DONALD L BUMGARNER M.D.
NPI 1518055847
Family Medicine in Shenandoah, IA

NPI Status: Active since October 11, 2006

Contact Information

1 JACK FOSTER DR
SHENANDOAH, IA
ZIP 51601
Phone: (712) 246-7400
Fax: (712) 246-7334

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  • Individual
  • Male
  • Family Medicine
  • Accepts Insurance
  • PECOS Enrolled

About DONALD BUMGARNER

This page provides the complete NPI Profile along with additional information for Donald Bumgarner, a primary care provider established in Shenandoah, Iowa with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1518055847 assigned on October 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 25365 (IA). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI
1518055847
Provider Name
DONALD L BUMGARNER M.D.
Gender
Male
Entity Type
Individual
Location Address
1 JACK FOSTER DR SHENANDOAH, IA 51601
Location Phone
(712) 246-7400
Location Fax
(712) 246-7334
Mailing Address
1 JACK FOSTER DR SHENANDOAH, IA 51601
Mailing Phone
(712) 246-7400
Mailing Fax
(712) 246-7334
Is Sole Proprietor?
No
Enumeration Date
10-11-2006
Last Update Date
10-14-2021
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A primary care provider (PCP) like Donald Bumgarner 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 .

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.
25365
License State
IA
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:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Silver - EPO
  • Clear Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Clear Silver - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Silver - HMO
  • Elite Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Central Bronze - HMO
  • Central Bronze + Vision + Adult Dental - HMO
  • Central Gold - HMO
  • Central Gold + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Medica Insure Bronze $0 Copay PCP Visits - EPO
  • Medica Insure Bronze Premier - EPO
  • Medica Insure Bronze Share - EPO
  • Medica Insure Expanded Bronze Standard - EPO
  • Medica Insure Gold $0 Copay PCP Visits - EPO
  • Medica Insure Gold Share - EPO
  • Medica Insure Gold Standard - EPO
  • Medica Insure Silver $0 Copay PCP Visits - EPO
  • Medica Insure Silver Share - EPO
  • Medica Insure Silver Standard - EPO
  • Wellmark Bronze HDHP HMO HSA Qualified - HMO
  • Wellmark Bronze Traditional HMO - HMO
  • Wellmark Gold Traditional HMO - HMO
  • Wellmark Silver Traditional HMO - HMO
  • Wellmark Standard Bronze HMO - HMO
  • Wellmark Standard Gold HMO - HMO
  • Wellmark Standard Silver HMO - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Donald Bumgarner 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

  • 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 (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    3 DME suppliers used 39 Medicare Claims 94 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    3 DME suppliers used 13 Medicare Claims 13 Services Paid

  • DME-Other DME (DE001N)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    4 DME suppliers used 18 Medicare Claims 18 Services Paid

  • DME-Other DME (DE001N)

    Full face mask used with positive airway pressure device, each (HCPCS:A7030)

    3 DME suppliers used 19 Medicare Claims 19 Services Paid

  • DME-Other DME (DE001N)

    Face mask interface, replacement for full face mask, each (HCPCS:A7031)

    3 DME suppliers used 19 Medicare Claims 48 Services Paid

  • DME-Other DME (DE001N)

    Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

    3 DME suppliers used 11 Medicare Claims 50 Services Paid

  • DME-Other DME (DE001N)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    3 DME suppliers used 15 Medicare Claims 15 Services Paid

  • DME-Other DME (DE001N)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    4 DME suppliers used 20 Medicare Claims 20 Services Paid

  • DME-Other DME (DE001N)

    Tubing used with positive airway pressure device (HCPCS:A7037)

    3 DME suppliers used 15 Medicare Claims 15 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    4 DME suppliers used 30 Medicare Claims 176 Services Paid

  • DME-Other DME (DE001N)

    Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)

    4 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Other DME (DE001N)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    2 DME suppliers used 35 Medicare Claims 35 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)

