MARIA TERESA DE LA MORENA MD
NPI 1891764353
Pediatrics - Pediatric Allergy/Immunology in Seattle, WA
NPI Status: Active since March 16, 2006
Contact Information
4800 SAND POINT WAY NE
M/S: HB.B.501
SEATTLE, WA
ZIP 98105
Phone: (206) 987-7450
Fax: (206) 985-3119
- Individual
- Female
- Years of Experience 44
- Pediatrics
- Pediatric Allergy/Immunology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MARIA TERESA DE LA MORENA
This page provides the complete NPI Profile along with additional information for Maria Teresa De La Morena, a pediatrician established in Seattle, Washington with a medical specialization in Pediatrics, focusing in pediatric allergy/immunology and more than 44 years of experience. The healthcare provider is registered in the NPI registry with number 1891764353 assigned on March 2006. The practitioner's primary taxonomy code is 2080P0201X with license number M2598 (TX). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1891764353
- Provider Name
- MARIA TERESA DE LA MORENA MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4800 SAND POINT WAY NE M/S: HB.B.501 SEATTLE, WA 98105
- Location Phone
- (206) 987-7450
- Location Fax
- (206) 985-3119
- Mailing Address
- 4800 SAND POINT WAY NE M/S: HB.B.501 SEATTLE, WA 98105
- Mailing Phone
- (206) 987-7450
- Mailing Fax
- (206) 985-3119
- Medical School Name
- OTHER
- Graduation Year
- 1982
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-16-2006
- Last Update Date
- 01-09-2019
- Code Navigator
A pediatrician like Maria Teresa De La Morena 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
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 Allergy/Immunology
- Taxonomy Code
- 2080P0201X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- M2598
- License State
- TX
- Taxonomy Description
- A pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
- Premera Blue Cross Family Dental - PPO
- Premera Blue Cross Pediatric Dental - PPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - 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 |
|---|---|---|---|
| 060847302 | MEDICAID (05) | TX |
Medicare Participation & PECOS Enrollment Status
Maria Teresa De La Morena 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.
Maria Teresa De La Morena 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: 7810918885
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: I20180604002390
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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) (HCPCS:A4221)
2 DME suppliers used 35 Medicare Claims 131 Services Paid
DME-Other DME (DE000N)
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each (HCPCS:K0552)
3 DME suppliers used 45 Medicare Claims 236 Services Paid
Unknown
Treatment-Injections and Infusions (nononcologic) (RI008N)
Injection, immune globulin (hizentra), 100 mg (HCPCS:J1559)
3 DME suppliers used 48 Medicare Claims 16320 Services Paid
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. Maria Teresa De La Morena is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| SEATTLE CHILDREN'S HOSPITAL | 4800 SAND POINT WAY NE, PO BOX C-5371 SEATTLE, WA 98105 | (206) 987-2000 | Childrens |
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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 1891764353, 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.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SEATTLE, WA 98105
SEATTLE, WA 98105
SEATTLE, WA 98105
SEATTLE, WA 98105
SEATTLE, WA 98105
SEATTLE, WA 98105
SEATTLE, WA 98105
SEATTLE, WA 98105
SEATTLE, WA 98105
SEATTLE, WA 98105
SEATTLE, WA 98105
SEATTLE, WA 98105
SEATTLE, WA 98105
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1891764353, enumerated as an "individual" on March 16, 2006.
The provider is located at 4800 SAND POINT WAY NE M/S: HB.B.501 SEATTLE, WA 98105 and the phone number is (206) 987-7450.
Pediatrics with taxonomy code 2080P0201X and a focus in Pediatric Allergy/Immunology.
The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska,. Please consult your insurance carrier or call the provider to verify.
Maria Teresa De La Morena is affiliated with: SEATTLE CHILDREN'S HOSPITAL.