DR. SPENCER BLANCHARD DPT
NPI 1104665504
Physical Therapist - Orthopedic in Houma, LA
NPI Status: Active since May 23, 2024
- Individual
- Male
- Years of Experience 2
- Physical Therapist
- Orthopedic
- Accepts Insurance
- Accepts Medicare Approved Payment
About SPENCER BLANCHARD
This page provides the complete NPI Profile along with additional information for Spencer Blanchard, a provider established in Houma, Louisiana with a medical specialization in Physical Therapist, focusing in orthopedic and more than 2 years of experience. The healthcare provider is registered in the NPI registry with number 1104665504 assigned on May 2024. The practitioner's primary taxonomy code is 2251X0800X with license number 11811 (LA). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1104665504
- Provider Name
- DR. SPENCER BLANCHARD DPT
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4795 FREEDOM RD HOUMA, LA 70360
- Location Phone
- (985) 857-9097
- Mailing Address
- 420 SIXTH ST HOUMA, LA 70364
- Mailing Phone
- (985) 856-5075
- Medical School Name
- OTHER
- Graduation Year
- 2024
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-23-2024
- Last Update Date
- 05-23-2024
- Code Navigator
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
Physical Therapist Orthopedic
- Taxonomy Code
- 2251X0800X
- Type
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- License No.
- 11811
- License State
- LA
- Taxonomy Description
- A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Max 70/50 $6700 - PPO
- Blue Max 90/70 $1500 - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $3300 - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan - PPO
- Blue Saver 60/40 $6100 - PPO
- Blue Saver 90/70 $3200 - PPO
- Blue POS 60/40 $6500 - POS
- Blue POS 70/50 $4550 - POS
- Blue POS 80/60 $3200 - POS
- Blue POS Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - POS
- Blue POS Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - POS
- Blue POS Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan - POS
- Blue POS Copay (PCP, Specialist, Urgent Care) 80/60 $1000 - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Spencer Blanchard 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.
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.
PECOS PAC ID: 8628510617
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: I20240605002726
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.
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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 | 1 | 0 | 4 | 6 | 6 | 5 | 5 | 0 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 0 | 4 | 12 | 6 | 10 | 5 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 0 + 4 + 1 + 2 + 6 + 1 + 0 + 5 + 0 + 24 = 46 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 46 = 4 | 4 | ||||||||
The NPI number 1104665504 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1881692705 | NICOLA MCKEON PT Individual | Physical Therapist | 4795 FREEDOM RD HOUMA, LA 70360 (985) 857-9097 |
| 1922008275 | ROBERT DREW RICE MPT Individual | Physical Therapist | 4795 FREEDOM RD HOUMA, LA 70360 (985) 857-9097 |
| 1588709984 | BACK TO NORMAL PHYSICAL REHABILITATION Organization | Physical Therapist | 4795 FREEDOM RD HOUMA, LA 70360 (985) 857-9097 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104665504, enumerated in the NPI registry as an "individual" on May 23, 2024
The provider is located at 4795 Freedom Rd Houma, La 70360 and the phone number is (985) 857-9097
The provider's speciality is Physical Therapist with taxonomy code 2251X0800X with a focus in Orthopedic
The provider has more than 2 years of experience.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Louisiana and HMO. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on May 23, 2024. 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.