LAUREN NICOLE HIMMEL PA-C
NPI 1861039844
Physician Assistant in Shelby Twp., MI

NPI Status: Active since December 09, 2019

Contact Information

13051 MICHAEL DR.
SHELBY TWP., MI
ZIP 48315
Phone: (586) 212-6041

Get Directions Reviews

  • Individual
  • Female
  • Years of Experience 5
  • Physician Assistant
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About LAUREN HIMMEL

Lauren Himmel is a primary care provider established in Shelby Twp., Michigan and her medical specialization is Physician Assistant with more than 5 years of experience. The healthcare provider is registered in the NPI registry with number 1861039844 assigned on December 2019. The practitioner's primary taxonomy code is 363A00000X with license number 5601009808 (MI). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1861039844
Provider Name
LAUREN NICOLE HIMMEL PA-C
Gender
Female
Entity Type
Individual
Location Address
13051 MICHAEL DR. SHELBY TWP., MI 48315
Location Phone
(586) 212-6041
Mailing Address
13051 MICHAEL DR. SHELBY TWP., MI 48315
Medical School Name
OTHER
Graduation Year
2019
Is Sole Proprietor?
No
Enumeration Date
12-09-2019
Last Update Date
07-28-2022
Code Navigator

A primary care provider (PCP) like Lauren Himmel 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

Lauren Himmel 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.

The typical physician office visit costs for Medicare beneficiaries in this area are: $23.37 for a new patient copayment and $18.9 for an established patient copayment.

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.
5601009808
License State
MI
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.

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)
1363A00000XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant

 

Insurance Plans Accepted

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

  • Molina Healthcare

    • Gold 1 - HMO
    • Gold 1 with Adult Vision Services - HMO
    • Gold 8 - HMO
    • Silver 1 - HMO
    • Silver 1 with Adult Vision Services - HMO
    • Silver 12 with First 4 Primary Care Visits Free - HMO
    • Silver 8 - HMO

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

PECOS Enrollment and Medicare Participation Status

Lauren Himmel 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: 8426451154

    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: I20210719003082

    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 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 48315 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $93.48
  • Minimum New Patient Price $60.64
  • Maximum New Patient Price $184.65
  • Average New Patient Copayment $23.37
  • Minimum New Patient Copayment $15.16
  • Maximum New Patient Copayment $46.16

Established Patients Visit Costs *

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

  • Average Established Patient Price $75.6
  • Minimum Established Patient Price $18.56
  • Maximum Established Patient Price $150
  • Average Established Patient Copayment $18.9
  • Minimum Established Patient Copayment $4.64
  • Maximum Established Patient Copayment $37.5

* 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.

Hospital Affiliations

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. Lauren Himmel is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
BEAUMONT HOSPITAL, TROY44201 DEQUINDRE ROAD
TROY, MI 48085
(248) 964-8800Acute Care Hospitals

Reviews for LAUREN NICOLE HIMMEL PA-C

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1861039844
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
28121031888
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 1 + 2 + 1 + 0 + 3 + 1 + 8 + 8 + 8 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1861039844 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1861039844, enumerated in the NPI registry as an "individual" on December 09, 2019

The provider is located at 13051 Michael Dr. Shelby Twp., Mi 48315 and the phone number is (586) 212-6041

The provider's speciality is Physician Assistant with taxonomy code 363A00000X

The provider has more than 5 years of experience.

The provider might be accepting Accepts: Molina Healthcare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

Medicare beneficiaries should expect a typical cost of $93.48 with an average copayment of $23.37 for new patient appointments. Established patients should expect a typical charge of $75.6 and an average copayment of 18.9. Please review your insurance plan or contact the provider directly to determine your specific costs.

The practitioner is affiliated to the following hospital(s): BEAUMONT HOSPITAL, TROY. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on December 09, 2019. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.