BRAD M GINEVAN MD
NPI 1285732016
Family Medicine in Sheffield, AL
Quality Rating: 75 out of 100 score
NPI Status: Active since September 20, 2006
Contact Information
342 COX BLVD
SHEFFIELD, AL
ZIP 35660
Phone: (256) 383-4473
Fax: (256) 381-5232
- NPI Profile Information
- Primary Taxonomy
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Overall Quality Performance
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 23
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About BRAD GINEVAN
This page provides the complete NPI Profile along with additional information for Brad Ginevan, a primary care provider established in Sheffield, Alabama with a medical specialization in Family Medicine and more than 23 years of experience. He graduated from University Of Alabama School Of Medicine in 2003. The healthcare provider is registered in the NPI registry with number 1285732016 assigned on September 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 26857 (AL). The provider is registered as an individual and his NPI record was last updated 11 years ago.
- NPI
- 1285732016
- Provider Name
- BRAD M GINEVAN MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 342 COX BLVD SHEFFIELD, AL 35660
- Location Phone
- (256) 383-4473
- Location Fax
- (256) 381-5232
- Mailing Address
- PO BOX 2587 MUSCLE SHOALS, AL 35662
- Mailing Phone
- (256) 383-4473
- Mailing Fax
- (256) 381-5232
- Medical School Name
- UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
- Graduation Year
- 2003
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-20-2006
- Last Update Date
- 10-07-2014
- Code Navigator
A primary care provider (PCP) like Brad Ginevan sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 26857
- License State
- AL
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Blue Cross Select Gold - PPO
- Blue Cross Select Silver - PPO
- Blue HSA Bronze - PPO
- Blue Protect - PPO
- Blue Saver Bronze - PPO
- Blue Standardized Bronze - PPO
- Blue Standardized Gold - PPO
- Blue Standardized Silver - PPO
- Blue Value Gold - PPO
- Blue Value Silver - PPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus (No Referrals) - EPO
- UHC Bronze Copay Focus+ (Dental + Vision, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Bronze Value (No Referrals) - EPO
- UHC Bronze Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage (No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
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 |
---|---|---|---|
1326373861 | OTHER (01) | AL | GROUP NPI |
Medicare Participation & PECOS Enrollment Status
Brad Ginevan 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.
Brad Ginevan 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: 6507864105
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: I20061114000635
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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
10 DME suppliers used 16 Medicare Claims 34 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
8 DME suppliers used 12 Medicare Claims 13 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
2 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Other DME (DE005N)
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) (HCPCS:E0466)
2 DME suppliers used 22 Medicare Claims 22 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
4 DME suppliers used 27 Medicare Claims 27 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
2 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
5 DME suppliers used 11 Medicare Claims 12 Services Paid
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.
Administration of influenza virus vaccine
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Blood test, comprehensive group of blood chemicals
Blood test, lipids (cholesterol and triglycerides)
Blood test, thyroid stimulating hormone (tsh)
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month
Detection test by immunoassay with direct visual observation for influenza virus
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Hemoglobin a1c level
Hospital discharge day management, 30 minutes or less
Influenza vaccine, quadrivalent derived from cell cultures
Initial hospital inpatient care per day, typically 70 minutes
Injection of drug or substance under skin or into muscle
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
Injection, ceftriaxone sodium, per 250 mg
Injection, ketorolac tromethamine, per 15 mg
Insertion of needle into vein for collection of blood sample
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a
Prostate cancer screening; prostate specific antigen test (psa)
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Sex hormone binding globulin (protein) level
Test to determine lung volumes using gas dilution or washout
Test to examine how well the lungs exchange gases
Test to measure expiratory airflow and volume
Testosterone (hormone) level, total
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Urinalysis, manual test
X-ray of abdomen, 2 views
X-ray of chest, 2 views
X-ray of lower and sacral spine, minimum of 4 views
X-ray of paranasal sinus, minimum of 3 views
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 41 times for 41 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 23 times for 23 patientsA comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
This service was performed 450 times for 166 patientsA lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
This service was performed 416 times for 165 patientsA TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.
