SERITA NICOLE NEWTON M.D.
NPI 1023376621
Family Medicine in Vestavia Hills, AL
NPI Status: Active since May 02, 2012
Contact Information
2010 PATTON CHAPEL RD STE 103
VESTAVIA HILLS, AL
ZIP 35216
Phone: (205) 259-7035
Fax: (866) 636-3330
- Individual
- Female
- Family Medicine
- Accepts Insurance
- PECOS Enrolled
- Opted-Out Medicare
About SERITA NEWTON
This page provides the complete NPI Profile along with additional information for Serita Newton, a primary care provider established in Vestavia Hills, Alabama with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1023376621 assigned on May 2012. The practitioner's primary taxonomy code is 207Q00000X with license number 34319 (AL). The provider is registered as an individual and her NPI record was last updated February 2025.
- NPI
- 1023376621
- Provider Name
- SERITA NICOLE NEWTON M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2010 PATTON CHAPEL RD STE 103 VESTAVIA HILLS, AL 35216
- Location Phone
- (205) 259-7035
- Location Fax
- (866) 636-3330
- Mailing Address
- 2010 PATTON CHAPEL RD STE 103 VESTAVIA HILLS, AL 35216
- Mailing Phone
- (205) 259-7035
- Mailing Fax
- (866) 636-3330
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-02-2012
- Last Update Date
- 02-05-2025
- Code Navigator
A primary care provider (PCP) like Serita Newton 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. Serita Newton opted out of Medicare effective on 07-01-2022 until 07-01-2026. 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 but is permitted to order and refer services to other healthcare providers.
Location Map
Secondary Locations
- 14355 Miranda Way
Los Altos Hills, CA 94022
(888) 731-8994 - 111 N Orange Ave Ste 800
Orlando, FL 32801
(888) 731-8994 - 317 E Capitol St Ste 200
Jackson, MS 39201
(888) 731-8994 - 222 2nd Ave S Fl 17
Nashville, TN 37201
(888) 731-8994
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.
- 34319
- License State
- AL
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue HSA Bronze - PPO
- Blue Protect - PPO
- Blue Saver Bronze - PPO
- 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
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 12 - HMO
- Gold 8 - HMO
- Gold 8 with Rx Copay - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 1 with Rx Copay and Adult Vision Services - HMO
- Silver 12 - HMO
- Silver 12 with first 4 free PCP or MH visits - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Silver 9 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Serita Newton 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: 07-01-2022
Opt-Out End Date: 07-01-2026
Eligible to Order and Refer? 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
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 35216 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 99214
- Average Established Patient Price $93.72
- Minimum Established Patient Price $16.56
- Maximum Established Patient Price $131.65
- Average Established Patient Copayment $23.43
- 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.
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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. | |||||||||
1 | 0 | 2 | 3 | 3 | 7 | 6 | 6 | 2 | 1 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 0 | 4 | 3 | 6 | 7 | 12 | 6 | 4 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 0 + 4 + 3 + 6 + 7 + 1 + 2 + 6 + 4 + 24 = 59 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 59 = 1 | 1 |
The NPI number 1023376621 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1023376621, enumerated in the NPI registry as an "individual" on May 02, 2012
The provider is located at 2010 Patton Chapel Rd Ste 103 Vestavia Hills, Al 35216 and the phone number is (205) 259-7035
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Alabama and Molina. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a 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.
Medicare beneficiaries should expect a typical cost of $81.9 with an average copayment of $20.47 for new patient appointments. Established patients should expect a typical charge of $93.72 and an average copayment of 23.43. Please review your insurance plan or contact the provider directly to determine your specific costs.
No, the provider signed an affidavit on July 01, 2022 to opt-out of the Medicare program. The provider is excluded from the Medicare program until July 01, 2026.
This NPI record was last updated on May 02, 2012. 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.