DR. HAROLD THOMAS PRETORIUS M.D.
NPI 1760431159
Nuclear Medicine in Cincinnati, OH


Quality Rating: 15.83 out of 100 score

NPI Status: Active since May 10, 2006

Contact Information

4743 CORNELL RD
CINCINNATI, OH
ZIP 45241
Phone: (513) 561-3797
Fax: (513) 561-4043

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  • Individual
  • Male
  • Years of Experience 50
  • Nuclear Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About HAROLD PRETORIUS

This page provides the complete NPI Profile along with additional information for Harold Pretorius, a provider established in Cincinnati, Ohio with a medical specialization in Nuclear Medicine and more than 50 years of experience. He graduated from New York University School Of Medicine in 1976. The healthcare provider is registered in the NPI registry with number 1760431159 assigned on May 2006. The practitioner's primary taxonomy code is 207U00000X with license number 14225100-1205 (UT). The provider is registered as an individual and his NPI record was last updated June 2025.

NPI
1760431159
Provider Name
DR. HAROLD THOMAS PRETORIUS M.D.
Gender
Male
Entity Type
Individual
Location Address
4743 CORNELL RD CINCINNATI, OH 45241
Location Phone
(513) 561-3797
Location Fax
(513) 561-4043
Mailing Address
4743 CORNELL RD CINCINNATI, OH 45241
Mailing Phone
(513) 561-3797
Mailing Fax
(513) 561-4043
Medical School Name
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
1976
Is Sole Proprietor?
Yes
Enumeration Date
05-10-2006
Last Update Date
06-13-2025
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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

Nuclear Medicine

Taxonomy Code
207U00000X
Type
Allopathic & Osteopathic Physicians
License No.
14225100-1205
License State
UT
Taxonomy Description
A nuclear medicine specialist employs the properties of radioactive atoms and molecules in the diagnosis and treatment of disease and in research. Radiation detection and imaging instrument systems are used to detect disease as it changes the function and metabolism of normal cells, tissues and organs. A wide variety of diseases can be found in this way, usually before the structure of the organ involved by the disease can be seen to be abnormal by any other techniques. Early detection of coronary artery disease (including acute heart attack), early cancer detection and evaluation of the effect of tumor treatment, diagnosis of infection and inflammation anywhere in the body and early detection of blood clot in the lungs are all possible with these techniques. Unique forms of radioactive molecules can attack and kill cancer cells (e.g., lymphoma, thyroid cancer) or can relieve the severe pain of cancer that has spread to bone

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)
1207RE0101XAllopathic & Osteopathic Physicians

Internal Medicine
Endocrinology, Diabetes & Metabolism

31919 (KY)
2207RE0101XAllopathic & Osteopathic Physicians

Internal Medicine
Endocrinology, Diabetes & Metabolism

35 . 056690 (OH)
3207UN0902XAllopathic & Osteopathic Physicians

Nuclear Medicine
Nuclear Imaging & Therapy

35 . 056690 (OH)

Insurance Plans Accepted

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

  • Bronze First 7500 $25 Generic Drugs - HMO
  • Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Gold 1500 $15 Generic Drugs - HMO
  • Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
  • Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
  • Bronze HSA $7,300 ON-EX - HMO
  • Bronze Standard w/ Virtual & Wellness - HMO
  • Gold $1250 w/ Virtual & Wellness ON-EX - HMO
  • Gold $500 w/ Virtual & Wellness ON-EX - HMO
  • Gold Standard w/ Virtual & Wellness - HMO
  • Silver $5000 w/ Virtual & Wellness ON-EX - HMO
  • Silver Standard w/ Virtual & Wellness - HMO
  • SilverSelect w/ Virtual & Wellness ON-EX - HMO
  • Young Adult Essentials ON-EX - HMO
  • Bronze 10 - HMO
  • Bronze 8 - HMO
  • Bronze 9 - HMO
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with first 4 free PCP or MH visits - HMO
  • Silver 8 - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
  • UHC Bronze Value ($5 Tier 2 Rx, No Referrals) - HMO
  • UHC Bronze Value+ ($5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Advantage ($3 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - 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.

