BRIAN GEORGE FABIAN MD
NPI 1245362763
Dermatology in Jacksonville, FL
Quality Rating: 87.21 out of 100 score
NPI Status: Active since March 10, 2007
Contact Information
4500 SAN PABLO RD S
JACKSONVILLE, FL
ZIP 32224
Phone: (904) 953-2000
Fax: (239) 949-0768
- Individual
- Male
- Years of Experience 35
- Dermatology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
- CLIA Number: 10D1013827
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-17-2025
About BRIAN FABIAN
This page provides the complete NPI Profile along with additional information for Brian Fabian, a provider established in Jacksonville, Florida with a medical specialization in Dermatology and more than 35 years of experience. He graduated from Louisiana State University School Of Medicine In Shreveport in 1991. The healthcare provider is registered in the NPI registry with number 1245362763 assigned on March 2007. The practitioner's primary taxonomy code is 207N00000X with license number ME75652 (FL). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1245362763
- Provider Name
- BRIAN GEORGE FABIAN MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4500 SAN PABLO RD S JACKSONVILLE, FL 32224
- Location Phone
- (904) 953-2000
- Location Fax
- (239) 949-0768
- Mailing Address
- 4500 SAN PABLO RD S JACKSONVILLE, FL 32224
- Mailing Phone
- (904) 953-2000
- Mailing Fax
- (239) 949-0768
- Medical School Name
- LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
- Graduation Year
- 1991
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-10-2007
- Last Update Date
- 09-16-2024
- Code Navigator
A dermatologist like Brian Fabian is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
Location Map
Secondary Locations
- 26800 S Tamiami Trl suite 310
Bonita Springs, FL 34134
(239) 949-0742
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
Dermatology
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- ME75652
- License State
- FL
- Taxonomy Description
- A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
- BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
- BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
- BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
- BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
- BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) - PPO
- BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) - PPO
- BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
- BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
- BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) - POS
- BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) - POS
- BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
- BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) - POS
- BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
- BlueCare Gold 24K01-10 ($0 Virtual PCP Visits / $15 Labs / Rewards) - POS
- BlueCare Gold 24K01-33S ($30 PCP Visits / Multilingual Available/ Rewards) - POS
- BlueCare Gold 24K02-20 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
- BlueCare Gold 24K02-28S ($30 PCP Visits / Multilingual Available / Rewards) - POS
- BlueCare Platinum 24K01-04 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K01-07 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
- BlueCare Platinum 24K02-15 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
- BlueCare Silver 24K01-02 ($0 Virtual PCP Visits / $0 Labs / Rewards) - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Brian Fabian 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.
Brian Fabian 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: 2062427396
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: I20060208000279
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.
Biopsy of related skin growth, each additional growth
Biopsy of related skin growth, first growth
Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm
Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm
Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm
Complicated repair of wound of trunk, 2.6-7.5 cm
Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm
Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm
Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm
Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm
Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm
Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm
Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm
Destruction of precancer skin growth, 1 growth
Destruction of precancer skin growth, 2-14 growths
Destruction of skin growth, 1-14 growths
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
Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 15-29 minutes
New patient office or other outpatient visit, 30-44 minutes
Pathology examination of specimen during surgery, first tissue block
Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks
Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks
Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks
Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks
Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm
Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm
Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less
Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm
Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm
Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm
A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.
This service was performed 209 times for 149 patientsA biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
This service was performed 756 times for 593 patientsThis procedure involves repairing a wound on your eyelids, nose, ears, or lip that is between 2.6 and 7.5 cm long. It's considered complicated due to the location and size. The doctor will clean, treat, and stitch the wound to promote healing.
This service was performed 30 times for 30 patientsThis procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.
This service was performed 340 times for 308 patientsThis is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.
This service was performed 84 times for 80 patientsThis service involves the intricate repair of a wound on your body's main structure, between your neck and limbs. The wound measures 2.6-7.5 cm. The procedure includes deep-layer stitching and may involve repairing damaged tissue.
