MISS ESHA ELIZABETH OOMMEN
NPI 1396001830
Internal Medicine - Pulmonary Disease in San Antonio, TX
Quality Rating: 75 out of 100 score
NPI Status: Active since April 10, 2012
Contact Information
4458 MEDICAL DR STE 505
SAN ANTONIO, TX
ZIP 78229
Phone: (210) 690-7400
Fax: (210) 690-7405
- NPI Profile Information
- Primary Taxonomy
- Insurance Plans Accepted
- Secondary Locations
- 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
- Female
- Years of Experience 14
- Internal Medicine
- Pulmonary Disease
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About ESHA OOMMEN
This page provides the complete NPI Profile along with additional information for Esha Oommen, an internist established in San Antonio, Texas with a medical specialization in Internal Medicine, focusing in pulmonary disease and more than 14 years of experience. She graduated from Temple University School Of Medicine in 2012. The healthcare provider is registered in the NPI registry with number 1396001830 assigned on April 2012. The practitioner's primary taxonomy code is 207RP1001X with license number R9529 (TX). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1396001830
- Provider Name
- MISS ESHA ELIZABETH OOMMEN
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229
- Location Phone
- (210) 690-7400
- Location Fax
- (210) 690-7405
- Mailing Address
- 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229
- Mailing Phone
- (210) 690-7400
- Mailing Fax
- (210) 690-7405
- Medical School Name
- TEMPLE UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2012
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-10-2012
- Last Update Date
- 01-09-2019
- Code Navigator
An internist like Esha Oommen is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Secondary Locations
- 72 East Concord Street Evans 124 Boston Medical Center
Boston, MA 02118
(617) 638-6513 - 72 East Concord Street Evans 124 Boston Medical Center
Boston, MA 02118
(617) 638-6513
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
Internal Medicine Pulmonary Disease
- Taxonomy Code
- 207RP1001X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- R9529
- License State
- TX
- Taxonomy Description
- An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 10: $0 PCP at Aetna network & MinuteClinic Primary Care + $0 CVS Health Virtual Care - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Silver 10: $0 PCP at Aetna network & MinuteClinic Primary Care + $0 CVS Health Virtual Care - HMO
- Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Complete Silver (QualChoice) - POS
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold (QualChoice) - POS
- Elite Gold (QualChoiceLife) - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Everyday Silver (QualChoiceLife) - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- Standard Expanded Bronze - PPO
- 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
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Clear VALUE Silver - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Complete VALUE Gold - HMO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Focused VALUE Silver - HMO
- Focused VALUE Silver + Vision + Adult Dental - HMO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Gold VALUE - HMO
- Standard Silver - EPO
- Standard Silver VALUE - HMO
- Standard Silver VALUE + Vision + Adult Dental - HMO
- Complete VALUE Gold - HMO
- Complete VALUE Silver - HMO
- Elite VALUE Bronze - HMO
- Focused VALUE Silver - HMO
- Standard Expanded Bronze VALUE - HMO
- Standard Gold VALUE - HMO
- Standard Silver VALUE - HMO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- Standard Expanded Bronze - PPO
- Standard Expanded Bronze + Vision + Adult Dental - PPO
- Standard Gold - PPO
- Standard Gold + Vision + Adult Dental - PPO
- Standard Silver - PPO
- BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Elite Gold HMO 004 (Two free PCP visits, $0 Pediatric PCP visits) - HMO
- BSW Elite Gold HMO 012 - HMO
- BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Prime Silver HMO 008 (Two free PCP visits, $0 Pediatric PCP visit) - HMO
- BSW Prime Silver HMO 005 - HMO
- BSW Savers Bronze HMO H S A 006 - HMO
- BSW Vital Bronze HMO 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Vital Bronze HMO 009 (One free PCP visit, $0 Pediatric PCP visit) - HMO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
- Imperial Preferred Bronze - HMO
- Imperial Preferred Gold - HMO
- Imperial Preferred Gold Zero - HMO
- Imperial Preferred Silver - HMO
- Imperial Standard Bronze - HMO
- Imperial Standard Gold - HMO
- Imperial Standard Silver - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 12 - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic - EPO
- Gold Classic Guided Care - HMO
- Gold Classic Standard - EPO
- Gold Classic Standard Guided Care - HMO
- Gold Elite - EPO
- Gold Simple Guided Care - HMO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Classic Standard Guided Care - HMO
- Silver Simple Chronic Care CKM Guided Care - HMO
- Silver Simple Diabetes Guided Care - HMO
- Silver Simple Guided Care - HMO
- Silver Simple PCP Saver - EPO
- Silver Simple PCP Saver Guided Care - HMO
- Wellpoint Essential Bronze 4000 HSA ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 6000 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs) - HMO
- Wellpoint Essential Bronze 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze POS 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Bronze POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Bronze POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Catastrophic 9200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold POS 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Gold POS 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Gold POS 700 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver POS 2500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Silver POS 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Esha Oommen 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.
