ALYSSA RUWE MARTZ
NPI 1043757867
Nurse Practitioner - Family in Maryville, IL
Quality Rating: 73.97 out of 100 score
NPI Status: Active since January 31, 2017
Contact Information
6812 STATE ROUTE 162
SUITE 123
MARYVILLE, IL
ZIP 62062
Phone: (618) 288-9460
Fax: (618) 288-9461
- Individual
- Female
- Years of Experience 10
- Nurse Practitioner
- Family
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About ALYSSA MARTZ
This page provides the complete NPI Profile along with additional information for Alyssa Martz, a provider established in Maryville, Illinois with a medical specialization in Nurse Practitioner, focusing in family and more than 10 years of experience. The healthcare provider is registered in the NPI registry with number 1043757867 assigned on January 2017. The practitioner's primary taxonomy code is 363LF0000X with license number 209015399 (IL). The provider is registered as an individual and her NPI record was last updated 2 years ago.
- NPI
- 1043757867
- Provider Name
- ALYSSA RUWE MARTZ
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 6812 STATE ROUTE 162 SUITE 123 MARYVILLE, IL 62062
- Location Phone
- (618) 288-9460
- Location Fax
- (618) 288-9461
- Mailing Address
- 6812 STATE ROUTE 162 SUITE 123 MARYVILLE, IL 62062
- Mailing Phone
- (618) 288-9460
- Mailing Fax
- (618) 288-9461
- Medical School Name
- OTHER
- Graduation Year
- 2016
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-31-2017
- Last Update Date
- 11-09-2023
- Code Navigator
A nurse practitioner (NP) like Alyssa Martz is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
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
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 209015399
- License State
- IL
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- WellFirst by Medica Bronze $0 Copay PCP Visits - EPO
- WellFirst by Medica Bronze Share - EPO
- WellFirst by Medica Catastrophic - EPO
- WellFirst by Medica Expanded Bronze Standard - EPO
- WellFirst by Medica Gold $0 Copay PCP Visits - EPO
- WellFirst by Medica Gold Copay Plus - EPO
- WellFirst by Medica Gold Standard - EPO
- WellFirst by Medica Silver $0 Copay PCP Visits - EPO
- WellFirst by Medica Silver Copay Plus - EPO
- WellFirst by Medica Silver Standard - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Alyssa Martz 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.
Alyssa Martz 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: 5597040121
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: I20170322002764
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
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.
Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit, 20-29 minutes
Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose
Initial hospital inpatient care per day, typically 50 minutes
Injection, methylprednisolone acetate, 80 mg
New patient office or other outpatient visit, 30-44 minutes
X-ray of hip, 2-3 views
X-ray of knee, 4 or more views
X-ray of shoulder, minimum of 2 views
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 277 times for 106 patientsThis 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 194 times for 126 patientsHyaluronan or derivatives like Hyalgan, Supartz, or Visco-3, are used in intra-articular injections for joint pain relief. They help by improving joint lubrication, reducing inflammation, and promoting tissue healing. Each dose is administered directly into the joint space.
This service was performed 152 times for 23 patientsInitial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
This service was performed 15 times for 14 patientsMethylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.
This service was performed 188 times for 85 patientsThis 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 29 times for 29 patientsAn X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
This service was performed 11 times for 11 patientsAn X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
This service was performed 60 times for 56 patientsAn X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
This service was performed 14 times for 14 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.11 for a new patient copayment and $24.92 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 62062 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $88.44
- Minimum New Patient Price $56.28
- Maximum New Patient Price $173.35
- Average New Patient Copayment $22.11
- Minimum New Patient Copayment $14.07
- Maximum New Patient Copayment $43.33
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $99.71
- Minimum Established Patient Price $17.51
- Maximum Established Patient Price $139.99
- Average Established Patient Copayment $24.92
- Minimum Established Patient Copayment $4.37
- Maximum Established Patient Copayment $34.99
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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 73.97, 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.
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Final Score: 73.97 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.
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Quality Score: 61.46
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.