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
1137929OTHER (01)OHWORKERS COMPENSATION
56690OTHER (01)OHHUMANA
64-869316MEDICAID (05)KY 
0764589MEDICAID (05)OH 
4100195OTHER (01)OHAETNA
000000014674OTHER (01)OHANTHEM
56690OTHER (01)OHCHOICECARE
9252401OTHER (01)OHMEDICARE PROVIDER ID#

Medicare Participation & PECOS Enrollment Status

Harold Pretorius 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.

Harold Pretorius 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: 5799739827

    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: I20101011001050

    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

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 (DE017N)

    Supplies for maintenance of insulin infusion catheter, per week (HCPCS:A4224)

    5 DME suppliers used 16 Medicare Claims 200 Services Paid

  • DME-Other DME (DE017N)

    Supplies for external insulin infusion pump, syringe type cartridge, sterile, each (HCPCS:A4225)

    6 DME suppliers used 15 Medicare Claims 445 Services Paid

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    14 DME suppliers used 35 Medicare Claims 117 Services Paid

  • DME-Other DME (DE017N)

    External ambulatory infusion pump, insulin (HCPCS:E0784)

    2 DME suppliers used 22 Medicare Claims 22 Services Paid

  • DME-Other DME (DE017N)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    13 DME suppliers used 205 Medicare Claims 205 Services Paid

Unknown

  • Treatment-Injections and Infusions (nononcologic) (RI000N)

    Insulin for administration through dme (i.e., insulin pump) per 50 units (HCPCS:J1817)

    2 DME suppliers used 15 Medicare Claims 1060 Services Paid

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.

Blood glucose (sugar) level

A blood glucose level test measures the amount of sugar in your blood. It's often used to monitor and manage conditions like diabetes. High or low levels can indicate a health issue. The test is usually done by pricking your finger for a small blood sample.

This service was performed 93 times for 71 patients

Blood glucose (sugar) test performed by hand-held instrument

A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.

This service was performed 225 times for 69 patients

Blood test, lipids (cholesterol and triglycerides)

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

This service was performed 108 times for 79 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

This service was performed 32 times for 13 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 680 times for 185 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 38 times for 22 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

This service was performed 29 times for 29 patients

Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries

Fluorodeoxyglucose F-18 FDG is a radioactive drug used in PET scans. It helps doctors see how your tissues and organs are functioning. The drug is given in a specific dose, up to 45 millicuries, depending on your body size and the type of scan.

This service was performed 58 times for 54 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 70 times for 15 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 141 times for 65 patients

Injection, regadenoson, 0.1 mg

Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.

This service was performed 72 times for 18 patients

Liver enzyme (sgot), level

A Liver Enzyme (SGOT) Level test is a simple blood test used to measure the amount of certain enzymes in your blood. These enzymes are normally found in liver cells. If the liver is damaged or diseased, these enzymes can leak into your bloodstream, indicating potential liver issues.

This service was performed 108 times for 79 patients

Liver enzyme (sgpt), level

A liver enzyme (SGPT) level test is a blood test that checks the health of your liver. SGPT is an enzyme found in your liver cells. If your liver is damaged or inflamed, SGPT can leak into your bloodstream, raising the enzyme level. This test helps identify liver diseases early.

This service was performed 108 times for 79 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 28 times for 28 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

This service was performed 26 times for 26 patients

Nuclear medicine study of bone and/or joint whole body

A nuclear medicine study of bone and/or joint whole body involves injecting a small amount of radioactive material into your body. This material travels to your bones and emits energy. A special camera captures this energy, creating images of your bones to help identify any abnormalities.

This service was performed 19 times for 18 patients

Nuclear medicine study of brain with metabolic evaluation

A nuclear medicine study of the brain with metabolic evaluation involves using a safe radioactive substance and special imaging to assess brain function. It helps identify changes in brain metabolism that can indicate certain disorders.

This service was performed 57 times for 53 patients

Nuclear medicine study of liver and spleen

A nuclear medicine study of the liver and spleen involves injecting a small amount of radioactive material into your body. This material travels to these organs and gives off energy, which is detected by a special camera to create images. This helps doctors assess organ function and detect disease.

This service was performed 20 times for 20 patients

Nuclear medicine study, 1 area with spect

A nuclear medicine study with SPECT involves a safe, small amount of radioactive substance to help visualize body organs. SPECT, or Single Photon Emission Computed Tomography, creates detailed 3D images. This helps doctors diagnose and monitor conditions in a specific body area.

