TIMOTHY FRANCIS GARNER M.D.
NPI 1902868813
Family Medicine in Marion, OH

NPI Status: Active since April 05, 2006

Contact Information

241 EXECUTIVE DR
MARION, OH
ZIP 43302
Phone: (740) 387-3256
Fax: (740) 383-4906

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Durable Medical Equipment
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Family Medicine
Accepts Insurance
PECOS Enrolled
Medicare Quality Reporting

About TIMOTHY GARNER

This page provides the complete NPI Profile along with additional information for Timothy Garner, a primary care provider established in Marion, Ohio with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1902868813 assigned on April 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 35-051305 (OH). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI: 1902868813
Provider Name: TIMOTHY FRANCIS GARNER M.D.
Gender: Male
Entity Type: Individual
Location Address: 241 EXECUTIVE DR MARION, OH 43302
Location Phone: (740) 387-3256
Location Fax: (740) 383-4906
Mailing Address: 241 EXECUTIVE DR MARION, OH 43302
Mailing Phone: (740) 387-3256
Mailing Fax: (740) 383-4906
Is Sole Proprietor?: No
Enumeration Date: 04-05-2006
Last Update Date: 08-20-2008
Code Navigator

A primary care provider (PCP) like Timothy Garner 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 .

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: Family Medicine
Taxonomy Code: 207Q00000X
Type: Allopathic & Osteopathic Physicians
License No.: 35-051305
License State: OH
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.

Insurance Plans Accepted

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

CareSource

Bronze 7500 $25 Generic Drugs - HMO
Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
Core Gold 1500 $10 Generic Drugs - HMO
Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
Gold 2000 $15 Generic Drugs - HMO
Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
Low Premium Bronze 10600 $25 Generic Drugs - HMO
Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
Low Premium Silver 6200 $3 Generic Drugs - HMO
Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
Silver 6000 $20 Generic Drugs - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

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
0695805	MEDICAID (05)	OH
0615226	MEDICARE PIN (08)	OH
A17414	MEDICARE UPIN (02)

Medicare Participation & PECOS Enrollment Status

Timothy Garner 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
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-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 11 Medicare Claims 11 Services Paid

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 43302 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $84.72
Minimum New Patient Price $54.34
Maximum New Patient Price $166.65

Average New Patient Copayment $21.18
Minimum New Patient Copayment $13.58
Maximum New Patient Copayment $41.66

Established Patients Visit Costs *

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

Average Established Patient Price $96.44
Minimum Established Patient Price $17.1
Maximum Established Patient Price $135.4

Average Established Patient Copayment $24.11
Minimum Established Patient Copayment $4.27
Maximum Established Patient Copayment $33.85

* 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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Advance Care Planning	Yes	N/A
Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning.
Care Plan	86%	186
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel Level	Yes	N/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Participation in an AHRQ-listed patient safety organization.	Yes	N/A
Participation in an AHRQ-listed patient safety organization.

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 1902868813, 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.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 0

Pos 4

Unchanged

Pos 5

Doubled → 16 → 1 + 6

Pos 6

Unchanged

Pos 7

Doubled → 16 → 1 + 6

Pos 8

Unchanged

Pos 9

Doubled → 2

Check

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 0 → 0 8 → 16 → 7 8 → 16 → 7 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 9 + 0 + 2 + 1 + 6 + 6 + 1 + 6 + 8 + 2 + 24 = 67

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.

70 - 67 = 3

This NPI is valid

The calculated check digit is 3, which matches the last digit of 1902868813.