MARK ANTHONY VERRA MD
NPI 1245214063
Ophthalmology in Saratoga Springs, NY
Quality Rating: 67.73 out of 100 score
NPI Status: Active since December 05, 2005
Contact Information
254 CHURCH ST
SUITE 1
SARATOGA SPRINGS, NY
ZIP 12866
Phone: (518) 587-8400
Fax: (518) 587-4155
- Individual
- Male
- Ophthalmology
- PECOS Enrolled
- Medicare Quality Reporting
About MARK VERRA
This page provides the complete NPI Profile along with additional information for Mark Verra, a provider established in Saratoga Springs, New York with a medical specialization in Ophthalmology. The healthcare provider is registered in the NPI registry with number 1245214063 assigned on December 2005. The practitioner's primary taxonomy code is 207W00000X with license number 1898671 (NY). The provider is registered as an individual and his NPI record was last updated 16 years ago.
- NPI
- 1245214063
- Provider Name
- MARK ANTHONY VERRA MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 254 CHURCH ST SUITE 1 SARATOGA SPRINGS, NY 12866
- Location Phone
- (518) 587-8400
- Location Fax
- (518) 587-4155
- Mailing Address
- 254 CHURCH ST SUITE 1 SARATOGA SPRINGS, NY 12866
- Mailing Phone
- (518) 587-8400
- Mailing Fax
- (518) 587-4155
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-05-2005
- Last Update Date
- 01-27-2010
- Code Navigator
Ophthalmologists like Mark Verra specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
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
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 1898671
- License State
- NY
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| CC1853 | MEDICARE PIN (08) | NY | |
| F20262 | MEDICARE UPIN (02) | ||
| 01341340 | MEDICAID (05) | NY |
Medicare Participation & PECOS Enrollment Status
Mark Verra 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
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.
Closure of tear duct opening using plug
Established patient complete exam of visual system
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Exam of the internal drainage system of eye
Exam of visual field with extended testing
Imaging of optic nerve
Imaging of retina
New patient complete exam of visual system
New patient office or other outpatient visit, 45-59 minutes
Photography of the retina
Removal of recurring cataract in lens capsule using a laser
Ultrasound scan of cornea to determine thickness
Closure of the tear duct opening using a plug is a procedure to address excessive tear production. A small device is inserted into the tear duct to block it, reducing tear flow and relieving symptoms. This is a safe, reversible process, often performed in-office.
This service was performed 19 times for 19 patientsAn established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
This service was performed 388 times for 387 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 11 times for 11 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 244 times for 206 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 87 times for 80 patientsThis is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.
This service was performed 145 times for 141 patientsAn extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
This service was performed 105 times for 105 patientsImaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
This service was performed 240 times for 209 patientsImaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
This service was performed 78 times for 75 patientsA new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
This service was performed 11 times for 11 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 11 times for 11 patientsPhotography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
This service was performed 166 times for 166 patientsThis procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
This service was performed 16 times for 13 patientsAn ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.
This service was performed 12 times for 12 patientsPhysician Visit Costs
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 12866 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.4
- Minimum New Patient Price $54.87
- Maximum New Patient Price $166.88
- Average New Patient Copayment $31.6
- Minimum New Patient Copayment $13.71
- Maximum New Patient Copayment $41.72
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.57
- Minimum Established Patient Price $17.54
- Maximum Established Patient Price $136.14
- Average Established Patient Copayment $17.14
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.03
* 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 67.73, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 67.73 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 57.93
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: 69.58
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: 69.58
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 |
|---|---|---|
| Closing the Referral Loop: Receipt of Specialist Report | 60% | 291 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred | ||
| Diabetes: Eye Exam | 97% | 450 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| Diabetes: Medical Attention for Nephropathy | 34% | 188 |
| The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period | ||
| Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care | 99% | 86 |
| Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months | ||
| Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy | 69% | 128 |
| Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months | ||
| Documentation of Current Medications in the Medical Record | 62% | 5476 |
| 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 | ||
| Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop | Yes | N/A |
| Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology. | ||
| Pneumococcal Vaccination Status for Older Adults | 18% | 1034 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 13% | 1438 |
| 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 | 24% | 649 |
| 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 | 50% | 141 |
| 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 | ||
| Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 60% | 549 |
| Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| 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. | ||
| 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. | 2342 |
| 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 | ||
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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 | 4 | 5 | 2 | 1 | 4 | 0 | 6 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 8 | 5 | 4 | 1 | 8 | 0 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 8 + 5 + 4 + 1 + 8 + 0 + 1 + 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 1245214063 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 15 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1922082742 | THOMAS JOHN FRANCOMANO MD Individual | Ophthalmology | 254 CHURCH ST SUITE 1 SARATOGA SPRINGS, NY 12866 (518) 587-8400 |
| 1437273299 | MR. RICHARD ROBERT CHECCA OPTICIAN Individual | Technician/Technologist (Optician) | 254 CHURCH ST EYE CARE OPTICALS SARATOGA SPR, NY 12866 (518) 587-8111 |
| 1457559809 | EDWARD J. MORCONE CASAC Individual | Counselor (Addiction (Substance Use Disorder)) | 254 CHURCH ST SARATOGA SPRINGS, NY 12866 (518) 587-8800 |
| 1881892230 | SHEILA A. BUCKLEY CASAC Individual | Counselor (Addiction (Substance Use Disorder)) | 254 CHURCH ST SARATOGA SPRINGS, NY 12866 (518) 587-8800 |
| 1487852950 | CATHERINE M WELDEN MSW Individual | Counselor (Addiction (Substance Use Disorder)) | 254 CHURCH ST SARATOGA SPRINGS, NY 12866 (518) 587-8800 |
| 1285832766 | SHIRLEYAN EBERT LCSW Individual | Social Worker (Clinical) | 254 CHURCH ST SARATOGA SPRINGS, NY 12866 (518) 587-8800 |
| 1588862932 | DEBORAH L. GREENE LCSW Individual | Social Worker (Clinical) | 254 CHURCH ST SARATOGA SPRINGS, NY 12866 (518) 587-8800 |
| 1245439611 | CONNIE LAVERY REGISTERED NURSE Individual | Counselor (Addiction (Substance Use Disorder)) | 254 CHURCH ST SARATOGA SPRINGS, NY 12866 (518) 587-8800 |
| 1639352354 | FRANCOMANO DAVISON & CHECCA INC. Organization | Eyewear Supplier | 254 CHURCH ST SARATOGA SPRINGS, NY 12866 (518) 587-8111 |
| 1982850848 | COLLEEN HAVERLY RN Individual | Counselor (Addiction (Substance Use Disorder)) | 254 CHURCH ST SARATOGA SPRINGS, NY 12866 (518) 587-8800 |
| 1417214453 | SARATOGA SCHENECTADY GASTROENTEROLOGY ASSOCIATES, P.C. Organization | Internal Medicine (Gastroenterology) | 254 CHURCH ST 2ND FLOOR SARATOGA SPRINGS, NY 12866 (518) 831-1500 |
| 1770551715 | DR. THEODOROS LADDIS MD Individual | Internal Medicine (Cardiovascular Disease) | 254 CHURCH ST SARATOGA SPRINGS, NY 12866 (518) 886-5080 |
| 1720186554 | DR. RONALD ANTHONY LOFFREDO MD Individual | Obstetrics & Gynecology | 254 CHURCH ST STE 2 SARATOGA SPRINGS, NY 12866 (518) 584-3377 |
| 1801353784 | BALOG NURSE PRACTITIONER IN FAMILY HEALTH PLLC Organization | Nurse Practitioner (Community Health) | 254 CHURCH ST SARATOGA SPRINGS, NY 12866 (518) 477-0479 |
| 1801050679 | DR. SHAHID MUSHTAQ KHAN M.D. Individual | Internal Medicine (Cardiovascular Disease) | 254 CHURCH ST SARATOGA SPRINGS, NY 12866 (518) 886-5080 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245214063, enumerated in the NPI registry as an "individual" on December 05, 2005
The provider is located at 254 Church St Suite 1 Saratoga Springs, Ny 12866 and the phone number is (518) 587-8400
The provider's speciality is Ophthalmology with taxonomy code 207W00000X
The provider might be accepting Accepts: Medicare and Medicaid. 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.
Medicare beneficiaries should expect a typical cost of $126.4 with an average copayment of $31.6 for new patient appointments. Established patients should expect a typical charge of $68.57 and an average copayment of 17.14. 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: Closure of tear duct opening using plug, Established patient complete exam of visual system, Established patient office or other outpatient visit, 10-19 minutes, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Exam of the internal drainage system of eye, Exam of visual field with extended testing, Imaging of optic nerve, Imaging of retina, New patient complete exam of visual system, New patient office or other outpatient visit, 45-59 minutes, Photography of the retina, Removal of recurring cataract in lens capsule using a laser and Ultrasound scan of cornea to determine thickness.
This NPI record was last updated on December 05, 2005. 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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