 Plaza St
    Bogalusa, LA 70427
    (985) 730-6700
  • 8300 Constantin Blvd
    Baton Rouge, LA 70809
    (225) 374-1468

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 Pediatric Cardiology

Taxonomy Code
2080P0202X
Type
Allopathic & Osteopathic Physicians
License No.
019862
License State
LA
Taxonomy Description
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.

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)
1208000000XAllopathic & Osteopathic Physicians

Pediatrics

019862 (LA)
22080P0203XAllopathic & Osteopathic Physicians

Pediatrics
Pediatric Critical Care Medicine

019862 (LA)

Insurance Plans Accepted

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

  • AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
  • AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
  • AmeriHealth Caritas Next Gold Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Essential + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Signature + No Referrals - HMO
  • Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible - PPO
  • Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits - PPO
  • Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits - PPO
  • Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible - PPO
  • Blue Max Copay (PCP) 60/40 $6000 Standardized - PPO
  • Blue Max Copay (PCP) 75/55 $2000 Standardized - PPO
  • Blue Saver 60/40 $6100 - PPO
  • Blue Saver 90/70 $3400 - PPO
  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (L) - POS
  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (N) - POS
  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (S) - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (H) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (L) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (N) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (S) HSA Eligible - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (L) - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (N) - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (S) - POS
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO
  • UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Copay Focus + $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO

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
1656232MEDICAID (05)LA 

Medicare Participation & PECOS Enrollment Status

Michael Crapanzano 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.

Michael Crapanzano 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: 2264332246

    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: I20080609000218

    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

Reviews for DR. MICHAEL SANDERS CRAPANZANO SR. M.D.

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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 1811996184, 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 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 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
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
9
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
1
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
4
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 6 → 12 → 3 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 + 9 + 1 + 2 + 1 + 1 + 6 + 24 = 66

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

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1811996184.

Other Providers at the Same Location


The following 12 providers are registered at the same or a nearby location.

Pediatrics (Pediatric Cardiology)
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809
Pediatrics (Pediatric Cardiology)
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809
Pediatrics (Pediatric Cardiology)
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809
Pediatrics (Pediatric Cardiology)
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809
Pediatrics
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809
Pediatrics (Pediatric Critical Care Medicine)
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809
Pediatrics (Pediatric Critical Care Medicine)
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809
Pediatrics
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809
Pediatrics (Pediatric Critical Care Medicine)
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809
Physician Assistant
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809
Physician Assistant (Medical)
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809
Physician Assistant (Medical)
8200 CONSTANTIN BLVD STE 200
BATON ROUGE, LA 70809

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811996184, enumerated as an "individual" on July 19, 2005.

The provider is located at 8200 CONSTANTIN BLVD STE 200 BATON ROUGE, LA 70809 and the phone number is (225) 767-6700.

Pediatrics with taxonomy code 2080P0202X and a focus in Pediatric Cardiology.

The provider might be accepting Accepts: AmeriHealth Caritas Next, Blue Cross and Blue. Please consult your insurance carrier or call the provider to verify.