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Promoting Interoperability Score: 90
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: 60.11
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: 60.11
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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Annual registration in the Prescription Drug Monitoring Program | Yes | N/A |
| Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months. | ||
| Care Plan | 53% | 139 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| Documentation of Current Medications in the Medical Record | 95% | 508 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Engagement of patients through implementation of improvements in patient portal | Yes | N/A |
| Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Medication Reconciliation | 78% | 68 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 94% | 386 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 37% | 134 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Practice Improvements for Bilateral Exchange of Patient Information | Yes | N/A |
| Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: • Participate in a Health Information Exchange if available; and/or • Use structured referral notes. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 51% | 312 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Influenza Immunization | 30% | 233 |
| Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 99% | 219 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide Patient Access | 96% | 386 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 3% | 386 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Use of High-Risk Medications in the Elderly | 0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 134 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Alyssa Martz is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| ANDERSON HOSPITAL | 6800 STATE ROUTE 162 MARYVILLE, IL 62062 | (618) 288-5711 | Acute Care Hospitals |
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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. | |||||||||
| 1 | 0 | 4 | 3 | 7 | 5 | 7 | 8 | 6 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 8 | 3 | 14 | 5 | 14 | 8 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 8 + 3 + 1 + 4 + 5 + 1 + 4 + 8 + 1 + 2 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1043757867 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 12 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1124261219 | MARYVILLE PHYSICIANS SERVICES INC Organization | Orthopaedic Surgery | 6812 STATE ROUTE 162 SUITE 123 MARYVILLE, IL 62062 (618) 288-9460 |
| 1447252978 | DR. BRETT R GREBING MD Individual | Orthopaedic Surgery | 6812 STATE ROUTE 162 SUITE 123 MARYVILLE, IL 62062 (618) 288-9460 |
| 1295728988 | JASON E BARNETT MD Individual | Family Medicine | 6812 STATE ROUTE 162 SUITE 120 MARYVILLE, IL 62062 (618) 288-0044 |
| 1396831780 | DR. KATHRYN FOLLOWELL MD Individual | Family Medicine | 6812 STATE ROUTE 162 SUITE 204 MARYVILLE, IL 62062 (618) 288-6464 |
| 1922159037 | DR. KEVIN BRADLEY GARNER M.D. Individual | Internal Medicine | 6812 STATE ROUTE 162 SUITE 204 MARYVILLE, IL 62062 (618) 288-2120 |
| 1689092132 | ALYSSA RYANNE GODDARD VERHEYEN FNP Individual | Nurse Practitioner (Family) | 6812 STATE ROUTE 162 SUITE 202 MARYVILLE, IL 62062 (618) 288-7605 |
| 1114454733 | MICHAEL BARAJAS PA Individual | Physician Assistant | 6812 STATE ROUTE 162 SUITE 120 MARYVILLE, IL 62062 (618) 288-0044 |
| 1700960572 | MR. RODNEY L. GREELING DO Individual | Internal Medicine | 6812 STATE ROUTE 162 STE 21 MARYVILLE, IL 62062 (618) 288-5566 |
| 1427042381 | SOPHIA ROSTOVTSEVA MD Individual | Family Medicine | 6812 STATE ROUTE 162 STE 120 MARYVILLE, IL 62062 (618) 288-0044 |
| 1922348002 | LAURA E. MCKINZIE NP Individual | Nurse Practitioner | 6812 STATE ROUTE 162 SUITE 21 MARYVILLE, IL 62062 (618) 288-7855 |
| 1912117912 | EDMUNDO ALEJANDRO RODRIGUEZ-FRIAS MD Individual | Internal Medicine (Gastroenterology) | 6812 STATE ROUTE 162 SUITE 204 MARYVILLE, IL 62062 (618) 391-5070 |
| 1700973351 | DR. JAMES M SIMMERING MD Individual | Internal Medicine | 6812 STATE ROUTE 162 SUITE 120 MARYVILLE, IL 62062 (618) 288-1122 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043757867, enumerated in the NPI registry as an "individual" on January 31, 2017
The provider is located at 6812 State Route 162 Suite 123 Maryville, Il 62062 and the phone number is (618) 288-9460
The provider's speciality is Nurse Practitioner with taxonomy code 363LF0000X with a focus in Family
The provider has more than 10 years of experience.
The provider might be accepting Accepts: Medica. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
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: uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $88.44 with an average copayment of $22.11 for new patient appointments. Established patients should expect a typical charge of $99.71 and an average copayment of 24.92. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Aspiration and/or injection of fluid from large joint, Established patient office or other outpatient visit, 20-29 minutes, Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose, Initial hospital inpatient care per day, typically 50 minutes, Injection, methylprednisolone acetate, 80 mg, New patient office or other outpatient visit, 30-44 minutes, X-ray of hip, 2-3 views, X-ray of knee, 4 or more views and X-ray of shoulder, minimum of 2 views.
The practitioner is affiliated to the following hospital(s): ANDERSON HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on January 31, 2017. 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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