HEATHER MCLAUGHLIN PT, DPT
NPI 1699071720
Physical Therapist in Chapel Hill, NC
NPI Status: Active since February 08, 2011
Contact Information
1709 LEGION RD STE 100
CHAPEL HILL, NC
ZIP 27517
Phone: (919) 932-7266
Fax: (919) 932-7250
- Individual
- Female
- Years of Experience 16
- Physical Therapist
- Accepts Medicare Approved Payment
About HEATHER MCLAUGHLIN
This page provides the complete NPI Profile along with additional information for Heather Mclaughlin, a provider established in Chapel Hill, North Carolina with a medical specialization in Physical Therapist and more than 16 years of experience. The healthcare provider is registered in the NPI registry with number 1699071720 assigned on February 2011. The practitioner's primary taxonomy code is 225100000X with license number P13023 (NC). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1699071720
- Provider Name
- HEATHER MCLAUGHLIN PT, DPT
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1709 LEGION RD STE 100 CHAPEL HILL, NC 27517
- Location Phone
- (919) 932-7266
- Location Fax
- (919) 932-7250
- Mailing Address
- 1709 LEGION RD STE 100 CHAPEL HILL, NC 27517
- Mailing Phone
- (919) 932-7266
- Mailing Fax
- (919) 932-7250
- Medical School Name
- OTHER
- Graduation Year
- 2010
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-08-2011
- Last Update Date
- 12-18-2024
- 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.
- P13023
- License State
- NC
- 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:
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 |
|---|---|---|---|
| 7211452 | MEDICAID (05) | NC |
Medicare Participation & PECOS Enrollment Status
Heather Mclaughlin 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: 5294064994
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: I20190905001393
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.
Evaluation for physical therapy, typically 20 minutes
Therapy procedure using functional activities
An evaluation for physical therapy is a short, 20-minute assessment where your physical condition, mobility, and pain levels are examined. This helps in designing a personalized therapy plan to enhance your physical function and well-being.
This service was performed 25 times for 25 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 960 times for 34 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.97 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 27517 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.9
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $20.97
- 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 HEATHER MCLAUGHLIN PT, DPT
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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 | 9 | 9 | 0 | 7 | 1 | 7 | 2 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 18 | 9 | 0 | 7 | 2 | 7 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 8 + 9 + 0 + 7 + 2 + 7 + 4 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1699071720 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 3 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1225008204 | MRS. DEBRA KAY ALBRECHT PT Individual | Physical Therapist | 1709 LEGION RD STE 100 CHAPEL HILL, NC 27517 (919) 932-7266 |
| 1497724660 | KJC CORP Organization | Physical Therapist | 1709 LEGION RD STE 100 CHAPEL HILL, NC 27517 (919) 932-7266 |
| 1649978453 | DANIELLE WILD PT, DPT Individual | Physical Therapist | 1709 LEGION RD STE 100 CHAPEL HILL, NC 27517 (919) 932-7266 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1699071720, enumerated in the NPI registry as an "individual" on February 08, 2011
The provider is located at 1709 Legion Rd Ste 100 Chapel Hill, Nc 27517 and the phone number is (919) 932-7266
The provider's speciality is Physical Therapist with taxonomy code 225100000X
The provider has more than 16 years of experience.
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.
Medicare beneficiaries should expect a typical cost of $83.9 with an average copayment of $20.97 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.
The most common procedures or services performed by this practitioner are: Evaluation for physical therapy, typically 20 minutes and Therapy procedure using functional activities.
This NPI record was last updated on February 08, 2011. 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.