ADEL A GHAFFARI
NPI 1619986650
Physical Therapist in Austell, GA
NPI Status: Active since August 07, 2006
Contact Information
1810 MULKEY RD STE 101
AUSTELL, GA
ZIP 30106
Phone: (678) 642-7039
Fax: (770) 475-5385
- Individual
- Male
- Years of Experience 47
- Physical Therapist
- Accepts Insurance
- Accepts Medicare Approved Payment
About ADEL GHAFFARI
This page provides the complete NPI Profile along with additional information for Adel Ghaffari, a provider established in Austell, Georgia with a medical specialization in Physical Therapist and more than 47 years of experience. The healthcare provider is registered in the NPI registry with number 1619986650 assigned on August 2006. The practitioner's primary taxonomy code is 225100000X with license number 2574 (GA). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1619986650
- Provider Name
- ADEL A GHAFFARI
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1810 MULKEY RD STE 101 AUSTELL, GA 30106
- Location Phone
- (678) 642-7039
- Location Fax
- (770) 475-5385
- Mailing Address
- 1810 MULKEY RD STE 101 AUSTELL, GA 30106
- Mailing Phone
- (678) 642-7039
- Mailing Fax
- (770) 475-5385
- Medical School Name
- OTHER
- Graduation Year
- 1979
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-07-2006
- Last Update Date
- 01-25-2008
- 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.
- 2574
- License State
- GA
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SoloCare Bronze EPO HDHP 8050 10004 - EPO
- SoloCare Exp Bronze EPO 7200 - $0 Generic Rx 10015 - EPO
- SoloCare Gold EPO 2300 - 3 Free PCP Visits, $5 Generic Rx 10010 - EPO
- SoloCare Silver EPO 6000/60 - 3 Free PCP Visits 10014 - EPO
- SoloCare Silver EPO 7000 - 3 Free PCP Visits, $5 Generic Rx 10013 - EPO
- SoloCare Standard Exp Bronze EPO 10008 - EPO
- SoloCare Standard Gold EPO 10006 - EPO
- SoloCare Standard Platinum EPO 10005 - EPO
- SoloCare Standard Silver EPO 10007 - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| GRP4790 | MEDICARE PIN (08) | GA | |
| P00387224 | OTHER (01) | GA | RAILROAD MEDICARE |
| 65BBBWK | MEDICARE PIN (08) | GA |
Medicare Participation & PECOS Enrollment Status
Adel Ghaffari 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: 4587630611
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: I20080624000147
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.
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.01 for a new patient copayment and $17.71 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 30106 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $88.06
- Minimum New Patient Price $56.84
- Maximum New Patient Price $172.43
- Average New Patient Copayment $22.01
- Minimum New Patient Copayment $14.21
- Maximum New Patient Copayment $43.1
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $70.85
- Minimum Established Patient Price $18.22
- Maximum Established Patient Price $140.4
- Average Established Patient Copayment $17.71
- Minimum Established Patient Copayment $4.55
- Maximum Established Patient Copayment $35.1
* 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 | 6 | 1 | 9 | 9 | 8 | 6 | 6 | 5 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 2 | 9 | 18 | 8 | 12 | 6 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 2 + 9 + 1 + 8 + 8 + 1 + 2 + 6 + 1 + 0 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1619986650 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 provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1114106010 | MCPARS PHYSICAL THERAPY AND REHAB ASSOCIATES PC Organization | Physical Therapist | 1810 MULKEY RD STE 101 AUSTELL, GA 30106 (770) 443-4483 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619986650, enumerated in the NPI registry as an "individual" on August 07, 2006
The provider is located at 1810 Mulkey Rd Ste 101 Austell, Ga 30106 and the phone number is (678) 642-7039
The provider's speciality is Physical Therapist with taxonomy code 225100000X
The provider has more than 47 years of experience.
The provider might be accepting Accepts: Alliant Health Plans, Inc., Medicare, Medicaid and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Medicare beneficiaries should expect a typical cost of $88.06 with an average copayment of $22.01 for new patient appointments. Established patients should expect a typical charge of $70.85 and an average copayment of 17.71. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on August 07, 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.