DR. KRISTEN E RADCLIFF MD
NPI 1003071010
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in Somers Point, NJ


Quality Rating: 88.73 out of 100 score

NPI Status: Active since July 20, 2008

Contact Information

415 NEW RD STE 3
SOMERS POINT, NJ
ZIP 08244
Phone: (609) 800-3472
Fax: (609) 800-3472

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  • Individual
  • Male
  • Years of Experience 22
  • Orthopaedic Surgery
  • Orthopaedic Surgery of the Spine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About KRISTEN RADCLIFF

This page provides the complete NPI Profile along with additional information for Kristen Radcliff, a provider established in Somers Point, New Jersey with a medical specialization in Orthopaedic Surgery, focusing in orthopaedic surgery of the spine and more than 22 years of experience. He graduated from Duke University School Of Medicine in 2004. The healthcare provider is registered in the NPI registry with number 1003071010 assigned on July 2008. The practitioner's primary taxonomy code is 207XS0117X with license number 25MA08665500 (NJ). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1003071010
Provider Name
DR. KRISTEN E RADCLIFF MD
Gender
Male
Entity Type
Individual
Location Address
415 NEW RD STE 3 SOMERS POINT, NJ 08244
Location Phone
(609) 800-3472
Location Fax
(609) 800-3472
Mailing Address
415 NEW RD STE 3 SOMERS POINT, NJ 08244
Mailing Phone
(609) 800-3472
Medical School Name
DUKE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
2004
Is Sole Proprietor?
No
Enumeration Date
07-20-2008
Last Update Date
08-02-2022
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Location Map

Secondary Locations

  • 2500 English Creek Ave Ste 1300
    Egg Harbor Township, NJ 08234
    (267) 339-3558
  • 4301 US-1, 3rd Floor, Suite 300
    Monmouth Junction, NJ 08852
    (267) 339-3558
  • 517 Route 72 W Ste J
    Manahawkin, NJ 08050
    (267) 339-3558

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

Orthopaedic Surgery Orthopaedic Surgery of the Spine

Taxonomy Code
207XS0117X
Type
Allopathic & Osteopathic Physicians
License No.
25MA08665500
License State
NJ
Taxonomy Description
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive.

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)
1207X00000XAllopathic & Osteopathic Physicians

Orthopaedic Surgery

25MA08665500 (NJ)
2207X00000XAllopathic & Osteopathic Physicians

Orthopaedic Surgery

308177 (NY)
3207X00000XAllopathic & Osteopathic Physicians

Orthopaedic Surgery

BP10016967 (TX)
4207XS0117XAllopathic & Osteopathic Physicians

Orthopaedic Surgery
Orthopaedic Surgery of the Spine

MD437115 (PA)

Medicare Participation & PECOS Enrollment Status

Kristen Radcliff 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.

Kristen Radcliff is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

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.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3779634779

    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: I20100804000450

    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.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE000N)

    Osteogenesis stimulator, electrical, non-invasive, spinal applications (HCPCS:E0748)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 49 times for 40 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 215 times for 174 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 27 times for 26 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

This service was performed 29 times for 18 patients

Laminectomy or laminotomy (partial removal of spine bones)

A laminectomy or laminotomy is a surgical procedure that involves removing part of the bone in your spine, specifically the lamina, to alleviate pressure on your spinal cord or nerves. This can help reduce pain and improve mobility if you're suffering from conditions like herniated discs or spinal stenosis.

This service was performed for 27 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 17 times for 17 patients

Spinal fusion

Spinal fusion is a surgical procedure aimed at connecting two or more vertebrae in your spine to reduce pain and improve stability. It involves using a bone graft to cause the vertebrae to grow together, limiting the movement between them. This procedure is often performed to treat conditions like herniated discs or spinal stenosis.

This service was performed for 29 patients

X-ray of lower and sacral spine, 2-3 views

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

This service was performed 41 times for 29 patients

X-ray of lower and sacral spine, minimum of 4 views

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

This service was performed 72 times for 63 patients

X-ray of upper spine, 2-3 views

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

This service was performed 13 times for 12 patients

X-ray of upper spine, 4-5 views

An X-ray of the upper spine with 4-5 views is a non-invasive imaging test. It uses radiation to capture detailed images of the bones and structures in your neck and upper back. This procedure helps identify issues like fractures, infections, or deformities.

This service was performed 24 times for 22 patients

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 88.73, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 88.73 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 90.36

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: 72.08

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: 72.08

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

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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.
1003071010
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200307202
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 7 + 2 + 0 + 2 + 24 = 40
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1003071010 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1285378885RADCLIFF SPINE
Organization
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)415 NEW RD STE 3
SOMERS POINT, NJ 08244
(609) 800-3472

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003071010, enumerated in the NPI registry as an "individual" on July 20, 2008

The provider is located at 415 New Rd Ste 3 Somers Point, Nj 08244 and the phone number is (609) 800-3472

The provider's speciality is Orthopaedic Surgery with taxonomy code 207XS0117X with a focus in Orthopaedic Surgery of the Spine

The provider has more than 22 years of experience. He graduated from Duke University School Of Medicine in 2004.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Insertion of cage or mesh device to spine bone and disc space during spine fusion, Laminectomy or laminotomy (partial removal of spine bones), New patient office or other outpatient visit, 30-44 minutes, Spinal fusion, X-ray of lower and sacral spine, 2-3 views, X-ray of lower and sacral spine, minimum of 4 views, X-ray of upper spine, 2-3 views and X-ray of upper spine, 4-5 views.

This NPI record was last updated on July 20, 2008. 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].
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