CAROL AKERS COX MD
NPI 1922427871
Obstetrics & Gynecology in Breckenridge, CO

NPI Status: Active since April 08, 2014

Contact Information

16172 HIGHWAY 9
BRECKENRIDGE, CO
ZIP 80424
Phone: (970) 423-8840
Fax: (970) 423-8850

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  • Individual
  • Female
  • Years of Experience 12
  • Obstetrics & Gynecology
  • Accepts Insurance
  • Accepts Medicare Approved Payment

About CAROL COX

This page provides the complete NPI Profile along with additional information for Carol Cox, a women's health care provider established in Breckenridge, Colorado with a medical specialization in Obstetrics & Gynecology and more than 12 years of experience. The healthcare provider is registered in the NPI registry with number 1922427871 assigned on April 2014. The practitioner's primary taxonomy code is 207V00000X with license number DR0066810 (CO). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1922427871
Provider Name
CAROL AKERS COX MD
Gender
Female
Entity Type
Individual
Location Address
16172 HIGHWAY 9 BRECKENRIDGE, CO 80424
Location Phone
(970) 423-8840
Location Fax
(970) 423-8850
Mailing Address
16172 HIGHWAY 9 BRECKENRIDGE, CO 80424
Mailing Phone
(970) 423-8840
Mailing Fax
(970) 423-8850
Medical School Name
OTHER
Graduation Year
2014
Is Sole Proprietor?
No
Enumeration Date
04-08-2014
Last Update Date
11-09-2021
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Women's health care providers like Carol Cox treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, 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

Obstetrics & Gynecology

Taxonomy Code
207V00000X
Type
Allopathic & Osteopathic Physicians
License No.
DR0066810
License State
CO
Taxonomy Description
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

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)
1207V00000XAllopathic & Osteopathic Physicians

Obstetrics & Gynecology

51246 (KY)
2390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

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
  • 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
  • HDHP Preventive Silver 5500 $0 Select Drugs - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • HSA Eligible Bronze 6000 - HMO
  • Low Premium Bronze 9200 $25 Generic Drugs - HMO
  • Low Premium Bronze 9200 $25 Generic Drugs Adult Vision & Fitness - HMO
  • Low Premium Silver 6000 $3 Generic Drugs - HMO
  • Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
  • Platinum Zero $5 Generic Drugs - HMO
  • Platinum Zero $5 Generic Drugs Adult Vision & Fitness - 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.

*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
9000197336MEDICAID (05)CO 

Medicare Participation & PECOS Enrollment Status

Carol Cox 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: 244546745

    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: I20211202000361

    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.

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $33.13 for a new patient copayment and $18.05 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 80424 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $132.55
  • Minimum New Patient Price $58.06
  • Maximum New Patient Price $174.82
  • Average New Patient Copayment $33.13
  • Minimum New Patient Copayment $14.51
  • Maximum New Patient Copayment $43.7

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $72.2
  • Minimum Established Patient Price $18.88
  • Maximum Established Patient Price $142.79
  • Average Established Patient Copayment $18.05
  • Minimum Established Patient Copayment $4.72
  • Maximum Established Patient Copayment $35.69

* 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.
1922427871
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
29428214814
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 4 + 2 + 8 + 2 + 1 + 4 + 8 + 1 + 4 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1922427871 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 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1093087108SWAN MOUNTAIN WOMEN'S CENTER, PC
Organization
Obstetrics & Gynecology16172 HIGHWAY 9
BRECKENRIDGE, CO 80424
(719) 649-0708
1124174701 ANTONINO F. BARBERA MD
Individual
Obstetrics & Gynecology16172 HIGHWAY 9
BRECKENRIDGE, CO 80424
(303) 667-1735
1114210184DR. SHELBY ELIZABETH OSBORNE D.O.
Individual
Obstetrics & Gynecology16172 HIGHWAY 9 SWAN MOUNTAIN WOMEN'S CENTER
BRECKENRIDGE, CO 80424
(970) 423-8840
1679953053DR. JULIE BLACK MCKENZIE D.O.
Individual
Family Medicine16172 HIGHWAY 9
BRECKENRIDGE, CO 80424
(970) 423-8840
1831586882 HOLLY HICKMAN MD
Individual
Obstetrics & Gynecology16172 HIGHWAY 9
BRECKENRIDGE, CO 80424
(731) 695-0669

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1922427871, enumerated in the NPI registry as an "individual" on April 08, 2014

The provider is located at 16172 Highway 9 Breckenridge, Co 80424 and the phone number is (970) 423-8840

The provider's speciality is Obstetrics & Gynecology with taxonomy code 207V00000X

The provider has more than 12 years of experience.

The provider might be accepting Accepts: CareSource, 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 $132.55 with an average copayment of $33.13 for new patient appointments. Established patients should expect a typical charge of $72.2 and an average copayment of 18.05. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on April 08, 2014. 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.