    3 DME suppliers used 52 Medicare Claims 52 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    2 DME suppliers used 40 Medicare Claims 40 Services Paid

  • DME-Other DME (DE000N)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    2 DME suppliers used 11 Medicare Claims 11 Services Paid

Drugs Administered Through DME

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

    2 DME suppliers used 12 Medicare Claims 1020 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 51601 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $81.84
  • Minimum New Patient Price $52.96
  • Maximum New Patient Price $161.4
  • Average New Patient Copayment $20.46
  • Minimum New Patient Copayment $13.24
  • Maximum New Patient Copayment $40.35

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $94.05
  • Minimum Established Patient Price $16.91
  • Maximum Established Patient Price $131.98
  • Average Established Patient Copayment $23.51
  • Minimum Established Patient Copayment $4.22
  • Maximum Established Patient Copayment $32.99

* 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.
1518055847
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2528051088
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 2 + 8 + 0 + 5 + 1 + 0 + 8 + 8 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 77

The NPI number 1518055847 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1427300201SHENANDOAH MEDICAL CENTER
Organization
Clinic/Center (Rural Health)1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7240
1710917026DR. HEATHER LEE BABE M.D.
Individual
Family Medicine1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1184033300SHENANDOAH MEDICAL CENTER
Organization
Nurse Practitioner1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1730172040 PAUL ANDREW ROZEBOOM M.D.
Individual
Pediatrics (Adolescent Medicine)1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1821059510DR. BRIAN ANTHONY ROWAN MD
Individual
Orthopaedic Surgery1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1770718660DR. MICHAEL THEODORE SALWITZ MD
Individual
Family Medicine1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1295761856NEBRASKA MEDICAL CENTER
Organization
Family Medicine1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1376037770 STEPHANIE ROBINETTE ARNP
Individual
Nurse Practitioner (Family)1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1841260346SHENANDOAH DOCTORS CLINIC
Organization
Clinic/Center1 JACK FOSTER DR SUITE #447
SHENANDOAH, IA 51601
(712) 246-1000
1396189007MRS. MELISSA MARIE HOBBIE LMSW
Individual
Counselor (Mental Health)1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7423
1003027939DR. TODD MIKAEL ISAACSON M.D.
Individual
Family Medicine1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1245404086 MARTEE R MACLEOD-KOZAL M.D.
Individual
Obstetrics & Gynecology1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7054
1609015577DR. REBECCA JUDENE ROSE MD
Individual
Surgery1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7485
1639861677MRS. CAITLIN ALEXIS CROSBY CLEM LMSW
Individual
Social Worker1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1447937230SHENANDOAH MEDICAL CENTER
Organization
Pharmacy (Community/Retail Pharmacy)1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1326764093 RACHEL LAUREN TIMMERMAN APRN
Individual
Nurse Practitioner1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1134966195 HOLLY LYNN JORGENSEN FNP, ARNP
Individual
Nurse Practitioner (Family)1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1124852611 SHELBY MARIE VANLEUVEN ARNP
Individual
Nurse Practitioner (Family)1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7400
1801566054MRS. CRYSTAL LYNN MICK ARNP, PMHNP-BC
Individual
Nurse Practitioner (Psychiatric/Mental Health)1 JACK FOSTER DR
SHENANDOAH, IA 51601
(712) 246-7215
1972186922 DAVID LUTZ MD
Individual
Family Medicine1 JACK FOSTER DR
SHENANDOAH, IA 51601
(385) 630-1117

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1518055847, enumerated in the NPI registry as an "individual" on October 11, 2006

The provider is located at 1 Jack Foster Dr Shenandoah, Ia 51601 and the phone number is (712) 246-7400

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. 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 $81.84 with an average copayment of $20.46 for new patient appointments. Established patients should expect a typical charge of $94.05 and an average copayment of 23.51. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on October 11, 2006. 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.