DR. ANDREW LEIGH ELM OD
NPI 1235866500
Optometrist in New York, NY
NPI Status: Active since August 05, 2022
- Individual
- Male
- Optometrist
- PECOS Enrolled
About ANDREW ELM
This page provides the complete NPI Profile along with additional information for Andrew Elm, a provider established in New York, New York with a medical specialization in Optometrist. The healthcare provider is registered in the NPI registry with number 1235866500 assigned on August 2022. The practitioner's primary taxonomy code is 152W00000X with license number 009634 (NY). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1235866500
- Provider Name
- DR. ANDREW LEIGH ELM OD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 173 7TH AVE NEW YORK, NY 10011
- Location Phone
- (212) 627-4488
- Mailing Address
- 1869 RAINBOW AVE DE PERE, WI 54115
- Mailing Phone
- (920) 246-9353
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-05-2022
- Last Update Date
- 08-05-2022
- 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
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 009634
- License State
- NY
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Medicare Participation & PECOS Enrollment Status
Andrew Elm 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: Durable Medical Equipment (DME).
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
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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 10011 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $150.24
- Minimum New Patient Price $65.69
- Maximum New Patient Price $198.19
- Average New Patient Copayment $37.56
- Minimum New Patient Copayment $16.42
- Maximum New Patient Copayment $49.54
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $81.44
- Minimum Established Patient Price $21.2
- Maximum Established Patient Price $160.66
- Average Established Patient Copayment $20.36
- Minimum Established Patient Copayment $5.3
- Maximum Established Patient Copayment $40.16
* 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 | 2 | 3 | 5 | 8 | 6 | 6 | 5 | 0 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 6 | 5 | 16 | 6 | 12 | 5 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 6 + 5 + 1 + 6 + 6 + 1 + 2 + 5 + 0 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1235866500 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1740509736 | LMJ VISION, INC. Organization | Optometrist | 173 7TH AVE NEW YORK, NY 10011 (212) 627-4488 |
| 1194106807 | BAILEY CATHERINE FETZER O.D. Individual | Optometrist | 173 7TH AVE NEW YORK, NY 10011 (212) 627-4488 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1235866500, enumerated in the NPI registry as an "individual" on August 05, 2022
The provider is located at 173 7th Ave New York, Ny 10011 and the phone number is (212) 627-4488
The provider's speciality is Optometrist with taxonomy code 152W00000X
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: Durable Medical Equipment (DME).
Medicare beneficiaries should expect a typical cost of $150.24 with an average copayment of $37.56 for new patient appointments. Established patients should expect a typical charge of $81.44 and an average copayment of 20.36. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on August 05, 2022. 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].
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