MEGAN JANIECE ABBOTT MD
NPI 1861997355
Psychiatry & Neurology - Epilepsy in Aurora, CO

NPI Status: Active since March 27, 2018

Contact Information

13123 E 16TH AVE
AURORA, CO
ZIP 80045
Phone: (720) 777-1234

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  • Individual
  • Female
  • Years of Experience 8
  • Psychiatry & Neurology
  • Epilepsy
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MEGAN ABBOTT

This page provides the complete NPI Profile along with additional information for Megan Abbott, a provider established in Aurora, Colorado with a medical specialization in Psychiatry & Neurology, focusing in epilepsy and more than 8 years of experience. She graduated from Baylor College Of Medicine in 2018. The healthcare provider is registered in the NPI registry with number 1861997355 assigned on March 2018. The practitioner's primary taxonomy code is 2084E0001X with license number DR.0070867 (CO). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1861997355
Provider Name
MEGAN JANIECE ABBOTT MD
Gender
Female
Entity Type
Individual
Location Address
13123 E 16TH AVE AURORA, CO 80045
Location Phone
(720) 777-1234
Mailing Address
PO BOX 110429 AURORA, CO 80042
Medical School Name
BAYLOR COLLEGE OF MEDICINE
Graduation Year
2018
Is Sole Proprietor?
No
Enumeration Date
03-27-2018
Last Update Date
08-09-2024
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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

Psychiatry & Neurology Epilepsy

Taxonomy Code
2084E0001X
Type
Allopathic & Osteopathic Physicians
License No.
DR.0070867
License State
CO
Taxonomy Description
Epilepsy is a subspecialty of neurology focused on the diagnosis and treatment of patients with epilepsy, including new-onset, medically refractory epilepsy, psychogenic nonepileptic seizures, and epilepsy in special populations (the elderly, women, patients with co-morbidities). Epilepsy is a multidisciplinary field that provides comprehensive care of the patient.

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)
12084N0402XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Neurology with Special Qualifications in Child Neurology

DR.0070867 (CO)

Insurance Plans Accepted

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

  • Medica Insure Bronze $0 Copay PCP Visits - EPO
  • Medica Insure Bronze Premier - EPO
  • Medica Insure Bronze Share - EPO
  • Medica Insure Expanded Bronze Standard - EPO
  • Medica Insure Gold $0 Copay PCP Visits - EPO
  • Medica Insure Gold Share - EPO
  • Medica Insure Gold Standard - EPO
  • Medica Insure Silver $0 Copay PCP Visits - EPO
  • Medica Insure Silver Share - EPO
  • Medica Insure Silver Standard - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Bronze Value HSA (No Referrals) - EPO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO
  • UHC Gold Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Silver Standard (No Referrals) - EPO
  • UHC Silver Value ($0 Virtual Urgent Care, No Referrals) - EPO

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

Medicare Participation & PECOS Enrollment Status

Megan Abbott 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.

Megan Abbott 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: 4587929682

    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: I20240703002486

    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

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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 1861997355, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

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
6
Doubled → 12 → 1 + 2
Pos 4
1
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
9
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
3
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
5
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 6 → 12 → 3 9 → 18 → 9 7 → 14 → 5 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 1 + 2 + 1 + 1 + 8 + 9 + 1 + 4 + 3 + 1 + 0 + 24 = 65

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

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1861997355.

Other Providers at the Same Location


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

Physician Assistant
13123 E 16TH AVE
AURORA, CO 80045
Physician Assistant
13123 E 16TH AVE, B145
AURORA, CO 80045
Physician Assistant
13123 E 16TH AVE
AURORA, CO 80045
Pediatrics (Pediatric Hematology-Oncology)
13123 E 16TH AVE
AURORA, CO 80045
Anesthesiology
13123 E 16TH AVE
AURORA, CO 80045
Pediatrics (Pediatric Infectious Diseases)
13123 E 16TH AVE
AURORA, CO 80045
Pediatrics (Pediatric Gastroenterology)
13123 E 16TH AVE, THE CHILDRENS HOSPITAL
AURORA, CO 80045
Urology (Pediatric Urology)
13123 E 16TH AVE
AURORA, CO 80045
Pediatrics
13123 E 16TH AVE
AURORA, CO 80045
Clinical Neuropsychologist
13123 E 16TH AVE
AURORA, CO 80045
Pediatrics (Pediatric Gastroenterology)
13123 E 16TH AVE
AURORA, CO 80045
Pediatrics
13123 E 16TH AVE
AURORA, CO 80045
Anesthesiology
13123 E 16TH AVE
AURORA, CO 80045
Orthopaedic Surgery
13123 E 16TH AVE
AURORA, CO 80045
Social Worker (Clinical)
13123 E 16TH AVE
AURORA, CO 80045
Occupational Therapist
13123 E 16TH AVE
AURORA, CO 80045
Pediatrics
13123 E 16TH AVE, B390
AURORA, CO 80045
Nurse Practitioner (Pediatrics)
13123 E 16TH AVE, THE CHILDREN'S HOSPITAL
AURORA, CO 80045
Pediatrics (Neonatal-Perinatal Medicine)
13123 E 16TH AVE
AURORA, CO 80045
Emergency Medicine
13123 E 16TH AVE
AURORA, CO 80045

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1861997355, enumerated as an "individual" on March 27, 2018.

The provider is located at 13123 E 16TH AVE AURORA, CO 80045 and the phone number is (720) 777-1234.

Psychiatry & Neurology with taxonomy code 2084E0001X and a focus in Epilepsy .

The provider might be accepting Accepts: Medica and UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.