BRUCE A PISZEL MD
NPI 1467553966
Specialist in Brandon, FL


Quality Rating: 75 out of 100 score

NPI Status: Active since September 26, 2006

Contact Information

403 S KINGS AVE STE 201
BRANDON, FL
ZIP 33511
Phone: (813) 872-4492
Fax: (813) 490-9635

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  • Individual
  • Male
  • Years of Experience 27
  • Specialist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About BRUCE PISZEL

This page provides the complete NPI Profile along with additional information for Bruce Piszel, a provider established in Brandon, Florida with a medical specialization in Specialist and more than 27 years of experience. The healthcare provider is registered in the NPI registry with number 1467553966 assigned on September 2006. The practitioner's primary taxonomy code is 174400000X with license number ME121364 (FL). The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI
1467553966
Provider Name
BRUCE A PISZEL MD
Gender
Male
Entity Type
Individual
Location Address
403 S KINGS AVE STE 201 BRANDON, FL 33511
Location Phone
(813) 872-4492
Location Fax
(813) 490-9635
Mailing Address
403 S KINGS AVE STE 201 BRANDON, FL 33511
Mailing Phone
(813) 872-4492
Mailing Fax
(813) 490-9635
Medical School Name
OTHER
Graduation Year
1999
Is Sole Proprietor?
Yes
Enumeration Date
09-26-2006
Last Update Date
09-05-2019
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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

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
ME121364
License State
FL
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208VP0000XAllopathic & Osteopathic Physicians

Pain Medicine
Pain Medicine

35084603 (OH)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
  • Clear VALUE Silver - HMO
  • Complete VALUE Gold - HMO
  • Focused VALUE Silver - HMO
  • Focused VALUE Silver + Vision + Adult Dental - HMO
  • Standard Gold VALUE - HMO
  • 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
  • AvMed Entrust Bronze 600 (2025) - HMO
  • AvMed Entrust Bronze 650 (2025) - HMO
  • AvMed Entrust Expanded Bronze Standard (2025) - HMO
  • AvMed Entrust Gold 125 (2025) - HMO
  • AvMed Entrust Gold 125 Dental+Vision (2025) - HMO
  • AvMed Entrust Gold Standard (2025) - HMO
  • AvMed Entrust Platinum 25 (2025) - HMO
  • AvMed Entrust Platinum 25 Dental+Vision (2025) - HMO
  • AvMed Entrust Platinum Standard (2025) - HMO
  • AvMed Entrust Silver 350 (2025) - HMO
  • AvMed Entrust Silver 350 Dental+Vision (2025) - HMO
  • AvMed Entrust Silver 550 (2025) - HMO
  • AvMed Entrust Silver 550 Dental+Vision (2025) - HMO
  • AvMed Entrust Silver Standard (2025) - HMO
  • Connect Bronze 0 Indiv Med Deductible - EPO
  • Connect Bronze 5500 Indiv Med Deductible - EPO
  • Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - EPO
  • Connect Bronze CMS Standard - EPO
  • Connect Gold 2000 Indiv Med Deductible - EPO
  • Connect Gold 800 Indiv Med Deductible - EPO
  • Connect Gold CMS Standard - EPO
  • Connect Silver 3600 Indiv Med Deductible - EPO
  • Connect Silver 4300 Indiv Med Deductible - EPO
  • Connect Silver CMS Standard - EPO
  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - PPO
  • BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) - PPO
  • BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) - PPO
  • BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
  • BlueSelect Bronze 1449 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - EPO
  • BlueSelect Bronze 2139 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - EPO
  • BlueSelect Bronze 2139E ($0 Virtual PCP Visits / $50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
  • BlueSelect Bronze 2139V ($0 Virtual PCP Visits / $50 PCP Visits / Adult Vision / Rewards) - EPO
  • BlueSelect Bronze 2342S ($50 PCP Visits / Multilingual Available / Rewards) - EPO
  • BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
  • BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
  • BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) - POS
  • BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
  • BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) - POS
  • BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K01-10 ($0 Virtual PCP Visits / $15 Labs / Rewards) - POS
  • BlueCare Gold 24K01-33S ($30 PCP Visits / Multilingual Available/ Rewards) - POS
  • BlueCare Gold 24K02-20 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K02-28S ($30 PCP Visits / Multilingual Available / Rewards) - POS
  • BlueCare Platinum 24K01-04 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - POS
  • BlueCare Platinum 24K01-07 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
  • BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
  • BlueCare Platinum 24K02-15 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
  • BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
  • BlueCare Silver 24K01-02 ($0 Virtual PCP Visits / $0 Labs / Rewards) - POS
  • Bronze 1826 ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
  • Bronze 1826 + Adult Dental + Adult Vision ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
  • Bronze Savings 1820 (Primary Care Copay Visits 1-5, Open Access) - HMO
  • Bronze Savings 1820 + Adult Dental + Adult Vision (Primary Care Copay Visits 1-5, Open Access) - HMO
  • Bronze Standard 1828 - HMO
  • Bronze Value 1814 (High Value Network Savings, Open Access) - HMO
  • Bronze Value 1814 + Adult Dental + Adult Vision (High Value Network Savings, Open Access) - HMO
  • Catastrophic 1746 (Primary Care Copay Visits 1-3, Open Access) - HMO
  • Gold 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
  • Gold 1742 + Adult Dental + Adult Vision (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
  • Gold Savings 1825 ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
  • Gold Savings 1825 + Adult Dental + Adult Vision ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
  • Gold Standard 1833 - HMO
  • Gold Value 1819 ($1,300 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
  • Gold Value 1819 + Adult Dental + Adult Vision ($1,300 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
  • Silver 1664 (Primary Care & Specialist Copays, Open Access) - HMO
  • Silver 1664 + Adult Dental + Adult Vision (Primary Care & Specialist Copays, Open Access) - HMO
  • Silver Savings 1821 (Primary Care Copay, Open Access) - HMO
  • Silver Savings 1821 + Adult Dental + Adult Vision (Primary Care Copay, Open Access) - HMO
  • Silver Standard 1829 - HMO
  • Bronze 4 - HMO
  • Bronze 8 - HMO
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - 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
  • Silver 9 - HMO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Gold Classic Standard - EPO
  • Gold Elite - EPO
  • Gold Elite Saver Plus - EPO
  • Secure - EPO
  • Silver Classic Standard - EPO
  • Silver Elite - EPO
  • Silver Simple Chronic Care CKM - EPO
  • Silver Simple Diabetes - EPO
  • Silver Simple PCP Saver - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Standard - HMO
  • UHC Bronze Value ($0 Virtual Urgent Care) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
  • UHC Gold Standard - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Silver Standard - HMO
  • UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO

