MATTHEW DUNCAN
NPI 1821472473
Anesthesiologist Assistant in Atlanta, GA
NPI Status: Active since July 14, 2015
Contact Information
4210 MORGAN PLACE CT NE
ATLANTA, GA
ZIP 30324
Phone: (434) 548-6288
- Individual
- Male
- Years of Experience 11
- Anesthesiologist Assistant
- Accepts Insurance
- Accepts Medicare Approved Payment
- Medicare Quality Reporting
About MATTHEW DUNCAN
This page provides the complete NPI Profile along with additional information for Matthew Duncan, a provider established in Atlanta, Georgia with a medical specialization in Anesthesiologist Assistant and more than 11 years of experience. He graduated from Emory University School Of Medicine in 2015. The healthcare provider is registered in the NPI registry with number 1821472473 assigned on July 2015. The practitioner's primary taxonomy code is 367H00000X. The provider is registered as an individual and his NPI record was last updated 11 years ago.
- NPI
- 1821472473
- Provider Name
- MATTHEW DUNCAN
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4210 MORGAN PLACE CT NE ATLANTA, GA 30324
- Location Phone
- (434) 548-6288
- Mailing Address
- 4210 MORGAN PLACE CT NE ATLANTA, GA 30324
- Mailing Phone
- (434) 548-6288
- Medical School Name
- EMORY UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2015
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-14-2015
- Last Update Date
- 07-14-2015
- Code Navigator
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
Anesthesiologist Assistant
- Taxonomy Code
- 367H00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- Taxonomy Description
- An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze Classic 4700 - EPO
- Bronze Classic 4700 | MercyOne - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard | MercyOne - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus | MercyOne - EPO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits | MercyOne - EPO
- Bronze Simple Chronic Care CKM | MercyOne - EPO
- Bronze Simple Diabetes | MercyOne - EPO
- Gold Classic Standard - EPO
- Gold Classic Standard | MercyOne - EPO
- Gold Elite - EPO
- Gold Elite | MercyOne - EPO
- Secure - EPO
- Secure | MercyOne - EPO
- Silver Classic - EPO
- Silver Classic | MercyOne - EPO
- Silver Classic Standard - EPO
- Silver Classic Standard | MercyOne - EPO
- Silver Simple Breathe Easy with Enhanced COPD Benefits | MercyOne - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Matthew Duncan 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.
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.
PECOS PAC ID: 2961710074
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: I20151008002165
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.
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.
Anesthesia for extensive surgery on spine
Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope
Anesthesia for other procedure on large bowel using an endoscope
Anesthesia for extensive spine surgery involves medication to block pain and make you unconscious during the procedure. It ensures comfort and prevents movement. Two types may be used: general (you sleep) or regional (numbs a large area). The choice depends on the surgery specifics and your health.
This service was performed 13 times for 13 patientsThis procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.
This service was performed 19 times for 17 patientsAnesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.
This service was performed 11 times for 11 patientsQuality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Participation in an AHRQ-listed patient safety organization. | Yes | N/A |
| Participation in an AHRQ-listed patient safety organization. | ||
| Post-Anesthetic Transfer of Care Measure: Procedure Room to a Post Anesthesia Care Unit (PACU) | 35% | 207 |
| Percentage of patients, regardless of age, who are under the care of an anesthesia practitioner and are admitted to a PACU or other non-ICU location in which a post-anesthetic formal transfer of care protocol or checklist which includes the key transfer of care elements is utilized | ||
| Use of QCDR data for ongoing practice assessment and improvements | Yes | N/A |
| Use of QCDR data, for ongoing practice assessment and improvements in patient safety. | ||
| Use of QCDR to promote standard practices, tools and processes in practice for improvement in care coordination | Yes | N/A |
| Participation in a Qualified Clinical Data Registry, demonstrating performance of activities that promote use of standard practices, tools and processes for quality improvement (e.g., documented preventative screening and vaccinations that can be shared across MIPS eligible clinician or groups). | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Matthew Duncan is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| NORTHSIDE HOSPITAL CHEROKEE | 450 NORTHSIDE CHEROKEE BOULEVARD CANTON, GA 30115 | (770) 244-1000 | Acute Care Hospitals |
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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 1821472473, we treat the final digit (3) 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1821472473, enumerated as an "individual" on July 14, 2015.
The provider is located at 4210 MORGAN PLACE CT NE ATLANTA, GA 30324 and the phone number is (434) 548-6288.
Anesthesiologist Assistant with taxonomy code 367H00000X.
The provider might be accepting Accepts: Oscar Insurance Company. Please consult your insurance carrier or call the provider to verify.
Matthew Duncan is affiliated with: NORTHSIDE HOSPITAL CHEROKEE.