This service was performed 427 times for 163 patientsChronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
This service was performed 307 times for 87 patientsA Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
This service was performed 442 times for 165 patientsComplex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.
This service was performed 48 times for 48 patientsThis is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
This service was performed 20 times for 14 patientsThis is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
This service was performed 28 times for 24 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 215 times for 110 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 621 times for 165 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 1,329 times for 302 patientsHemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
This service was performed 133 times for 63 patientsHospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
This service was performed 133 times for 126 patientsThe quadrivalent influenza vaccine, derived from cell cultures, is a flu shot that protects against four different flu viruses. It's made in labs using cell cultures instead of eggs, making it a good option for those with egg allergies. It's a crucial tool in preventing the flu.
This service was performed 41 times for 41 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 140 times for 129 patientsThis procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
This service was performed 127 times for 46 patientsThis injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
This service was performed 106 times for 38 patientsCeftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.
This service was performed 97 times for 20 patientsKetorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.
This service was performed 112 times for 17 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 468 times for 161 patientsThis service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
This service was performed 167 times for 20 patientsThis is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
This service was performed 25 times for 18 patientsThis procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.
This service was performed 39 times for 20 patientsProstate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.
This service was performed 27 times for 27 patientsThis service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
This service was performed 128 times for 17 patientsAn electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
This service was performed 38 times for 38 patientsSex hormone binding globulin (SHBG) level is a blood test that measures a specific protein in your body. This protein helps regulate certain hormones. If these hormone levels are too high or too low, it may cause health issues. The test helps assess hormone-related conditions.
This service was performed 18 times for 11 patientsThis test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.
This service was performed 11 times for 11 patientsThis is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
This service was performed 11 times for 11 patientsThis test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.
This service was performed 12 times for 12 patientsA total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.
This service was performed 18 times for 11 patientsThis is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
This service was performed 15 times for 15 patientsA urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
This service was performed 26 times for 16 patientsAn X-ray of the abdomen, 2 views, is a non-invasive imaging test. It uses a small amount of radiation to capture pictures of the structures inside your belly. The two views provide different angles, helping doctors see your organs clearly and detect any issues.
This service was performed 11 times for 11 patientsA chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
This service was performed 80 times for 58 patientsAn X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.
This service was performed 15 times for 15 patientsAn X-ray of the paranasal sinus involves taking multiple images of the spaces around your nose that produce mucus, aiding in clearing and moistening your nasal passages. This helps detect issues like infections, blockages, or abnormalities.
This service was performed 20 times for 16 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.47 for a new patient copayment and $23.43 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 35660 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $81.9
- Minimum New Patient Price $52.65
- Maximum New Patient Price $161.63
- Average New Patient Copayment $20.47
- Minimum New Patient Copayment $13.16
- Maximum New Patient Copayment $40.4
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.72
- Minimum Established Patient Price $16.56
- Maximum Established Patient Price $131.65
- Average Established Patient Copayment $23.43
- Minimum Established Patient Copayment $4.14
- Maximum Established Patient Copayment $32.91
* 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 75, 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: 75 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: N/A
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: N/A
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.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Brad Ginevan is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
TISHOMINGO HEALTH SERVICES INC | 1777 CURTIS DRIVE IUKA, MS 38852 | (662) 423-6051 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 2 | 8 | 5 | 7 | 3 | 2 | 0 | 1 | 6 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 16 | 5 | 14 | 3 | 4 | 0 | 2 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 2 + 1 + 6 + 5 + 1 + 4 + 3 + 4 + 0 + 2 + 24 = 54 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 54 = 6 | 6 |