Esha Oommen 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: 3678705688
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: I20190131002570
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 (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
6 DME suppliers used 21 Medicare Claims 21 Services Paid
DME-Other DME (DE001N)
Full face mask used with positive airway pressure device, each (HCPCS:A7030)
5 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE001N)
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)
4 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
6 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
6 DME suppliers used 17 Medicare Claims 97 Services Paid
DME-Other DME (DE001N)
Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)
5 DME suppliers used 11 Medicare Claims 11 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 14 Medicare Claims 14 Services Paid
DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
3 DME suppliers used 16 Medicare Claims 16 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
4 DME suppliers used 30 Medicare Claims 30 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)
5 DME suppliers used 66 Medicare Claims 66 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
2 DME suppliers used 41 Medicare Claims 41 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.
Critical care, first 30-74 minutes
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 15 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Initial hospital inpatient care per day, typically 70 minutes
New patient office or other outpatient visit, 45-59 minutes
Test to determine lung volumes using sensors
Test to examine how well the lungs exchange gases
Test to measure expiratory airflow and volume changes before and after medication administration
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
This service was performed 363 times for 142 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 13 times for 12 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 42 times for 31 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 22 times for 21 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 84 times for 63 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 527 times for 196 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 47 times for 47 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 17 times for 17 patientsThis test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
This service was performed 24 times for 24 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 31 times for 28 patientsThis procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
This service was performed 24 times for 23 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.6 for a new patient copayment and $24.26 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 78229 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.4
- Minimum New Patient Price $54.84
- Maximum New Patient Price $166.88
- Average New Patient Copayment $31.6
- Minimum New Patient Copayment $13.71
- Maximum New Patient Copayment $41.72
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.05
- Minimum Established Patient Price $17.52
- Maximum Established Patient Price $136.11
- Average Established Patient Copayment $24.26
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.02
* 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. Esha Oommen is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
METHODIST HOSPITAL | 7700 FLOYD CURL DR SAN ANTONIO, TX 78229 | (210) 575-4000 | 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 | 9 | 6 | 0 | 0 | 1 | 8 | 3 | 0 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 3 | 18 | 6 | 0 | 0 | 2 | 8 | 6 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 3 + 1 + 8 + 6 + 0 + 0 + 2 + 8 + 6 + 24 = 60 | |||||||||
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
0 |
The NPI number 1396001830 is valid because the calculated check digit 0 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 |
---|---|---|---|
1659783843 | KHUSHBU PATEL M.D. Individual | Internal Medicine (Critical Care Medicine) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1952697179 | JEFFREY JAVED MD Individual | Internal Medicine (Critical Care Medicine) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1518232818 | DR. JAMES WALTER STEVES M.D. Individual | Internal Medicine (Critical Care Medicine) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1629368535 | TEXAS IPS LLC Organization | Internal Medicine (Pulmonary Disease) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1053623512 | DR. BRAVEIN AMALAKUHAN M.D. Individual | Internal Medicine (Pulmonary Disease) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1063954964 | KIMBERLY ANN BOOTH NP Individual | Nurse Practitioner (Acute Care) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1083091771 | DR. PRAVEEN BELUR M.D. Individual | Internal Medicine (Pulmonary Disease) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1487933446 | AHMAD HASHEM ALTARAWNEH Individual | Internal Medicine (Nephrology) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1588843239 | CHARLES J. BURCH, M.D., P.A. Organization | Internal Medicine (Pulmonary Disease) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1528413598 | MOHAMED ABDALLA MD Individual | Internal Medicine (Pulmonary Disease) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1538512371 | FERNANDO VAZQUEZ DE LARA PADILLA M.D. Individual | Internal Medicine (Pulmonary Disease) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1477084366 | ADAM LAERTES GOTTULA Individual | Internal Medicine (Critical Care Medicine) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1720425580 | MICHELLE JOY BRUCAL DO Individual | Internal Medicine | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1588185854 | AJIT K. THOTA MD Individual | Internal Medicine (Pulmonary Disease) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1184078412 | AKSHAR CHAUHAN MD Individual | Internal Medicine (Pulmonary Disease) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1790217420 | ALEXANDRA MARI DO Individual | Internal Medicine (Pulmonary Disease) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1861889180 | NANCY SATSANGI Individual | Anesthesiology (Critical Care Medicine) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1457856213 | ALICIA ROCIO LIENDO MD Individual | Internal Medicine (Critical Care Medicine) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1225559081 | ARISTIDES JOSE ARMAS VILLALBA MD Individual | Internal Medicine (Pulmonary Disease) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
1851122915 | ISABELLA RENE NOVACK AGACNP-BC Individual | Nurse Practitioner (Acute Care) | 4458 MEDICAL DR STE 505 SAN ANTONIO, TX 78229 (210) 690-7400 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396001830, enumerated in the NPI registry as an "individual" on April 10, 2012
The provider is located at 4458 Medical Dr Ste 505 San Antonio, Tx 78229 and the phone number is (210) 690-7400
The provider's speciality is Internal Medicine with taxonomy code 207RP1001X with a focus in Pulmonary Disease
The provider has more than 14 years of experience. She graduated from Temple University School Of Medicine in 2012.
The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Arizona Complete. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $126.4 with an average copayment of $31.6 for new patient appointments. Established patients should expect a typical charge of $97.05 and an average copayment of 24.26. 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: Critical care, first 30-74 minutes, 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 15 minutes, Follow-up hospital inpatient care per day, typically 25 minutes, Follow-up hospital inpatient care per day, typically 35 minutes, Initial hospital inpatient care per day, typically 70 minutes, New patient office or other outpatient visit, 45-59 minutes, Test to determine lung volumes using sensors, Test to examine how well the lungs exchange gases and Test to measure expiratory airflow and volume changes before and after medication administration.
The practitioner is affiliated to the following hospital(s): METHODIST HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on April 10, 2012. 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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