GERARDO MACIAS
NPI 1356895908
Physical Therapist in Los Angeles, CA
NPI Status: Active since August 12, 2016
Contact Information
488 S SAN VICENTE BLVD
LOS ANGELES, CA
ZIP 90048
Phone: (323) 655-9055
Fax: (323) 655-9255
- Individual
- Male
- Years of Experience 10
- Physical Therapist
- Accepts Medicare Approved Payment
- Medicare Quality Reporting
About GERARDO MACIAS
This page provides the complete NPI Profile along with additional information for Gerardo Macias, a provider established in Los Angeles, California with a medical specialization in Physical Therapist and more than 10 years of experience. The healthcare provider is registered in the NPI registry with number 1356895908 assigned on August 2016. The practitioner's primary taxonomy code is 225100000X with license number PT 291812 (CA). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1356895908
- Provider Name
- GERARDO MACIAS
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 488 S SAN VICENTE BLVD LOS ANGELES, CA 90048
- Location Phone
- (323) 655-9055
- Location Fax
- (323) 655-9255
- Mailing Address
- 488 S SAN VICENTE BLVD LOS ANGELES, CA 90048
- Mailing Phone
- (323) 655-9055
- Mailing Fax
- (323) 655-9255
- Medical School Name
- OTHER
- Graduation Year
- 2016
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-12-2016
- Last Update Date
- 08-30-2016
- 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
- Taxonomy Code
- 225100000X
- Type
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- License No.
- PT 291812
- License State
- CA
- Taxonomy Description
- Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Medicare Participation & PECOS Enrollment Status
Gerardo Macias 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: 5799063145
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: I20161107000076
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.
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.
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care
Evaluation for physical therapy, typically 30 minutes
Evaluation for physical therapy, typically 45 minutes
Re-evaluation for physical therapy, typically 20 minutes
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes
Therapy procedure using functional activities
Therapy procedure using manual technique, each 15 minutes
Therapy procedure using water pool to exercises, each 15 minutes
Training for self-care or home management, each 15 minutes
Electrical stimulation is a therapy method where mild electrical pulses are used to treat pain or stimulate muscles in certain areas. It's not for wound care but is part of a broader therapy plan. It's safe, non-invasive, and can help improve overall health.
This service was performed 200 times for 36 patientsAn evaluation for physical therapy is a 30-minute session where a physical therapist assesses your current physical condition. They'll examine your strength, flexibility, balance, and mobility to identify areas needing improvement. This helps tailor a therapy plan to your specific needs.
This service was performed 28 times for 27 patientsAn evaluation for physical therapy is a comprehensive assessment of your body's functionality. It typically takes 45 minutes and involves tests to determine your strength, flexibility, balance, and pain levels. This information is crucial to create a personalized therapy plan to improve your mobility and comfort.
This service was performed 25 times for 24 patientsA re-evaluation for physical therapy is a 20-minute session where your progress is assessed. Your physical therapist will check your current condition, compare it to previous records, and adjust your treatment plan if needed. This ensures your therapy remains effective and tailored to your needs.
This service was performed 65 times for 43 patientsThis therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.
This service was performed 120 times for 26 patientsThis therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.
This service was performed 1,011 times for 90 patientsA therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.
This service was performed 100 times for 45 patientsThis therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.
This service was performed 1,309 times for 102 patientsThis therapy involves exercising in a water pool for 15-minute intervals. The buoyancy of the water supports your body, reducing stress on joints and muscles. It's beneficial for improving strength, flexibility, and balance. It's a gentle, low-impact form of exercise suitable for all ages.
This service was performed 587 times for 49 patientsThis service involves training sessions, each lasting 15 minutes, focused on teaching you essential self-care or home management skills. You'll learn techniques to manage your health condition at home, promoting independence and enhancing your quality of life.
This service was performed 182 times for 70 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $24.09 for a new patient copayment and $19.49 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 90048 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $96.36
- Minimum New Patient Price $62.96
- Maximum New Patient Price $187.6
- Average New Patient Copayment $24.09
- Minimum New Patient Copayment $15.74
- Maximum New Patient Copayment $46.9
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $77.96
- Minimum Established Patient Price $20.84
- Maximum Established Patient Price $153.61
- Average Established Patient Copayment $19.49
- Minimum Established Patient Copayment $5.21
- Maximum Established Patient Copayment $38.4
* 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 |
|---|---|---|
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 100% | 34 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
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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 | 3 | 5 | 6 | 8 | 9 | 5 | 9 | 0 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 10 | 6 | 16 | 9 | 10 | 9 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 0 + 6 + 1 + 6 + 9 + 1 + 0 + 9 + 0 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1356895908 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1265681688 | DR. KAREN IWANAGA DPT Individual | Physical Therapist (Orthopedic) | 488 S SAN VICENTE BLVD LOS ANGELES, CA 90048 (323) 655-9055 |
| 1003140096 | DR. SEAN DENNIS JOHNSON PT, DPT Individual | Physical Therapist (Orthopedic) | 488 S SAN VICENTE BLVD LOS ANGELES, CA 90048 (323) 655-9055 |
| 1659681997 | STEPHEN GROSSERODE DPT Individual | Physical Therapist (Orthopedic) | 488 S SAN VICENTE BLVD LOS ANGELES, CA 90048 (323) 655-9055 |
| 1811337082 | KRISTIN MICHELE ANDERSON DPT Individual | Physical Therapist | 488 S SAN VICENTE BLVD LOS ANGELES, CA 90048 (323) 655-9055 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356895908, enumerated in the NPI registry as an "individual" on August 12, 2016
The provider is located at 488 S San Vicente Blvd Los Angeles, Ca 90048 and the phone number is (323) 655-9055
The provider's speciality is Physical Therapist with taxonomy code 225100000X
The provider has more than 10 years of experience.
Medicare beneficiaries should expect a typical cost of $96.36 with an average copayment of $24.09 for new patient appointments. Established patients should expect a typical charge of $77.96 and an average copayment of 19.49. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care, Evaluation for physical therapy, typically 30 minutes, Evaluation for physical therapy, typically 45 minutes, Re-evaluation for physical therapy, typically 20 minutes, Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes, Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes, Therapy procedure using functional activities, Therapy procedure using manual technique, each 15 minutes, Therapy procedure using water pool to exercises, each 15 minutes and Training for self-care or home management, each 15 minutes.
This NPI record was last updated on August 12, 2016. 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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