DR. ROBERT A APPEL M.D.
NPI 1649275884
Urology in Fayetteville, NC

NPI Status: Active since June 15, 2005

Contact Information

1786 METROMEDICAL DR
FAYETTEVILLE, NC
ZIP 28304
Phone: (910) 485-8151
Fax: (910) 485-2963

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  • Individual
  • Male
  • Years of Experience 45
  • Urology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ROBERT APPEL

This page provides the complete NPI Profile along with additional information for Robert Appel, a provider established in Fayetteville, North Carolina with a medical specialization in Urology and more than 45 years of experience. He graduated from University Of Virginia School Of Medicine in 1981. The healthcare provider is registered in the NPI registry with number 1649275884 assigned on June 2005. The practitioner's primary taxonomy code is 208800000X with license number 38731 (NC). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI
1649275884
Provider Name
DR. ROBERT A APPEL M.D.
Gender
Male
Entity Type
Individual
Location Address
1786 METROMEDICAL DR FAYETTEVILLE, NC 28304
Location Phone
(910) 485-8151
Location Fax
(910) 485-2963
Mailing Address
1786 METROMEDICAL DR FAYETTEVILLE, NC 28304
Mailing Phone
(910) 485-8151
Mailing Fax
(910) 485-2963
Medical School Name
UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Graduation Year
1981
Is Sole Proprietor?
No
Enumeration Date
06-15-2005
Last Update Date
07-08-2007
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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

Urology

Taxonomy Code
208800000X
Type
Allopathic & Osteopathic Physicians
License No.
38731
License State
NC
Taxonomy Description
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision - HMO

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
E67562MEDICARE UPIN (02)NC 
2147741MEDICARE ID-TYPE UNSPECIFIED (04)NC 
7911675MEDICAID (05)NC 

Medicare Participation & PECOS Enrollment Status

Robert Appel 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.

Robert Appel 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

  • PECOS PAC ID: 7315076486

    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: I20100803000504

    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.

  • 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

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.25 for a new patient copayment and $16.93 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 28304 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $125.01
  • Minimum New Patient Price $54.12
  • Maximum New Patient Price $165.09
  • Average New Patient Copayment $31.25
  • Minimum New Patient Copayment $13.53
  • Maximum New Patient Copayment $41.27

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.72
  • Minimum Established Patient Price $17.21
  • Maximum Established Patient Price $134.61
  • Average Established Patient Copayment $16.93
  • Minimum Established Patient Copayment $4.3
  • Maximum Established Patient Copayment $33.65

* 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.

Reviews for DR. ROBERT A APPEL M.D.

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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.
1649275884
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
26894710816
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 8 + 9 + 4 + 7 + 1 + 0 + 8 + 1 + 6 + 24 = 76
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 76 = 44

The NPI number 1649275884 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
1124022561DR. HENRY EDWARD PARFITT JR. M.D.
Individual
Urology1786 METROMEDICAL DR
FAYETTEVILLE, NC 28304
(910) 485-8151
1730184979DR. JAMES FRANCIS NOLAN M.D.
Individual
Urology1786 METROMEDICAL DR
FAYETTEVILLE, NC 28304
(910) 485-8151
1811726185AUTRY EARLY INTERVENTION HUB
Organization
Community/Behavioral Health1786 METROMEDICAL DR
FAYETTEVILLE, NC 28304
(910) 691-4343

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1649275884, enumerated in the NPI registry as an "individual" on June 15, 2005

The provider is located at 1786 Metromedical Dr Fayetteville, Nc 28304 and the phone number is (910) 485-8151

The provider's speciality is Urology with taxonomy code 208800000X

The provider has more than 45 years of experience. He graduated from University Of Virginia School Of Medicine in 1981.

The provider might be accepting Accepts: Aetna CVS Health, Medicare and Medicaid. 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 $125.01 with an average copayment of $31.25 for new patient appointments. Established patients should expect a typical charge of $67.72 and an average copayment of 16.93. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on June 15, 2005. 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.