THOMAS LEE DUNCAN MD
NPI 1750377651
Family Medicine in Highlands, NC

NPI Status: Active since September 26, 2005

Contact Information

209 HOSPITAL DR
SUITE 303
HIGHLANDS, NC
ZIP 28741
Phone: (828) 526-4942
Fax: (828) 526-9218

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  • Individual
  • Male
  • Family Medicine
  • PECOS Enrolled

About THOMAS DUNCAN

This page provides the complete NPI Profile along with additional information for Thomas Duncan, a primary care provider established in Highlands, North Carolina with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1750377651 assigned on September 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 2013-00914 (NC). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1750377651
Provider Name
THOMAS LEE DUNCAN MD
Gender
Male
Entity Type
Individual
Location Address
209 HOSPITAL DR SUITE 303 HIGHLANDS, NC 28741
Location Phone
(828) 526-4942
Location Fax
(828) 526-9218
Mailing Address
PO BOX 602373 CHARLOTTE, NC 28260
Mailing Phone
(828) 526-1280
Mailing Fax
(828) 526-9218
Is Sole Proprietor?
No
Enumeration Date
09-26-2005
Last Update Date
03-24-2016
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A primary care provider (PCP) like Thomas Duncan 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.
2013-00914
License State
NC
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

23031 (IA)

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
1750377651MEDICAID (05)NC 
NCD510A194OTHER (01)NCMEDICARE PTAN
A02230MEDICARE UPIN (02)IA 

Medicare Participation & PECOS Enrollment Status

Thomas Duncan 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 (DE001N)

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

    3 DME suppliers used 13 Medicare Claims 13 Services Paid

  • DME-Other DME (DE001N)

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

    3 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Other DME (DE001N)

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

    2 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Other DME (DE001N)

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

    2 DME suppliers used 11 Medicare Claims 11 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 28741 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 99214

  • Average Established Patient Price $95.94
  • Minimum Established Patient Price $17.21
  • Maximum Established Patient Price $134.61
  • Average Established Patient Copayment $23.98
  • 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 THOMAS LEE DUNCAN MD

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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.
1750377651
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271006714610
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 6 + 7 + 1 + 4 + 6 + 1 + 0 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1750377651 is valid because the calculated check digit 1 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
1679564793DR. ROBERT CARTER DAVIS MD
Individual
Internal Medicine (Gastroenterology)209 HOSPITAL DR SUITE 303
HIGHLANDS, NC 28741
(828) 526-4300
1295710085DR. JOHN F. BAUMRUCKER MD
Individual
Family Medicine209 HOSPITAL DR SUITE #304
HIGHLANDS, NC 28741
(828) 526-1700
1639135692DR. ROBERT T BUCHANAN M.D.
Individual
Plastic Surgery209 HOSPITAL DR SUITE 202
HIGHLANDS, NC 28741
(828) 526-3783
1215981501DR. CARL CURTISS MD
Individual
Internal Medicine (Cardiovascular Disease)209 HOSPITAL DR SUITE 304
HIGHLANDS, NC 28741
(828) 787-2450
1538195177DR. PAUL SQUIRE CABIRAN M.D.
Individual
Specialist209 HOSPITAL DR SUITE 302
HIGHLANDS, NC 28741
(828) 526-1232
1295917490HIGHLANDS CASHIERS HOSPITAL INC
Organization
Surgery209 HOSPITAL DR SUITE 104
HIGHLANDS, NC 28741
(828) 526-1495
1144550708ALPERT MEDICAL CENTER,PC
Organization
Specialist209 HOSPITAL DR SUITE 304
HIGHLANDS, NC 28741
(828) 526-1700
1518308501J SCOTT BAKER, M.D.
Organization
Family Medicine209 HOSPITAL DR SUITE 304
HIGHLANDS, NC 28741
(828) 526-1700
1235531906HIGHLANDS DERMATOLOGY PA
Organization
Dermatology209 HOSPITAL DR SUITE 302
HIGHLANDS, NC 28741
(828) 526-1232
1023415833MISSION MEDICAL ASSOCIATES INC.
Organization
Internal Medicine (Obesity Medicine)209 HOSPITAL DR
HIGHLANDS, NC 28741
(828) 213-4100
1700254489ANGEL MEDICAL CENTER, INC
Organization
Surgery209 HOSPITAL DR
HIGHLANDS, NC 28741
(828) 526-5045
1922487917MISSION MEDICAL ASSOCIATES, INC.
Organization
Internal Medicine (Cardiovascular Disease)209 HOSPITAL DR
HIGHLANDS, NC 28741
(828) 526-4346
1922456763HIGHLANDS-CASHIERS HOSPITAL, INC.
Organization
Family Medicine209 HOSPITAL DR
HIGHLANDS, NC 28741
(828) 526-4346
1134291347WAGNER MEDICAL ASSOCIATES
Organization
Internal Medicine209 HOSPITAL DR SUITE 203
HIGHLANDS, NC 28741
(828) 787-2430
1841455896MRS. ANN H DAVIS M.D
Individual
Family Medicine209 HOSPITAL DR
HIGHLANDS, NC 28741
(828) 482-6160
1447783360 KRISTY NICOLE FINCHER DO
Individual
Family Medicine209 HOSPITAL DR
HIGHLANDS, NC 28741
(828) 482-6160
1265411169 PATTI BEARD WHEELER MD
Individual
Family Medicine209 HOSPITAL DR SUITE 104
HIGHLANDS, NC 28741
(828) 526-4346
1811300064 ROBYN HAYNES RESTREPO MD
Individual
Family Medicine209 HOSPITAL DR
HIGHLANDS, NC 28741
(828) 526-4346
1821332941DR. MARGARET EVERHART MACK PHD, APRN, FNP-BC
Individual
Nurse Practitioner (Family)209 HOSPITAL DR
HIGHLANDS, NC 28741
(828) 526-4346
1952463523DR. RICHARD MCBEE STEWART SR. M.D.
Individual
Hospitalist209 HOSPITAL DR SUITE 303
HIGHLANDS, NC 28741
(828) 526-5012

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750377651, enumerated in the NPI registry as an "individual" on September 26, 2005

The provider is located at 209 Hospital Dr Suite 303 Highlands, Nc 28741 and the phone number is (828) 526-4942

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

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 $83.9 with an average copayment of $20.97 for new patient appointments. Established patients should expect a typical charge of $95.94 and an average copayment of 23.98. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on September 26, 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.