ALYSSA PABALAN
NPI 1225454929
Emergency Medicine in Chicago, IL
Quality Rating: 94.85 out of 100 score
NPI Status: Active since March 05, 2014
Contact Information
5841 S MARYLAND AVE
CHICAGO, IL
ZIP 60637
Phone: (773) 702-1000
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Insurance Plans Accepted
- Secondary Locations
- Medicare Participation & PECOS Status
- Areas of Expertise
- Physician Visit Costs
- Overall Quality Performance
- Quality Reporting
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Female
- Years of Experience 12
- Emergency Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About ALYSSA PABALAN
This page provides the complete NPI Profile along with additional information for Alyssa Pabalan, a provider established in Chicago, Illinois with a medical specialization in Emergency Medicine and more than 12 years of experience. She graduated from Philadelphia College Of Osteopathic Medicine in 2014. The healthcare provider is registered in the NPI registry with number 1225454929 assigned on March 2014. The practitioner's primary taxonomy code is 207P00000X with license number 036.146345 (IL). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1225454929
- Provider Name
- ALYSSA PABALAN
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 5841 S MARYLAND AVE CHICAGO, IL 60637
- Location Phone
- (773) 702-1000
- Mailing Address
- 150 HARVESTER DR STE 300 BURR RIDGE, IL 60527
- Medical School Name
- PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
- Graduation Year
- 2014
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 03-05-2014
- Last Update Date
- 12-23-2024
- Code Navigator
Location Map
Secondary Locations
- 10855 Virginia St
Crown Point, IN 46307
(773) 702-1000
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
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036.146345
- License State
- IL
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
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) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Alyssa Pabalan 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 Pabalan 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: 2264659911
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: I20180613003018
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.
Critical care, first 30-74 minutes
Emergency department visit for life threatening or functioning severity
Emergency department visit for problem of high severity
Emergency department visit for problem of moderate severity
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
This service was performed 41 times for 41 patientsAn emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
This service was performed 287 times for 278 patientsAn emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
This service was performed 76 times for 75 patientsAn emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
This service was performed 58 times for 57 patientsA routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
This service was performed 30 times for 27 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $23.51 for a new patient copayment and $26.42 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 60637 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $94.06
- Minimum New Patient Price $60.08
- Maximum New Patient Price $183.39
- Average New Patient Copayment $23.51
- Minimum New Patient Copayment $15.02
- Maximum New Patient Copayment $45.84
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $105.7
- Minimum Established Patient Price $18.97
- Maximum Established Patient Price $148.12
- Average Established Patient Copayment $26.42
- Minimum Established Patient Copayment $4.74
- Maximum Established Patient Copayment $37.03
* 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 94.85, 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: 94.85 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: 85
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: N/A
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: N/A
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: N/A
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 an ASP | Yes | N/A |
| Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance | ||
| 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. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Participation in an AHRQ-listed patient safety organization. | Yes | N/A |
| Participation in an AHRQ-listed patient safety organization. | ||
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 Pabalan is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| FRANCISCAN HEALTH MICHIGAN CITY | 3500 FRANCISCAN WAY MICHIGAN CITY, IN 46360 | (219) 879-8511 | 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 | 2 | 2 | 5 | 4 | 5 | 4 | 9 | 2 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 4 | 5 | 8 | 5 | 8 | 9 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 4 + 5 + 8 + 5 + 8 + 9 + 4 + 24 = 71 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 71 = 9 | 9 | ||||||||
