DR. MICHAEL PATRICK GOWEN SR. OD
NPI 1831170026
Optometrist in Harrisonburg, VA
NPI Status: Active since November 07, 2005
Contact Information
1870 RESERVOIR ST
HARRISONBURG, VA
ZIP 22801
Phone: (540) 434-6622
Fax: (540) 434-4187
- Individual
- Male
- Years of Experience 39
- Optometrist
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MICHAEL GOWEN
This page provides the complete NPI Profile along with additional information for Michael Gowen, a provider established in Harrisonburg, Virginia with a medical specialization in Optometrist and more than 39 years of experience. He graduated from Pennsylvania College Of Optometry in 1987. The healthcare provider is registered in the NPI registry with number 1831170026 assigned on November 2005. The practitioner's primary taxonomy code is 152W00000X with license number 0618000690 (VA). The provider is registered as an individual and his NPI record was last updated 7 years ago.
- NPI
- 1831170026
- Provider Name
- DR. MICHAEL PATRICK GOWEN SR. OD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1870 RESERVOIR ST HARRISONBURG, VA 22801
- Location Phone
- (540) 434-6622
- Location Fax
- (540) 434-4187
- Mailing Address
- 1950 OLD GALLOWS RD STE 520 VIENNA, VA 22182
- Mailing Phone
- (703) 847-8899
- Mailing Fax
- (540) 434-4187
- Medical School Name
- PENNSYLVANIA COLLEGE OF OPTOMETRY
- Graduation Year
- 1987
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-07-2005
- Last Update Date
- 01-26-2018
- Code Navigator
Location Map
Secondary Locations
- 1870 Reservoir St
Harrisonburg, VA 22801
(540) 434-6622
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
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 0618000690
- License State
- VA
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- Blue Precision Bronze HMO? 205 - HMO
- Blue Focus Bronze POS? 205 - POS
- Blue Focus Bronze POS? 705 - POS
- Blue Focus Bronze POS? Standard - POS
- Blue Focus Gold POS? 207 - POS
- Blue Focus Gold POS? Standard - POS
- Blue Focus Silver POS? 206 - POS
- Blue Focus Silver POS? Standard - POS
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Advantage Bronze PPO? 202 - PPO
- Blue Advantage Bronze PPO? 203 - PPO
- Blue Advantage Bronze PPO? Standard - PPO
- Blue Advantage Gold PPO? 309 - PPO
- Blue Advantage Gold PPO? 604 - PPO
- Blue Advantage Gold PPO? Standard - PPO
- Blue Advantage Silver PPO? 204 - PPO
- Blue Advantage Silver PPO? 501 - PPO
- Blue Advantage Silver PPO? Standard - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
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 |
|---|---|---|---|
| 1831170026 | MEDICAID (05) | VA |
Medicare Participation & PECOS Enrollment Status
Michael Gowen 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.
Michael Gowen 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) and a Home Health Agency (HHA).
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: 1951475649
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: I20101021001106
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: No
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.
Established patient complete exam of visual system
Established patient problem focused exam of visual system
New patient complete exam of visual system
Photography of the retina
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
This service was performed 99 times for 98 patientsThis is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
This service was performed 53 times for 38 patientsA new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
This service was performed 20 times for 20 patientsPhotography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
This service was performed 107 times for 104 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.26 for a new patient copayment and $17.52 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 22801 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $129.04
- Minimum New Patient Price $56.19
- Maximum New Patient Price $170.3
- Average New Patient Copayment $32.26
- Minimum New Patient Copayment $14.04
- Maximum New Patient Copayment $42.57
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $70.08
- Minimum Established Patient Price $18.07
- Maximum Established Patient Price $138.91
- Average Established Patient Copayment $17.52
- Minimum Established Patient Copayment $4.51
- Maximum Established Patient Copayment $34.72
* 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. | |||||||||
| 1 | 8 | 3 | 1 | 1 | 7 | 0 | 0 | 2 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 6 | 1 | 2 | 7 | 0 | 0 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 6 + 1 + 2 + 7 + 0 + 0 + 4 + 24 = 54 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 54 = 6 | 6 | ||||||||
The NPI number 1831170026 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1912029786 | MPG LLC Organization | Optometrist | 1870 RESERVOIR ST HARRISONBURG, VA 22801 (540) 434-6622 |
| 1396115226 | DR. ROBERT DAVID WELCH O.D. Individual | Optometrist | 1870 RESERVOIR ST HARRISONBURG, VA 22801 (540) 434-6622 |
| 1225112147 | DR. DAVID L CLAUSS O.D. Individual | Optometrist | 1870 RESERVOIR ST HARRISONBURG, VA 22801 (540) 434-6622 |
| 1295387629 | DR. JEROMICA BOSSHERA WARD OD Individual | Optometrist | 1870 RESERVOIR ST HARRISONBURG, VA 22801 (540) 434-6622 |
| 1417325135 | MYEYEDR OPTOMETRY OF VIRGINIA, PLLC Organization | Optometrist | 1870 RESERVOIR ST HARRISONBURG, VA 22801 (540) 434-6622 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1831170026, enumerated in the NPI registry as an "individual" on November 07, 2005
The provider is located at 1870 Reservoir St Harrisonburg, Va 22801 and the phone number is (540) 434-6622
The provider's speciality is Optometrist with taxonomy code 152W00000X
The provider has more than 39 years of experience. He graduated from Pennsylvania College Of Optometry in 1987.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Blue Cross. 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) and a Home Health Agency (HHA).
Medicare beneficiaries should expect a typical cost of $129.04 with an average copayment of $32.26 for new patient appointments. Established patients should expect a typical charge of $70.08 and an average copayment of 17.52. 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: Established patient complete exam of visual system, Established patient problem focused exam of visual system, New patient complete exam of visual system and Photography of the retina.
This NPI record was last updated on November 07, 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].
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