THAO NGOC DEBELEN CRNA
NPI 1154693075
Nurse Anesthetist, Certified Registered in Jacksonville, FL
Quality Rating: 77.12 out of 100 score
NPI Status: Active since February 08, 2012
Contact Information
4500 SAN PABLO RD S
JACKSONVILLE, FL
ZIP 32224
Phone: (904) 953-2000
- Individual
- Female
- Years of Experience 15
- Nurse Anesthetist, Certified Registered
- Accepts Insurance
- Accepts Medicare Approved Payment
- Medicare Quality Reporting
About THAO DEBELEN
This page provides the complete NPI Profile along with additional information for Thao Debelen, a provider established in Jacksonville, Florida with a medical specialization in Nurse Anesthetist, Certified Registered and more than 15 years of experience. The healthcare provider is registered in the NPI registry with number 1154693075 assigned on February 2012. The practitioner's primary taxonomy code is 367500000X with license number ARNP9173240 (FL). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1154693075
- Provider Name
- THAO NGOC DEBELEN CRNA
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4500 SAN PABLO RD S JACKSONVILLE, FL 32224
- Location Phone
- (904) 953-2000
- Mailing Address
- 4500 SAN PABLO RD S JACKSONVILLE, FL 32224
- Mailing Phone
- (904) 953-2000
- Medical School Name
- OTHER
- Graduation Year
- 2011
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 02-08-2012
- Last Update Date
- 10-13-2020
- Code Navigator
Location Map
Secondary Locations
- 2021 Kingsley Ave Suite 105
Orange Park, FL 32073
(904) 276-5400
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 Anesthetist, Certified Registered
- Taxonomy Code
- 367500000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- ARNP9173240
- License State
- FL
- Taxonomy Description
- (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Silver 9 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Thao Debelen 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.
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.
PECOS PAC ID: 345496782
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: I20120817000237
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.
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.
Anesthesia for exam of colon using an endoscope
Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope
Anesthesia for other procedure on large bowel using an endoscope
Anesthesia for procedure on small and large bowel using an endoscope
Anesthesia for a colon examination with an endoscope is a method used to ensure comfort during the procedure. It involves administering medication to help you relax or sleep, thus reducing discomfort as the endoscope, a thin, flexible tube, is navigated through your colon.
This service was performed 64 times for 64 patientsThis procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.
This service was performed 91 times for 91 patientsAnesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.
This service was performed 167 times for 167 patientsAnesthesia for an endoscopic procedure on the small and large bowel ensures comfort and relaxation during the procedure. It involves administering medicine to help you sleep or feel drowsy. This allows the doctor to examine your bowels without causing you discomfort or pain.
This service was performed 82 times for 82 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.51 for a new patient copayment and $17.51 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 32224 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $130.04
- Minimum New Patient Price $56
- Maximum New Patient Price $171.84
- Average New Patient Copayment $32.51
- Minimum New Patient Copayment $14
- Maximum New Patient Copayment $42.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $70.04
- Minimum Established Patient Price $17.57
- Maximum Established Patient Price $139.16
- Average Established Patient Copayment $17.51
- Minimum Established Patient Copayment $4.39
- Maximum Established Patient Copayment $34.79
* 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 77.12, 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: 77.12 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: 68.29
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: 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: 55.44
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: 55.44
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 |
---|---|---|
Implementation of formal quality improvement methods, practice changes, or other practice improvement processes | Yes | N/A |
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data. | ||
Participation in an AHRQ-listed patient safety organization. | Yes | N/A |
Participation in an AHRQ-listed patient safety organization. | ||
Participation in Joint Commission Evaluation Initiative | Yes | N/A |
Participation in Joint Commission Ongoing Professional Practice Evaluation initiative | ||
Use of QCDR data for ongoing practice assessment and improvements | Yes | N/A |