This service was performed 24 times for 21 patients

Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries

Technetium Tc-99m Medronate is a diagnostic procedure that uses a small amount of radioactive material to examine the health of your bones. It helps to detect bone diseases or abnormalities. The procedure is safe, with the radioactive substance naturally leaving your body after the test.

This service was performed 20 times for 19 patients

Technetium tc-99m sestamibi, diagnostic, per study dose

Technetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.

This service was performed 47 times for 24 patients

Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries

Technetium Tc-99m sulfur colloid is used in diagnostic imaging tests. It helps to highlight areas of concern in the body by emitting a small amount of radiation that can be detected by a special camera. This helps doctors to diagnose and monitor various health conditions.

This service was performed 20 times for 20 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.53 for a new patient copayment and $24.11 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 45241 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $126.12
  • Minimum New Patient Price $54.34
  • Maximum New Patient Price $166.65
  • Average New Patient Copayment $31.53
  • Minimum New Patient Copayment $13.58
  • Maximum New Patient Copayment $41.66

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $96.44
  • Minimum Established Patient Price $17.1
  • Maximum Established Patient Price $135.4
  • Average Established Patient Copayment $24.11
  • Minimum Established Patient Copayment $4.27
  • Maximum Established Patient Copayment $33.85

* 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.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 15.83, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 15.83 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 0

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 0

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: 52.78

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: 52.78

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Harold Pretorius is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
THE JEWISH HOSPITAL-MERCY HEALTH4777 EAST GALBRAITH ROAD
CINCINNATI, OH 45236
(513) 686-4127Acute Care Hospitals
MERCY HEALTH - FAIRFIELD HOSPITAL3000 MACK ROAD
FAIRFIELD, OH 45014
(513) 870-7111Acute Care Hospitals
BETHESDA NORTH10500 MONTGOMERY ROAD
CINCINNATI, OH 45242
(513) 865-5544Acute Care Hospitals
MERCY HEALTH - WEST HOSPITAL3300 MERCY HEALTH BLVD
CINCINNATI, OH 45211
(513) 215-0201Acute Care Hospitals

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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.
1760431159
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27120832110
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 2 + 0 + 8 + 3 + 2 + 1 + 1 + 0 + 24 = 51
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 51 = 99

The NPI number 1760431159 is valid because the calculated check digit 9 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
1619901840PRETORIUS AND ROBLES M.D.'S
Organization
Internal Medicine (Endocrinology, Diabetes & Metabolism)4743 CORNELL RD
CINCINNATI, OH 45241
(513) 561-3797

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1760431159, enumerated in the NPI registry as an "individual" on May 10, 2006

The provider is located at 4743 Cornell Rd Cincinnati, Oh 45241 and the phone number is (513) 561-3797

The provider's speciality is Nuclear Medicine with taxonomy code 207U00000X

The provider has more than 50 years of experience. He graduated from New York University School Of Medicine in 1976.

The provider might be accepting Accepts: CareSource, MedMutual, Molina Healthcare,. 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 $126.12 with an average copayment of $31.53 for new patient appointments. Established patients should expect a typical charge of $96.44 and an average copayment of 24.11. 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: Blood glucose (sugar) level, Blood glucose (sugar) test performed by hand-held instrument, Blood test, lipids (cholesterol and triglycerides), Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician, Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries, Follow-up hospital inpatient care per day, typically 35 minutes, Hemoglobin a1c level, Injection, regadenoson, 0.1 mg, Liver enzyme (sgot), level, Liver enzyme (sgpt), level, New patient office or other outpatient visit, 45-59 minutes, Nuclear medicine studies of heart muscle at rest and with stress and spect, Nuclear medicine study of bone and/or joint whole body, Nuclear medicine study of brain with metabolic evaluation, Nuclear medicine study of liver and spleen, Nuclear medicine study, 1 area with spect, Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries, Technetium tc-99m sestamibi, diagnostic, per study dose and Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries.

The practitioner is affiliated to the following hospital(s): THE JEWISH HOSPITAL-MERCY HEALTH, MERCY HEALTH - FAIRFIELD HOSPITAL, BETHESDA NORTH and MERCY HEALTH - WEST HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on May 10, 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.