CARL JOHN KORNMAN MD
NPI 1821613522
Hospitalist in Gatesville, TX

NPI Status: Active since June 09, 2020

Contact Information

1507 W MAIN ST
GATESVILLE, TX
ZIP 76528
Phone: (254) 865-8251
Fax: (254) 248-6306

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  • Individual
  • Male
  • Years of Experience 6
  • Hospitalist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About CARL KORNMAN

This page provides the complete NPI Profile along with additional information for Carl Kornman, a provider established in Gatesville, Texas with a medical specialization in Hospitalist and more than 6 years of experience. He graduated from Texas Tech University Health Science Center School Of Medicine in 2020. The healthcare provider is registered in the NPI registry with number 1821613522 assigned on June 2020. The practitioner's primary taxonomy code is 208M00000X with license number T4653 (TX). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1821613522
Provider Name
CARL JOHN KORNMAN MD
Gender
Male
Entity Type
Individual
Location Address
1507 W MAIN ST GATESVILLE, TX 76528
Location Phone
(254) 865-8251
Location Fax
(254) 248-6306
Mailing Address
1507 W MAIN ST GATESVILLE, TX 76528
Mailing Phone
(254) 865-8251
Mailing Fax
(254) 248-6306
Medical School Name
TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduation Year
2020
Is Sole Proprietor?
No
Enumeration Date
06-09-2020
Last Update Date
10-18-2023
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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

Hospitalist

Taxonomy Code
208M00000X
Type
Allopathic & Osteopathic Physicians
License No.
T4653
License State
TX
Taxonomy Description
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

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)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

T4653 (TX)
2207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

BP10070629 (TX)

Insurance Plans Accepted

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

  • BSW Diabetes Care Gold HMO 014 - HMO
  • BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Elite Gold HMO 004 - HMO
  • BSW Elite Gold HMO 012 - HMO
  • BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Prime Silver HMO 008 - HMO
  • BSW Prime Silver HMO 005 - HMO
  • BSW Savers Bronze HMO H S A 006 - HMO
  • BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Savers Bronze HMO H S A 009 - HMO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • MyBlue Health Bronze? 402 - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Carl Kornman 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.

Carl Kornman 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: 7719361898

    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: I20220909000091

    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

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.6 for a new patient copayment and $24.26 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 76528 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $126.4
  • Minimum New Patient Price $54.84
  • Maximum New Patient Price $166.88
  • Average New Patient Copayment $31.6
  • Minimum New Patient Copayment $13.71
  • Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $97.05
  • Minimum Established Patient Price $17.52
  • Maximum Established Patient Price $136.11
  • Average Established Patient Copayment $24.26
  • Minimum Established Patient Copayment $4.38
  • Maximum Established Patient Copayment $34.02

* 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.

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. Carl Kornman is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ADVENTHEALTH CENTRAL TEXAS2201 S CLEAR CREEK ROAD
KILLEEN, TX 76542
(254) 526-7523Acute Care Hospitals
CORYELL MEMORIAL HOSPITAL1507 W MAIN STREET
GATESVILLE, TX 76528
(254) 865-8251Critical Access Hospitals

Reviews for CARL JOHN KORNMAN MD

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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 1821613522, 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
2
Doubled → 4
Pos 4
1
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
1
Unchanged
Pos 7
3
Doubled → 6
Pos 8
5
Unchanged
Pos 9
2
Doubled → 4
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 2 → 4 6 → 12 → 3 3 → 6 2 → 4

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 4 + 1 + 1 + 2 + 1 + 6 + 5 + 4 + 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 1821613522.

Other Providers at the Same Location


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

Internal Medicine (Pulmonary Disease)
1507 W MAIN ST
GATESVILLE, TX 76528
Physician Assistant
1507 W MAIN ST
GATESVILLE, TX 76528
Psychologist (Clinical)
1507 W MAIN ST
GATESVILLE, TX 76528
Nurse Practitioner (Family)
1507 W MAIN ST
GATESVILLE, TX 76528
Physician Assistant
1507 W MAIN ST
GATESVILLE, TX 76528
Family Medicine
1507 W MAIN ST
GATESVILLE, TX 76528
Nurse Practitioner (Family)
1507 W MAIN ST
GATESVILLE, TX 76528
Podiatrist
1507 W MAIN ST
GATESVILLE, TX 76528
Family Medicine
1507 W MAIN ST
GATESVILLE, TX 76528
Ambulance (Land Transport)
1507 W MAIN ST
GATESVILLE, TX 76528
Nurse Practitioner (Family)
1507 W MAIN ST
GATESVILLE, TX 76528
Podiatrist
1507 W MAIN ST
GATESVILLE, TX 76528
Nurse Practitioner (Family)
1507 W MAIN ST
GATESVILLE, TX 76528
Emergency Medicine
1507 W MAIN ST
GATESVILLE, TX 76528
Dermatology
1507 W MAIN ST
GATESVILLE, TX 76528
Internal Medicine (Nephrology)
1507 W MAIN ST
GATESVILLE, TX 76528
Dermatology
1507 W MAIN ST
GATESVILLE, TX 76528
Orthopaedic Surgery
1507 W MAIN ST
GATESVILLE, TX 76528
Family Medicine
1507 W MAIN ST
GATESVILLE, TX 76528
Radiology (Diagnostic Radiology)
1507 W MAIN ST
GATESVILLE, TX 76528

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821613522, enumerated as an "individual" on June 09, 2020.

The provider is located at 1507 W MAIN ST GATESVILLE, TX 76528 and the phone number is (254) 865-8251.

Hospitalist with taxonomy code 208M00000X.

The provider might be accepting Accepts: Baylor Scott and White Health Plan and Blue Cross. Please consult your insurance carrier or call the provider to verify.

Carl Kornman is affiliated with: ADVENTHEALTH CENTRAL TEXAS and CORYELL MEMORIAL HOSPITAL.