SMAIN SADOK M.D NPI 1891916383
Family Medicine in Chicago, IL
About SMAIN SADOK M.D
Smain Sadok is a primary care provider established in Chicago, Illinois and his medical specialization is Family Medicine with more than 35 years of experience. The NPI number of this provider is 1891916383 and was assigned on May 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 036117726 (IL). The provider is registered as an individual and his NPI record was last updated 3 years ago.
|Provider Name||SMAIN SADOK M.D|
|Location Address||3844 W 63RD ST CHICAGO, IL 60629|
|Location Phone||(773) 284-8601|
|Mailing Address||3844 W 63RD ST CHICAGO, IL 60629|
|NPI Entity Type||Individual|
|Medical School Name||OTHER|
|Is Sole Proprietor?||Yes|
|Last Update Date||07-28-2020|
A primary care provider (PCP) like Smain Sadok 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 Smain Sadok 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.
Smain Sadok is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with .
The typical physician office visit costs for Medicare beneficiaries in this area are: $24.24 for a new patient copayment and $27.76 for an established patient copayment.
The CLIA number of Smain Sadok is 14D0970762 registered as a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued to Smain Sadok in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
|Type||Allopathic & Osteopathic Physicians|
|Taxonomy Description||Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.|
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
3844 W 63RD ST
Phone: (773) 284-8601
Fax: (773) 284-8605
3844 W 63RD ST
Phone: (773) 284-8601
Fax: (773) 284-8605
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
|Registered in PECOS?||Yes|
|PECOS PAC ID||8325132277|
|PECOS Enrollment ID||I20070921000823|
|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 order / refer Part B Clinical Laboratory and Imaging||Yes|
|Eligible order / refer Durable Medical Equipment||Yes|
|Eligible order / refer Home Health Agency (HHA)||Yes|
|Eligible order / refer Power Mobility Devices||Yes|
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 60629 ZIP code area.
|New Patients Office Visits Costs *|
|Most Utilized Procedure Code for new patients office visits: 99203|
|Minimum New Patient Pricing||Maximum New Patient Pricing||Typical New Patient Pricing|
|Minimum New Patient Copayment||Maximum New Patient Copayment||Typical New Patient Copayment|
|Established Patients Office Visits Costs *|
|Most Utilized Procedure Code for established patients office visits: 99214|
|Minimum Established Patient Pricing||Maximum Established Patient Pricing||Typical Established Patient Pricing|
|Minimum Established Patient Copayment||Maximum Established Patient Copayment||Typical Established Patient Copayment|
* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 108Insertion of needle into vein for collection of blood sample (HCPCS:36415)
- 45Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple (HCPCS:G0180)
- 41Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
- 39Administration of influenza virus vaccine (HCPCS:G0008)
- 36Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1891916383 is:
|Facility Type||PHYSICIAN OFFICE|
|Certificate Type||Certificate for Provider-Performed Microscopy Procedures (PPMP)|
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
|No.||Taxonomy Code||Type||Classification||Specialization||License No.||State||Primary|
|1||208D00000X||Allopathic & Osteopathic Physicians||General Practice||036117726||IL||No|
Taxonomy Description: a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
|Identifier||Type / Code||Identifier State|
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.|
|Step 1: Double the value of the alternate digits, beginning with the rightmost digit.|
|Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.|
|2 + 8 + 1 + 8 + 1 + 1 + 8 + 1 + 1 + 2 + 3 + 1 + 6 + 24 = 67|
|Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.|
|70 - 67 = 3||3|
The NPI number 1891916383 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
|NPI||Name / Type||Taxonomy||Address|
|1003007774|| GEORGINA SALGADO CHAVEZ ACUPUNCTURIST |
|Acupuncturist||3844 W 63RD ST |
CHICAGO, IL 60629
Frequently Asked Questions
What is Smain Sadok M.D NPI number?
The NPI number assigned to this healthcare provider is 1891916383, registered as an "individual" on May 01, 2007
Where is Smain Sadok M.D located?
The provider is located at 3844 W 63rd St Chicago, Il 60629 and the phone number is (773) 284-8601
Which is Smain Sadok M.D specialty?
The provider's speciality is Family Medicine
How many years of experience does Smain Sadok M.D have?
The provider has more than 35 years of experience.
What insurance does Smain Sadok M.D accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Smain Sadok M.D registered in PECOS?
Yes, as of March 13, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare 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.
How much is a visit to Smain Sadok M.D?
Medicare beneficiaries should expect a typical cost of $96.99 with an average copayment of $24.24 for new patient appointments. Established patients should expect a typical charge of $111.04 and an average copayment of 27.76. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Smain Sadok M.D?
The most common procedures or services performed by this practitioner are: Insertion of needle into vein for collection of blood sample, Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Administration of influenza virus vaccine and Injection beneath the skin or into muscle for therapy, diagnosis, or prevention.
What is Smain Sadok M.D CLIA number?
The provider's CLIA number is 14D0970762 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
How do I update my NPI information?
The NPI record of Smain Sadok M.D was last updated on May 01, 2007. 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]
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