This service was performed 44 times for 43 patientsThis procedure involves the removal of cancerous skin growths on the face, ears, eyelids, nose, lips, or mouth that are between 0.6-1.0 cm in size. The goal is to eliminate cancer cells, preventing further spread and promoting health.
This service was performed 20 times for 20 patientsThis procedure involves the removal of a cancerous skin growth on the face, ears, eyelids, nose, lips, or mouth that measures between 1.1 to 2.0 cm. It's done to prevent the spread of cancer and improve health.
This service was performed 40 times for 35 patientsThis procedure involves the removal of a small cancerous skin growth, between 0.6 to 1.0 cm, located on the scalp, neck, hands, or feet. The aim is to eliminate the cancerous cells and prevent their spread. The treatment is done in a safe, controlled environment.
This service was performed 13 times for 13 patientsThis procedure involves the removal of a cancerous skin growth measuring 1.1-2.0 cm, located on the scalp, neck, hands, or feet. The process may involve techniques like surgery, laser, or cryotherapy. The aim is to eliminate the cancer cells and prevent further spread.
This service was performed 96 times for 82 patientsThis procedure involves the removal of a cancerous skin growth on the trunk, arms, or legs that is between 0.6 and 1.0 cm in size. The goal is to eliminate the cancerous cells and prevent further spread. The method of destruction may vary, including methods such as surgery, laser, or cryotherapy.
This service was performed 38 times for 35 patientsThis procedure involves removing a cancerous skin growth on the trunk, arms, or legs that is between 1.1 and 2.0 cm in size. The growth is destroyed using methods like surgery, laser, or freezing, aiming to eliminate cancer and prevent its spread.
This service was performed 416 times for 261 patientsThis procedure targets and eliminates a cancerous skin growth between 2.1 and 3.0 cm on your trunk, arms, or legs. It's done by applying specific treatments like heat, cold, or medicated creams to destroy the cancer cells, preventing them from spreading.
This service was performed 60 times for 49 patients"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
This service was performed 1,286 times for 853 patientsThis procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
This service was performed 4,056 times for 647 patients"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
This service was performed 579 times for 495 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 690 times for 506 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 1,420 times for 954 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 37 times for 33 patientsA full thickness skin graft is a procedure where a layer of skin is taken from one area of the body and transplanted to another. If it's done on the nose, ears, eyelids, or lips, it helps restore these areas when damaged. The size of the graft is 20.0 sq cm or less.
This service was performed 49 times for 49 patientsMelanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.
This service was performed for 170 patientsThis service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
This service was performed 323 times for 323 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 261 times for 261 patientsA pathology examination during surgery involves the immediate analysis of a removed tissue sample. This helps the surgeon make decisions during your operation. The "first tissue block" refers to the initial sample examined. It's a vital step to ensure your health.
This service was performed 61 times for 39 patientsThis procedure involves the careful removal of a growth from the head, neck, hands, or feet. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to study its characteristics and determine the nature of the growth.
This service was performed 653 times for 521 patientsThis procedure involves the careful removal of abnormal growths from the head, neck, hands, or feet. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any irregularities. The process may be carried out in multiple stages for thorough examination.
This service was performed 207 times for 152 patientsThis procedure involves the removal of a growth from your trunk, arms, or legs. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to identify any abnormalities. This helps in diagnosing and planning further treatment.
This service was performed 124 times for 111 patientsThis procedure involves removing growths from the trunk, arms, or legs. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any abnormalities. This aids in diagnosing and treating your condition effectively.
This service was performed 12 times for 11 patientsThis procedure involves the removal of a cancerous skin growth, between 2.1 and 3.0 cm, from the body, arms, or legs. The area is numbed, then the growth is carefully cut out. The goal is to eliminate all cancer cells while minimizing scarring.
This service was performed 16 times for 16 patientsThis procedure involves the careful removal of a cancerous growth on the face, ears, eyelids, nose, lips, or mouth that measures between 2.1 to 3.0 cm. The goal is to eliminate the cancer while preserving surrounding healthy tissue.
