G & K HEALTH CARE PROFESSIONALS LLC – NPI #1053684209
Exclusive Provider Organization
(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.
G & K HEALTH CARE PROFESSIONALS LLC is an exclusive provider organization located in WASHINGTON, DC. NPPES has assigned the NPI number 1053684209 to G & K HEALTH CARE PROFESSIONALS LLC on February 20, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 302F00000X from the Health Care Provider Taxonomy code set, which is classified as Exclusive Provider Organization.
Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for G & K HEALTH CARE PROFESSIONALS LLC below.
NPI Profile for
G & K HEALTH CARE PROFESSIONALS LLC
(more than 14 years ago)
WASHINGTON, DC 20012-1422 Phone: (301) 675-5755 Fax:
MANAGER
Phone: (301) 675-5755
Identifiers for G & K HEALTH CARE PROFESSIONALS LLC
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| MEDICAID | DC | 1912217456 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 302F00000X - Exclusive Provider Organization (Primary) |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.