DR. JENY GHARTEY D.O.
NPI 1235306713
Obstetrics & Gynecology - Maternal & Fetal Medicine in Austin, TX
Quality Rating: 79.35 out of 100 score
NPI Status: Active since May 13, 2008
Contact Information
1301 W 38TH ST STE 315
AUSTIN, TX
ZIP 78705
Phone: (512) 324-7256
- Individual
- Female
- Years of Experience 22
- Obstetrics & Gynecology
- Maternal & Fetal Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About JENY GHARTEY
This page provides the complete NPI Profile along with additional information for Jeny Ghartey, a women's health care provider established in Austin, Texas with a medical specialization in Obstetrics & Gynecology, focusing in maternal & fetal medicine and more than 22 years of experience. She graduated from New York College Of Osteo Medicine Of New York Institute Of Technology in 2004. The healthcare provider is registered in the NPI registry with number 1235306713 assigned on May 2008. The practitioner's primary taxonomy code is 207VM0101X with license number R5264 (TX). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1235306713
- Provider Name
- DR. JENY GHARTEY D.O.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1301 W 38TH ST STE 315 AUSTIN, TX 78705
- Location Phone
- (512) 324-7256
- Mailing Address
- 1301 W 38TH ST STE 315 AUSTIN, TX 78705
- Mailing Phone
- (512) 324-7256
- Medical School Name
- NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
- Graduation Year
- 2004
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-13-2008
- Last Update Date
- 03-17-2018
- Code Navigator
Women's health care providers like Jeny Ghartey treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
Location Map
Secondary Locations
- 1300 Morris Park Ave Dept. of OBGYN Belfer 501
Bronx, NY 10461
(718) 430-3581
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
Obstetrics & Gynecology Maternal & Fetal Medicine
- Taxonomy Code
- 207VM0101X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- R5264
- License State
- TX
- Taxonomy Description
- An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic - EPO
- Gold Classic Guided Care - HMO
- Gold Classic Standard - EPO
- Gold Classic Standard Guided Care - HMO
- Gold Elite - EPO
- Gold Simple Guided Care - HMO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Classic Standard Guided Care - HMO
- Silver Simple Chronic Care CKM Guided Care - HMO
- Silver Simple Diabetes Guided Care - HMO
- Silver Simple Guided Care - HMO
- Silver Simple PCP Saver - EPO
- Silver Simple PCP Saver Guided Care - HMO
- Sendero Health Austin512 Silver / $40 PCP / $75 Specialist / $15 Generic Drugs / $0 Deductible - HMO
- Sendero Health Capital Silver / $40 PCP / $80 Specialist / $20 Generic Drugs - HMO
- Sendero Health Hill Country Gold / $30 PCP / $60 Specialist / $15 Generic Drugs - HMO
- Sendero Health Original Silver / $20 PCP + 2 $0 PCP Visits / $10 Generic Drugs - HMO
- Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs - HMO
- Sendero Health Quality Care Bronze High Deductible / $50 PCP / $25 Generic Drugs / $100 Specialist - HMO
- Sendero Health Real Gold / $350 Deductible - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Jeny Ghartey 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.
Jeny Ghartey 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: 7315012440
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: I20171204001816
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
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.98 for a new patient copayment and $17.98 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 78705 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $131.95
- Minimum New Patient Price $57.88
- Maximum New Patient Price $174
- Average New Patient Copayment $32.98
- Minimum New Patient Copayment $14.47
- Maximum New Patient Copayment $43.5
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $71.95
- Minimum Established Patient Price $18.88
- Maximum Established Patient Price $142.23
- Average Established Patient Copayment $17.98
- Minimum Established Patient Copayment $4.72
- Maximum Established Patient Copayment $35.55
* 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 79.35, 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: 79.35 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: 62.45
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: 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 |
---|---|---|
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. | ||
Patient-Specific Education | 16% | 1137 |
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. | ||
Provide Patient Access | 53% | 1137 |
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 | 10% | 1137 |
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 decision support and standardized treatment protocols | Yes | N/A |
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. |
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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 | 3 | 5 | 3 | 0 | 6 | 7 | 1 | 3 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 6 | 5 | 6 | 0 | 12 | 7 | 2 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 2 + 6 + 5 + 6 + 0 + 1 + 2 + 7 + 2 + 24 = 57 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 57 = 3 | 3 |
The NPI number 1235306713 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1760062152 | ROSEMARY PATRICIA ROGERS Individual | Genetic Counselor, MS | 1301 W 38TH ST STE 315 AUSTIN, TX 78705 (512) 324-0040 |
1609255686 | MOHAMMAD A YOUSEF MD Individual | Internal Medicine (Gastroenterology) | 1301 W 38TH ST STE 315 AUSTIN, TX 78705 (512) 324-7831 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1235306713, enumerated in the NPI registry as an "individual" on May 13, 2008
The provider is located at 1301 W 38th St Ste 315 Austin, Tx 78705 and the phone number is (512) 324-7256
The provider's speciality is Obstetrics & Gynecology with taxonomy code 207VM0101X with a focus in Maternal & Fetal Medicine
The provider has more than 22 years of experience. She graduated from New York College Of Osteo Medicine Of New York Institute Of Technology in 2004.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Oscar. 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 $131.95 with an average copayment of $32.98 for new patient appointments. Established patients should expect a typical charge of $71.95 and an average copayment of 17.98. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on May 13, 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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