This service was performed 12 times for 12 patientsThis procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.
This service was performed 43 times for 43 patientsThis procedure involves repairing a wound on the eyelids, nose, ears, or lips by transferring skin from another part of the body. The size of the skin transferred will be between 10.1 to 30.0 square centimeters. It is performed to restore function and appearance.
This service was performed 24 times for 22 patientsThis procedure involves the careful removal of a skin growth on your body, arms, or legs. The growth is between 1.1 and 2.0 cm. A special tool is used to shave off the growth, which is a quick and relatively painless process.
This service was performed 16 times for 11 patientsThis is a procedure to mend a surface wound measuring between 2.6-7.5 cm on your scalp, neck, underarms, trunk, arms, or legs. It involves cleaning, closing and dressing the wound to promote healing and prevent infection.
This service was performed 23 times for 22 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.9 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 99203
- Average New Patient Price $87.62
- Minimum New Patient Price $56
- Maximum New Patient Price $171.84
- Average New Patient Copayment $21.9
- 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 87.21, 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: 87.21 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: 100
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: 57.38
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: 57.38
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 |
---|---|---|
e-Prescribing | 99% | 499 |
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
Implementation of analytic capabilities to manage total cost of care for practice population | Yes | N/A |
Build the analytic capability required to manage total cost of care for the practice population that could include one or more of the following: Train appropriate staff on interpretation of cost and utilization information; and/or Use available data regularly to analyze opportunities to reduce cost through improved care. | ||
Leadership engagement in regular guidance and demonstrated commitment for implementing practice improvement changes | Yes | N/A |
Ensure full engagement of clinical and administrative leadership in practice improvement that could include one or more of the following: Make responsibility for guidance of practice change a component of clinical and administrative leadership roles; Allocate time for clinical and administrative leadership for practice improvement efforts, including participation in regular team meetings; and/or Incorporate population health, quality and patient experience metrics in regular reviews of practice performance. | ||
Medication Reconciliation | 2% | 240 |
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
Patient-Specific Education | 70% | 2076 |
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
Pneumococcal Vaccination Status for Older Adults | 100% | 1649 |
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
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. | ||
Provide Patient Access | 69% | 2076 |
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 | 1% | 2076 |
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. | ||
Specialized Registry Reporting | Yes | N/A |
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D1013827
- Facility Type
- Physician Office
- Certificate Effective Date
- August 18, 2023
- Certificate Expiration Date
- August 17, 2025
- Laboratory Director
- DR. BRIAN G. FABIAN
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Brian Fabian after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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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 | 3 | 6 | 2 | 7 | 6 | 3 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 8 | 5 | 6 | 6 | 4 | 7 | 12 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 2 + 8 + 5 + 6 + 6 + 4 + 7 + 1 + 2 + 24 = 67 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 67 = 3 | 3 |
The NPI number 1245362763 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 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 1245362763, enumerated in the NPI registry as an "individual" on March 10, 2007
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 Dermatology with taxonomy code 207N00000X
The provider has more than 35 years of experience. He graduated from Louisiana State University School Of Medicine In Shreveport in 1991.
The provider might be accepting Accepts: Aetna CVS Health, Florida Blue (BlueCross. 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 , uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $87.62 with an average copayment of $21.9 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: Biopsy of related skin growth, each additional growth, Biopsy of related skin growth, first growth, Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm, Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm, Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm, Complicated repair of wound of trunk, 2.6-7.5 cm, Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm, Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm, Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm, Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm, Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm, Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm, Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm, Destruction of precancer skin growth, 1 growth, Destruction of precancer skin growth, 2-14 growths, Destruction of skin growth, 1-14 growths, 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, Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less, Melanoma (skin cancer) excision, New patient office or other outpatient visit, 15-29 minutes, New patient office or other outpatient visit, 30-44 minutes, Pathology examination of specimen during surgery, first tissue block, Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks, Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks, Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks, Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks, Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm, Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm, Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less, Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm, Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm and Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm.
The provider's CLIA number is 10D1013827 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on March 10, 2007. 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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