DR. WAYNE MARK DURAN M.D.
NPI 1912099383
Preferred Provider Organization in Auburn, WA
NPI Status: Active since September 29, 2006
Contact Information
1402 LAKE TAPPS PKWY E
SUITE F106
AUBURN, WA
ZIP 98092
Phone: (253) 288-8882
Fax: (253) 288-2283
- Individual
- Male
- Preferred Provider Organization
- Accepts Insurance
- Opted-Out Medicare
About WAYNE DURAN
This page provides the complete NPI Profile along with additional information for Wayne Duran, a provider established in Auburn, Washington with a medical specialization in Preferred Provider Organization. The healthcare provider is registered in the NPI registry with number 1912099383 assigned on September 2006. The practitioner's primary taxonomy code is 305R00000X with license number MD 00020201 (WA). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1912099383
- Provider Name
- DR. WAYNE MARK DURAN M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1402 LAKE TAPPS PKWY E SUITE F106 AUBURN, WA 98092
- Location Phone
- (253) 288-8882
- Location Fax
- (253) 288-2283
- Mailing Address
- PO BOX 1237 MILTON, WA 98354
- Mailing Phone
- (253) 288-8882
- Mailing Fax
- (253) 288-2283
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 09-29-2006
- Last Update Date
- 07-08-2007
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Wayne Duran opted out of Medicare effective on 07-29-2024 until 07-29-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
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
Preferred Provider Organization
- Taxonomy Code
- 305R00000X
- Type
- Managed Care Organizations
- License No.
- MD 00020201
- License State
- WA
- Taxonomy Description
- A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
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
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 |
|---|---|---|---|
| A08902 | MEDICARE UPIN (02) | WA |
Medicare Participation & PECOS Enrollment Status
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.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 07-29-2024
Opt-Out End Date: 07-29-2026
Eligible to Order and Refer? No
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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 1912099383, 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.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912099383, enumerated as an "individual" on September 29, 2006.
The provider is located at 1402 LAKE TAPPS PKWY E SUITE F106 AUBURN, WA 98092 and the phone number is (253) 288-8882.
Preferred Provider Organization with taxonomy code 305R00000X.
The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska, Medicare. Please consult your insurance carrier or call the provider to verify.
