DEBORAH ASHLEY SCARBOROUGH PA-C
NPI 1316233695
Physician Assistant in Rome, GA
Quality Rating: 78.15 out of 100 score
NPI Status: Active since June 24, 2011
Contact Information
1825 MARTHA BERRY BLVD NW
ROME, GA
ZIP 30165
Phone: (706) 295-5331
Fax: (706) 238-8011
- Individual
- Female
- Years of Experience 15
- Physician Assistant
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About DEBORAH SCARBOROUGH
This page provides the complete NPI Profile along with additional information for Deborah Scarborough, a primary care provider established in Rome, Georgia with a medical specialization in Physician Assistant and more than 15 years of experience. She graduated from Mercer University School Of Medicine in 2011. The healthcare provider is registered in the NPI registry with number 1316233695 assigned on June 2011. The practitioner's primary taxonomy code is 363A00000X with license number 006133 (GA). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1316233695
- Provider Name
- DEBORAH ASHLEY SCARBOROUGH PA-C
- Other Name
- DEBORAH ASHLEY CUNNINGHAM
- Other Name Type
- Other Name (5)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1825 MARTHA BERRY BLVD NW ROME, GA 30165
- Location Phone
- (706) 295-5331
- Location Fax
- (706) 238-8011
- Mailing Address
- 221 TECHNOLOGY PKWY NW ROME, GA 30165
- Mailing Phone
- (762) 235-1000
- Medical School Name
- MERCER UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2011
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-24-2011
- Last Update Date
- 04-30-2020
- Code Navigator
A primary care provider (PCP) like Deborah Scarborough 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
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 006133
- License State
- GA
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SoloCare Bronze EPO HDHP 8050 10004 - EPO
- SoloCare Exp Bronze EPO 7200 - $0 Generic Rx 10015 - EPO
- SoloCare Gold EPO 2300 - 3 Free PCP Visits, $5 Generic Rx 10010 - EPO
- SoloCare Silver EPO 6000/60 - 3 Free PCP Visits 10014 - EPO
- SoloCare Silver EPO 7000 - 3 Free PCP Visits, $5 Generic Rx 10013 - EPO
- SoloCare Standard Exp Bronze EPO 10008 - EPO
- SoloCare Standard Gold EPO 10006 - EPO
- SoloCare Standard Platinum EPO 10005 - EPO
- SoloCare Standard Silver EPO 10007 - 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 |
|---|---|---|---|
| 003111398A | MEDICAID (05) | GA |
Medicare Participation & PECOS Enrollment Status
Deborah Scarborough 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.
Deborah Scarborough 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: 3072781731
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: I20110722000705
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.
Established patient office or other outpatient visit, 30-39 minutes
Follow-up hospital inpatient care per day, typically 15 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Insertion of needle into vein for collection of blood sample
Iron binding capacity
Iron level
New patient office or other outpatient visit, 45-59 minutes
Telephone medical discussion with physician, 11-20 minutes
This 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 80 times for 79 patientsFollow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
This service was performed 12 times for 11 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 121 times for 92 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 17 times for 13 patientsIron binding capacity is a blood test that measures how well your body can bind and transport iron. This helps your healthcare provider assess if your body has too little or too much iron, which can indicate certain health conditions.
This service was performed 26 times for 24 patientsAn iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.