The NPI number 1225454929 is valid because the calculated check digit 9 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 |
|---|---|---|---|
| 1275527848 | DR. ADAM BUCHANAN COCHRANE PHARM.D., BCPS Individual | Pharmacist (Pharmacotherapy) | 5841 S MARYLAND AVE MC 5026 CHICAGO, IL 60637 (773) 702-3583 |
| 1609861848 | MRS. VINAY KUMARI GARG Individual | Dietitian, Registered | 5841 S MARYLAND AVE CHICAGO, IL 60637 (773) 702-8165 |
| 1275528499 | THOMAS L FISHER JR. MD., M.P.H Individual | Emergency Medicine | 5841 S MARYLAND AVE CHICAGO, IL 60637 (773) 702-9501 |
| 1649261546 | LINDA MARIE NAHLIK R.PH. Individual | Pharmacist (Pharmacotherapy) | 5841 S MARYLAND AVE UNIVERSITY OF CHICAGO HOSPITALS CHICAGO, IL 60637 (773) 834-2017 |
| 1396723391 | HEATHER M MACLEOD MS Individual | Genetic Counselor, MS | 5841 S MARYLAND AVE MC 6088 CHICAGO, IL 60637 (773) 702-4310 |
| 1558333807 | RACHELLE J LORENZ M.S. Individual | Genetic Counselor, MS | 5841 S MARYLAND AVE MC 0077 CHICAGO, IL 60637 (773) 834-9801 |
| 1568426658 | DR. MARCO G. PATTI MD Individual | Surgery | 5841 S MARYLAND AVE MC 5031 CHICAGO, IL 60637 (773) 702-4865 |
| 1346292380 | TRISHA RABIDOUX RD, LDN Individual | Dietitian, Registered | 5841 S MARYLAND AVE MC 0988 CHICAGO, IL 60637 (773) 702-3867 |
| 1336193671 | DR. REBECCA LYNN BROWN M.D. Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 5841 S MARYLAND AVE MC1027 CHICAGO, IL 60637 (773) 702-1000 |
| 1205883444 | DR. JERRY KRISHNAN M.D., PHD. Individual | Internal Medicine (Pulmonary Disease) | 5841 S MARYLAND AVE CHICAGO, IL 60637 (773) 702-2274 |
| 1932145802 | DR. MARION S. VERP M.D. Individual | Obstetrics & Gynecology (Gynecology) | 5841 S MARYLAND AVE MC2050 CHICAGO, IL 60637 (773) 702-6127 |
| 1609802107 | DR. BASHARAT BUCHH MD Individual | Pediatrics (Neonatal-Perinatal Medicine) | 5841 S MARYLAND AVE MC 6060 CHICAGO, IL 60637 (773) 702-6210 |
| 1336178763 | DR. ARTHUR FRANCIS HANEY MD Individual | Obstetrics & Gynecology (Reproductive Endocrinology) | 5841 S MARYLAND AVE MC2050 CHICAGO, IL 60637 (773) 702-9200 |
| 1881625697 | KEME HEAVEN CARTER M.D. Individual | Emergency Medicine | 5841 S MARYLAND AVE MC 5068 CHICAGO, IL 60637 (773) 702-9500 |
| 1043241839 | MARY KRYSTOFIAK RUSSELL RD Individual | Dietitian, Registered | 5841 S MARYLAND AVE MC 0988 CHICAGO, IL 60637 (773) 770-2150 |
| 1952334781 | DR. LISA M SHAH M.D. Individual | Internal Medicine | 5841 S MARYLAND AVE CHICAGO, IL 60637 (773) 702-1000 |
| 1245263383 | ANNETTE C BOOGERD Individual | Dietitian, Registered | 5841 S MARYLAND AVE MC 3051 CHICAGO, IL 60637 (773) 702-5013 |
| 1962435263 | MRS. EMILY NICOLE LISCIANDRO MS, RD, LDN Individual | Dietitian, Registered (Nutrition, Pediatric) | 5841 S MARYLAND AVE MC0988 CHICAGO, IL 60637 (773) 702-0551 |
| 1104843788 | SEEMA S LIMAYE MD Individual | Internal Medicine | 5841 S MARYLAND AVE DEPARTMENT OF MEDICINE, (MC6098) CHICAGO, IL 60637 (773) 702-6459 |
| 1588682330 | CONSTANCE N DROSSOS PH.D. Individual | Psychologist (Clinical) | 5841 S MARYLAND AVE STE MC 3077 CHICAGO, IL 60637 (773) 702-2995 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1225454929, enumerated in the NPI registry as an "individual" on March 05, 2014
The provider is located at 5841 S Maryland Ave Chicago, Il 60637 and the phone number is (773) 702-1000
The provider's speciality is Emergency Medicine with taxonomy code 207P00000X
The provider has more than 12 years of experience. She graduated from Philadelphia College Of Osteopathic Medicine in 2014.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois. 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: quality clinical practices and patient outcomes and experiences.
Medicare beneficiaries should expect a typical cost of $94.06 with an average copayment of $23.51 for new patient appointments. Established patients should expect a typical charge of $105.7 and an average copayment of 26.42. 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: Critical care, first 30-74 minutes, Emergency department visit for life threatening or functioning severity, Emergency department visit for problem of high severity, Emergency department visit for problem of moderate severity and Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only.
The practitioner is affiliated to the following hospital(s): FRANCISCAN HEALTH MICHIGAN CITY. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on March 05, 2014. 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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