Use of QCDR data, for ongoing practice assessment and improvements in patient safety. | ||
Use of QCDR to promote standard practices, tools and processes in practice for improvement in care coordination | Yes | N/A |
Participation in a Qualified Clinical Data Registry, demonstrating performance of activities that promote use of standard practices, tools and processes for quality improvement (e.g., documented preventative screening and vaccinations that can be shared across MIPS eligible clinician or groups). |
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. Thao Debelen is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
MAYO CLINIC | 4500 SAN PABLO RD JACKSONVILLE, FL 32224 | (904) 953-2000 | 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 | 1 | 5 | 4 | 6 | 9 | 3 | 0 | 7 | 5 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 1 | 10 | 4 | 12 | 9 | 6 | 0 | 14 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 1 + 1 + 0 + 4 + 1 + 2 + 9 + 6 + 0 + 1 + 4 + 24 = 55 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 55 = 5 | 5 |
The NPI number 1154693075 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1023015062 | MS. KATHERINE ANN LEMASTER LCSW, RN Individual | Social Worker (Clinical) | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 296-3700 |
1962403964 | MS. NANCY DALTON CRNA Individual | Nurse Anesthetist, Certified Registered | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 296-4667 |
1285621573 | DR. ROBERT ALLEN GILLHAM JR. M.D. Individual | Allergy & Immunology | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1831186089 | DR. GEOFFREY STEVEN GATES M.D. Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1750378907 | DR. THOMAS PATRICK FOX M.D. Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1083601231 | DR. GRETCHEN KAY LIPKE M.D. Individual | Emergency Medicine | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1790772747 | DR. PHILIP PAUL METZGER M.D. Individual | Colon & Rectal Surgery | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1316935190 | DR. SANFORD JOSPEH FINCK M.D. Individual | Internal Medicine (Critical Care Medicine) | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1871582726 | DR. JAN MARIE LARSON M.D. Individual | Family Medicine | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1437148392 | DR. JERRY WAYNE SAYRE M.D. Individual | Family Medicine | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1912996877 | DR. WALTER CLYBURN TAYLOR III M.D. Individual | Family Medicine | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1689663569 | DR. JAMES SAMUEL SCOLAPIO M.D. Individual | Internal Medicine (Gastroenterology) | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1598754210 | DR. RONALD ALBERT HINDER M.D. Individual | Surgery | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1043209778 | DR. WILLIAM JAMES MAPLES M.D. Individual | Internal Medicine (Hematology & Oncology) | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1578552204 | DR. SHARON YVETT EZELL GERLACH M.D. Individual | Internal Medicine | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1619966348 | DR. FRANCOIS LETTE M.D. Individual | Internal Medicine | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1154310886 | DR. KAY MULLINAX MITCHELL M.D. Individual | Internal Medicine | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1518956192 | DR. KENNETH GORDON NIX JR. M.D. Individual | Internal Medicine | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1548259138 | DR. KATHLEEN ALLEN ROWLETT M.D. Individual | Internal Medicine | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
1427047018 | DR. JAMES HANNIS STEWART M.D. Individual | Internal Medicine | 4500 SAN PABLO RD S JACKSONVILLE, FL 32224 (904) 953-2000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154693075, enumerated in the NPI registry as an "individual" on February 08, 2012
The provider is located at 4500 San Pablo Rd S Jacksonville, Fl 32224 and the phone number is (904) 953-2000
The provider's speciality is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X
The provider has more than 15 years of experience.
The provider might be accepting Accepts: Molina Healthcare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
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 $130.04 with an average copayment of $32.51 for new patient appointments. Established patients should expect a typical charge of $70.04 and an average copayment of 17.51. 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: Anesthesia for exam of colon using an endoscope, Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope, Anesthesia for other procedure on large bowel using an endoscope and Anesthesia for procedure on small and large bowel using an endoscope.
The practitioner is affiliated to the following hospital(s): MAYO CLINIC. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on February 08, 2012. 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.