The NPI number 1285732016 is valid because the calculated check digit 6 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 |
---|---|---|---|
1639237340 | A LYNN RIDGEWAY MD PC Organization | Specialist | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1447332119 | MARK LOCKE HODGES CRNP Individual | Nurse Practitioner (Adult Health) | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1922355312 | JONATHAN SCOGIN CRNP Individual | Nurse Practitioner (Acute Care) | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1265428031 | DR. AARON W KARR D.O. Individual | Family Medicine | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1730128414 | DR. FRANCIS G GILLIS M.D. Individual | Family Medicine | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1942549860 | MATTHEW ALEXANDER MONTGOMERY CRNP Individual | Nurse Practitioner (Family) | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1629059175 | GREGG DELGADO D.O. Individual | Radiology (Diagnostic Radiology) | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1245276070 | DARIN KIM BOWLING DO Individual | Family Medicine | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1871530766 | ALAN L BILLSBY DO Individual | Surgery | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1124073788 | DR. GEORGE A EVANS M.D. Individual | Family Medicine | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1801213301 | MRS. KRISTINE ELIZABETH MOLLOHAN NP-C Individual | Nurse Practitioner (Family) | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1942245808 | PAOLA F TUMMINELLO MD Individual | Psychiatry & Neurology (Neurology) | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1275061806 | BAYLEE SMITH CORSBIE CRNP Individual | Nurse Practitioner (Adult Health) | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1619364791 | KELLI ROBERSON NP-C Individual | Nurse Practitioner (Family) | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1326373861 | SHOALS PRIMARY CARE, LLC Organization | Family Medicine | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1114542560 | MS. AMY LEA BARNETT CRNP Individual | Nurse Practitioner (Family) | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1932651478 | MISTY MAXWELL CRNP Individual | Nurse Practitioner (Family) | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1669913562 | MONICA PAGE IRONS CRNP Individual | Nurse Practitioner | 342 COX BLVD SHEFFIELD, AL 35660 (256) 627-8706 |
1326013558 | DR. ALBERT LYNN RIDGEWAY MD Individual | Specialist | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
1033500517 | ABBEY OLIVER CRNP Individual | Nurse Practitioner | 342 COX BLVD SHEFFIELD, AL 35660 (256) 383-4473 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285732016, enumerated in the NPI registry as an "individual" on September 20, 2006
The provider is located at 342 Cox Blvd Sheffield, Al 35660 and the phone number is (256) 383-4473
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider has more than 23 years of experience. He graduated from University Of Alabama School Of Medicine in 2003.
The provider might be accepting Accepts: Ambetter from Magnolia Health, Ambetter Health,. 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 $81.9 with an average copayment of $20.47 for new patient appointments. Established patients should expect a typical charge of $93.72 and an average copayment of 23.43. 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: Administration of influenza virus vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Blood test, comprehensive group of blood chemicals, Blood test, lipids (cholesterol and triglycerides), Blood test, thyroid stimulating hormone (tsh), Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month, Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count, Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month, Detection test by immunoassay with direct visual observation for influenza virus, Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19), Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Follow-up hospital inpatient care per day, typically 25 minutes, Hemoglobin a1c level, Hospital discharge day management, 30 minutes or less, Influenza vaccine, quadrivalent derived from cell cultures, Initial hospital inpatient care per day, typically 70 minutes, Injection of drug or substance under skin or into muscle, Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg, Injection, ceftriaxone sodium, per 250 mg, Injection, ketorolac tromethamine, per 15 mg, Insertion of needle into vein for collection of blood sample, Management using the results of remote vital sign monitoring per calendar month, first 20 minutes, Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and, Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a, Prostate cancer screening; prostate specific antigen test (psa), Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report, Sex hormone binding globulin (protein) level, Test to determine lung volumes using gas dilution or washout, Test to examine how well the lungs exchange gases, Test to measure expiratory airflow and volume, Testosterone (hormone) level, total, Ultrasound of heart with color-depicted blood flow, rate, direction and valve function, Urinalysis, manual test, X-ray of abdomen, 2 views, X-ray of chest, 2 views, X-ray of lower and sacral spine, minimum of 4 views and X-ray of paranasal sinus, minimum of 3 views.
The practitioner is affiliated to the following hospital(s): TISHOMINGO HEALTH SERVICES INC. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on September 20, 2006. 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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