DR. MARK VINCENT SIVIERI M.D.
NPI 1992701742
Family Medicine in Columbia, MD
NPI Status: Active since June 27, 2005
Contact Information
10005 OLD COLUMBIA RD STE P170
COLUMBIA, MD
ZIP 21046
Phone: (410) 312-5280
Fax: (877) 844-1423
- Individual
- Male
- Family Medicine
- PECOS Enrolled
- Opted-Out Medicare
About MARK SIVIERI
This page provides the complete NPI Profile along with additional information for Mark Sivieri, a primary care provider established in Columbia, Maryland with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1992701742 assigned on June 2005. The practitioner's primary taxonomy code is 207Q00000X with license number D0061704 (MD). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1992701742
- Provider Name
- DR. MARK VINCENT SIVIERI M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 10005 OLD COLUMBIA RD STE P170 COLUMBIA, MD 21046
- Location Phone
- (410) 312-5280
- Location Fax
- (877) 844-1423
- Mailing Address
- 10005 OLD COLUMBIA RD STE P170 COLUMBIA, MD 21046
- Mailing Phone
- (410) 312-5280
- Mailing Fax
- (877) 844-1423
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-27-2005
- Last Update Date
- 05-23-2011
- Code Navigator
A primary care provider (PCP) like Mark Sivieri 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 .
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. Mark Sivieri opted out of Medicare effective on 07-01-2013 until 07-01-2027. 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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- D0061704
- License State
- MD
- 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:
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 |
|---|---|---|---|
| G01909M01 | MEDICARE ID-TYPE UNSPECIFIED (04) | MD | |
| I02791 | MEDICARE UPIN (02) | MD | |
| 133N056G | MEDICARE ID-TYPE UNSPECIFIED (04) | MD |
Medicare Participation & PECOS Enrollment Status
Mark Sivieri 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
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 07-01-2013
Opt-Out End Date: 07-01-2027
Eligible to Order and Refer? No
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 (DE001N)
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)
6 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
7 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
8 DME suppliers used 17 Medicare Claims 90 Services Paid
DME-Oxygen and Supplies (DC000N)
Stationary oxygen contents, liquid, 1 month's supply = 1 unit (HCPCS:E0442)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
3 DME suppliers used 38 Medicare Claims 38 Services Paid
DME-Other DME (DE000N)
Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater (HCPCS:E0779)
2 DME suppliers used 26 Medicare Claims 26 Services Paid
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)
1 DME suppliers used 15 Medicare Claims 17 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 78 Medicare Claims 307 Services Paid
Unknown
Treatment-Injections and Infusions (nononcologic) (RI008N)
Injection, immune globulin (cuvitru), 100 mg (HCPCS:J1555)
2 DME suppliers used 38 Medicare Claims 21160 Services Paid
Treatment-Injections and Infusions (nononcologic) (RI008N)
Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg (HCPCS:J1557)
2 DME suppliers used 19 Medicare Claims 2660 Services Paid
Treatment-Injections and Infusions (nononcologic) (RI008N)
Injection, immune globulin (hizentra), 100 mg (HCPCS:J1559)
3 DME suppliers used 43 Medicare Claims 15720 Services Paid
Treatment-Injections and Infusions (nononcologic) (RI008N)
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg (HCPCS:J1561)
3 DME suppliers used 44 Medicare Claims 2430 Services Paid
Treatment-Injections and Infusions (nononcologic) (RI008N)
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg (HCPCS:J1569)
3 DME suppliers used 44 Medicare Claims 4410 Services Paid
Treatment-Injections and Infusions (nononcologic) (RI008N)
Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg (HCPCS:J1599)
2 DME suppliers used 18 Medicare Claims 1060 Services Paid
Treatment-Chemotherapy (RH012N)
Services, supplies and accessories used in the home under the medicare intravenous immune globulin (ivig) demonstration (HCPCS:Q2052)
4 DME suppliers used 103 Medicare Claims 120 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 21046 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $94.08
- Minimum New Patient Price $60.73
- Maximum New Patient Price $183.44
- Average New Patient Copayment $23.52
- Minimum New Patient Copayment $15.18
- Maximum New Patient Copayment $45.86
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $106.59
- Minimum Established Patient Price $19.6
- Maximum Established Patient Price $149.17
- Average Established Patient Copayment $26.64
- Minimum Established Patient Copayment $4.9
- Maximum Established Patient Copayment $37.29
* 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.
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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 1992701742, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
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 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
COLUMBIA, MD 21046
COLUMBIA, MD 21046
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992701742, enumerated as an "individual" on June 27, 2005.
The provider is located at 10005 OLD COLUMBIA RD STE P170 COLUMBIA, MD 21046 and the phone number is (410) 312-5280.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
