Magellan Healthcare Services, NPI 1164551503
Exclusive Provider Organization in Alpharetta, GA, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1164551503 |
| NPI Entity Type | Organization |
| Provider Name | Magellan Healthcare Services |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 2550 Northwinds Pkwy, Alpharetta, GA, US |
| Provider Mailing Address | 2785 Oak Meadow Dr, Snellville, GA, US, 300782794 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | MR. LMSW Nishma Herrera-daya |
| Official Position | SUPERVISOR |
| Phone | 800-201-8316 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Exclusive Provider Organization |
| Classification | |
| Group | |
| License No. | 002776 |
| License State | GA |
| Description | (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. |
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