DR. JOSEPH ZIFF SETON MD PC
NPI 1689742868
Surgery in New York, NY

NPI Status: Active since December 04, 2006

Contact Information

876 PARK AVENUE
NEW YORK, NY
ZIP 10021
Phone: (212) 288-0866
Fax: (212) 734-4476

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  • Individual
  • Male
  • Surgery
  • PECOS Enrolled
  • Opted-Out Medicare

About JOSEPH SETON

This page provides the complete NPI Profile along with additional information for Joseph Seton, a provider established in New York, New York with a medical specialization in Surgery. The healthcare provider is registered in the NPI registry with number 1689742868 assigned on December 2006. The practitioner's primary taxonomy code is 208600000X with license number 116950 (NY). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI
1689742868
Provider Name
DR. JOSEPH ZIFF SETON MD PC
Gender
Male
Entity Type
Individual
Location Address
876 PARK AVENUE NEW YORK, NY 10021
Location Phone
(212) 288-0866
Location Fax
(212) 734-4476
Mailing Address
876 PARK AVENUE NEW YORK, NY 10021
Mailing Phone
(212) 288-0866
Mailing Fax
(212) 734-4476
Is Sole Proprietor?
No
Enumeration Date
12-04-2006
Last Update Date
07-08-2007
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A surgeon like Joseph Seton treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Joseph Seton opted out of Medicare effective on 07-21-2017 until 07-21-2025. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.

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

Surgery

Taxonomy Code
208600000X
Type
Allopathic & Osteopathic Physicians
License No.
116950
License State
NY
Taxonomy Description
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Insurance Plans Accepted

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

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
318051MEDICARE ID-TYPE UNSPECIFIED (04)NY 
B12850MEDICARE UPIN (02) 

Medicare Participation & PECOS Enrollment Status

Joseph Seton 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

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 07-21-2017

  • Opt-Out End Date: 07-21-2025

  • Eligible to Order and Refer? 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

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 10021 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $102.04
  • Minimum New Patient Price $65.69
  • Maximum New Patient Price $198.19
  • Average New Patient Copayment $25.51
  • 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.
1689742868
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
261691444812
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 6 + 9 + 1 + 4 + 4 + 4 + 8 + 1 + 2 + 24 = 72
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 72 = 88

The NPI number 1689742868 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 provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1750437521 MARK S MCMAHON MD
Individual
Orthopaedic Surgery876 PARK AVENUE
NEW YORK, NY 10021
(212) 717-1405

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1689742868, enumerated in the NPI registry as an "individual" on December 04, 2006

The provider is located at 876 Park Avenue New York, Ny 10021 and the phone number is (212) 288-0866

The provider's speciality is Surgery with taxonomy code 208600000X

The provider might be accepting Accepts: 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 $102.04 with an average copayment of $25.51 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.

No, the provider signed an affidavit on July 21, 2017 to opt-out of the Medicare program. The provider is excluded from the Medicare program until July 21, 2025.

This NPI record was last updated on December 04, 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.