This service was performed 26 times for 24 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 38 times for 38 patientsThis is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
This service was performed 13 times for 13 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.8 for a new patient copayment and $16.72 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 30165 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.23
- Minimum New Patient Price $53.31
- Maximum New Patient Price $164.04
- Average New Patient Copayment $20.8
- Minimum New Patient Copayment $13.32
- Maximum New Patient Copayment $41.01
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.89
- Minimum Established Patient Price $16.68
- Maximum Established Patient Price $133.24
- Average Established Patient Copayment $16.72
- Minimum Established Patient Copayment $4.17
- Maximum Established Patient Copayment $33.31
* 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 78.15, 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: 78.15 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: 58.11
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: 69.08
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: 69.08
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 |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| e-Prescribing | 96% | 1450 |
| 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 medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Medication Reconciliation | 100% | 142 |
| 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 | 73% | 425 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Provide Patient Access | 99% | 425 |
| 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 | 27% | 425 |
| 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. | ||
| 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. | ||
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. Deborah Scarborough is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| REDMOND REGIONAL MEDICAL CENTER | 501 REDMOND ROAD NW ROME, GA 30165 | (706) 802-3012 | 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 | 3 | 1 | 6 | 2 | 3 | 3 | 6 | 9 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 2 | 6 | 4 | 3 | 6 | 6 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 2 + 6 + 4 + 3 + 6 + 6 + 1 + 8 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1316233695 is valid because the calculated check digit 5 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 |
|---|---|---|---|
| 1932104924 | NATASHA AMANDA SANDS MD Individual | Family Medicine | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 238-8073 |
| 1003802653 | MR. MICHAEL L WHITE PAC Individual | Physician Assistant | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 238-8073 |
| 1598752685 | ANTHONY TRAVIS PEMERTON CRNA Individual | Nurse Anesthetist, Certified Registered | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 234-5651 |
| 1033185681 | THERON WAYNE THOMPSON MD Individual | Family Medicine | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 238-8073 |
| 1033206784 | CHRISTINA REESE CRANE CFNP Individual | Nurse Practitioner | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 238-8073 |
| 1417017773 | CULLEN MASON BROWN III MD Individual | Family Medicine | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 238-8073 |
| 1891855169 | ALFONSO DIAZ JR. MD Individual | Internal Medicine (Cardiovascular Disease) | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 295-5331 |
| 1346301652 | BANNESTER LESTER HARBIN JR. MD Individual | Surgery | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 295-5331 |
| 1295896546 | BUFORD GOODWIN HARBIN MD Individual | Internal Medicine (Pulmonary Disease) | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 295-5331 |
| 1174684831 | MALINDA JEAN JORDAN RD, LD Individual | Dietitian, Registered | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 378-8129 |
| 1750446746 | JAMES CLAYTON WHATLEY MD Individual | Internal Medicine | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 295-5331 |
| 1124184734 | STEVEN ARNOLD FELLOWS MA Individual | Audiologist | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 295-5331 |
| 1497811715 | PAUL MICHAEL LAMPREY PA-C Individual | Physician Assistant | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 295-5331 |
| 1578611968 | JAMES SANFORD PAYNE JR. MED Individual | Audiologist | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 295-5331 |
| 1538204409 | MS. LANA C SWOPE MA,CCC-A Individual | Audiologist | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 295-5331 |
| 1700064631 | H & H OPTICAL SHOP, INC. Organization | Eyewear Supplier | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 233-8520 |
| 1700164357 | EVELYN ANN MURPHY NP-C Individual | Nurse Practitioner | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 295-5331 |
| 1780970236 | DONALD HUGH SHUMATE JR. FNP-BC Individual | Nurse Practitioner | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 238-8073 |
| 1295890358 | TRAMMELL STARR III MD Individual | Internal Medicine (Pulmonary Disease) | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 295-5331 |
| 1578819942 | SUSAN LEE DUPREE NP-C Individual | Nurse Practitioner | 1825 MARTHA BERRY BLVD NW ROME, GA 30165 (706) 238-8073 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1316233695, enumerated in the NPI registry as an "individual" on June 24, 2011
The provider is located at 1825 Martha Berry Blvd Nw Rome, Ga 30165 and the phone number is (706) 295-5331
The provider's speciality is Physician Assistant with taxonomy code 363A00000X
The provider has more than 15 years of experience. She graduated from Mercer University School Of Medicine in 2011.
The provider might be accepting Accepts: Alliant Health Plans, Inc., 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.
The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $83.23 with an average copayment of $20.8 for new patient appointments. Established patients should expect a typical charge of $66.89 and an average copayment of 16.72. 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: Established patient office or other outpatient visit, 30-39 minutes, Follow-up hospital inpatient care per day, typically 15 minutes, Follow-up hospital inpatient care per day, typically 25 minutes, Insertion of needle into vein for collection of blood sample, Iron binding capacity, Iron level, New patient office or other outpatient visit, 45-59 minutes and Telephone medical discussion with physician, 11-20 minutes.
The practitioner is affiliated to the following hospital(s): REDMOND REGIONAL MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on June 24, 2011. 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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