(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.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Exclusive Provider Organization | 302F00000X |
* Indicates primary specialty
| NPI Number | 1720253461 |
| Legal business name LBN |
PHYSICIANS CARE GROUP HEALTH CHOICE INC. |
| Authorized official | ENRIQUE ZAMORA - (MANAGER) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 04/24/2008 |
| Last updated | 04/24/2008 - About 18 years ago |
| Sole proprietor1 | Not specified |
| Identifiers | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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