DR. WILLIAM RUCKER STAGGERS
NPI 1952393951
Plastic Surgery in Fairhope, AL

NPI Status: Active since August 17, 2005

Contact Information

411 N SECTION ST
FAIRHOPE, AL
ZIP 36532
Phone: (251) 928-9090
Fax: (251) 990-0520

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

Individual
Male
Years of Experience 37
Plastic Surgery
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About WILLIAM STAGGERS

This page provides the complete NPI Profile along with additional information for William Staggers, a provider established in Fairhope, Alabama with a medical specialization in Plastic Surgery and more than 37 years of experience. He graduated from University Of Alabama School Of Medicine in 1989. The healthcare provider is registered in the NPI registry with number 1952393951 assigned on August 2005. The practitioner's primary taxonomy code is 208200000X with license number 15283 (AL). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI: 1952393951
Provider Name: DR. WILLIAM RUCKER STAGGERS
Gender: Male
Entity Type: Individual
Location Address: 411 N SECTION ST FAIRHOPE, AL 36532
Location Phone: (251) 928-9090
Location Fax: (251) 990-0520
Mailing Address: 2935 THOUSAND OAKS DR STE 294 SAN ANTONIO, TX 78247
Mailing Phone: (210) 494-1100
Mailing Fax: (251) 990-0520
Medical School Name: UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year: 1989
Is Sole Proprietor?: No
Enumeration Date: 08-17-2005
Last Update Date: 05-14-2019
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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: Plastic Surgery
Taxonomy Code: 208200000X
Type: Allopathic & Osteopathic Physicians
License No.: 15283
License State: AL
Taxonomy Description: A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Insurance Plans Accepted

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

Blue Cross and Blue Shield of Alabama

Blue HSA Bronze - PPO
Blue Protect - PPO
Blue Saver Bronze - PPO
Blue Standardized Statewide Silver EPO - EPO
Blue Statewide Silver EPO - EPO
Blue Value Gold - PPO
Blue Value Silver - PPO
Blue Access Gold for Business - PPO
Blue Choice Platinum for Business - PPO
Blue HSA Silver for Business - PPO
Blue Saver Bronze for Business - PPO
Blue Saver Gold for Business - PPO
Blue Secure Gold for Business - PPO
Blue Secure Silver for Business - PPO

Oscar Insurance Company

Bronze Classic 4700 - EPO
Bronze Classic Standard - EPO
Bronze Elite + PCP Saver Plus - EPO
Bronze Simple Chronic Care CKM - EPO
Gold Classic Standard - EPO
Gold Simple - EPO
Silver Classic Standard - EPO
Silver Simple - EPO
Silver Simple Chronic Care CKM - EPO

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
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, No Referrals) - HMO
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
UHC Bronze Essential- ($0 Virtual Urgent Care) - HMO
UHC Bronze Essential (No Referrals) - EPO
UHC Bronze Essential (No Referrals) - HMO
UHC Bronze Standard - HMO
UHC Bronze Standard (No Referrals) - EPO
UHC Bronze Standard (No Referrals) - HMO
UHC Bronze Standard+ (Dental + Vision) - HMO
UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) - HMO
UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO

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

Medicare Participation & PECOS Enrollment Status

William Staggers 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.

William Staggers 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: 42227548
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: I20110124000857
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-Medical/Surgical Supplies (DA023N)
Collagen dressing, sterile, size 16 sq. in. or less, each (HCPCS:A6021)
1 DME suppliers used 15 Medicare Claims 226 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6212)
1 DME suppliers used 17 Medicare Claims 202 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6402)
1 DME suppliers used 21 Medicare Claims 1260 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6446)
1 DME suppliers used 13 Medicare Claims 1276 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Tubular dressing with or without elastic, any width, per linear yard (HCPCS:A6457)
1 DME suppliers used 13 Medicare Claims 97 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Application of chemical to stop tissue regrowth in wound
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 30-44 minutes
Removal of muscle and/or tissue, 20.0 sq cm or less
Removal of skin and tissue, 20.0 sq cm or less
Removal of skin and tissue, each additional 20.0 sq cm or less

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $20.47 for a new patient copayment and $16.52 for an established patient copayment.

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 36532 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $81.9
Minimum New Patient Price $52.65
Maximum New Patient Price $161.63

Average New Patient Copayment $20.47
Minimum New Patient Copayment $13.16
Maximum New Patient Copayment $40.4

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $66.08
Minimum Established Patient Price $16.56
Maximum Established Patient Price $131.65

Average Established Patient Copayment $16.52
Minimum Established Patient Copayment $4.14
Maximum Established Patient Copayment $32.91

* 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
Medication Reconciliation	95%	104
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	96%	178
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of QCDR data for quality improvement such as comparative analysis reports across patient populations	Yes	N/A
Participation in a QCDR, clinical data registries, or other registries run by other government agencies such as FDA, or private entities such as a hospital or medical or surgical society. Activity must include use of QCDR data for quality improvement (e.g., comparative analysis across specific patient populations for adverse outcomes after an outpatient surgical procedure and corrective steps to address adverse outcome).
Use of QCDR to support clinical decision making	Yes	N/A
Participation in a QCDR, demonstrating performance of activities that promote implementation of shared clinical decision making capabilities.

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 1952393951, we treat the final digit (1) 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 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).

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 → 10 → 1 + 0

Pos 4

Unchanged

Pos 5

Doubled → 6

Pos 6

Unchanged

Pos 7

Doubled → 6

Pos 8

Unchanged

Pos 9

Doubled → 10 → 1 + 0

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 5 → 10 → 1 3 → 6 3 → 6 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 9 + 1 + 0 + 2 + 6 + 9 + 6 + 9 + 1 + 0 + 24 = 69

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

The next multiple of ten after 69 is 70. The difference is the calculated check digit.

70 - 69 = 1

This NPI is valid

The calculated check digit is 1, which matches the last digit of 1952393951.