NPI | Name | Type | Address |
---|---|---|---|
Albuquerque Neuroscience, Inc. |
Organization |
101 Hospital Loop Ne Suite 209 Albuquerque, NM |
|
Sandi's Smiles For Miles |
Organization |
901 Rio Grande Blvd Nw 154 G Albuquerque, NM |
|
Roots & Wings Community Charter School |
Organization |
35 La Lama Road Albuquerque, NM |
|
Ability First, Llc |
Organization |
1113 Rhode Island St Ne Albuquerque, NM |
|
Dermatology & Skin Cancer Center Of Nm Pc |
Organization |
6200 Uptown Blvd Ne Ste. 410 Albuquerque, NM |
Every health care provider, whether it’s a hospital, pharmacy, or individual specialist, must obtain their own NPI number. This identification number is unique and is assigned upon application. In tod...
Taxonomy Code | 302F00000X |
Display Name | Exclusive Provider Organization |
Taxonomy Group | Managed Care Organizations |
Taxonomy Classification | Exclusive Provider Organization |
Definition | (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. |
Effective Date | September 30, 2009 |