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
2495867MEDICAID (05)OH 

Medicare Participation & PECOS Enrollment Status

Bruce Piszel 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.

Bruce Piszel 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: 8224018965

    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: I20150213000703

    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.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 21 times for 16 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint

This procedure involves using imaging technology to locate and treat nerves in your lower spine or sacral area that may be causing pain. Each additional facet joint refers to treating more than one spinal nerve. It's a non-invasive way to manage chronic back pain.

This service was performed 24 times for 22 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 25 times for 23 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 1,260 times for 291 patients

Established patient office or other outpatient visit, 30-39 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 1,596 times for 395 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 46 times for 40 patients

Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance

This procedure involves injecting medicine into the joint where your lower spine meets your hip bone. Using special imaging technology, the doctor ensures the medicine is delivered accurately. This can help reduce pain and inflammation in that area.

This service was performed 23 times for 19 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

This service was performed 35 times for 25 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 35 times for 25 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 19 times for 19 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 18 times for 17 patients

Injection, ketorolac tromethamine, per 15 mg

Ketorolac 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 170 times for 79 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 143 times for 50 patients

Insertion of spinal neurostimulator generator or receiver

The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.

This service was performed 12 times for 11 patients

Needle measurement of electrical activity in arm or leg muscles, complete study

This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.

This service was performed 32 times for 27 patients

Nerve conduction, 13 or more studies

Nerve conduction studies involve 13 or more tests to check the speed and strength of signals traveling between your nerves and muscles. It helps diagnose conditions affecting nerves and muscles. The test involves small shocks and may cause minor discomfort.

This service was performed 29 times for 29 patients

New patient office or other outpatient visit, 45-59 minutes

This 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 65 times for 65 patients

Testing for presence of drug, by chemistry analyzers

Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.

This service was performed 268 times for 234 patients

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.

  • 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.

  • 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.

  • 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.

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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.
1467553966
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
241271056912
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 2 + 7 + 1 + 0 + 5 + 6 + 9 + 1 + 2 + 24 = 64
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 64 = 66

The NPI number 1467553966 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 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1568426906 ANTHONY JOHN JIMENEZ PA-C
Individual
Physician Assistant (Surgical)403 S KINGS AVE STE 201
BRANDON, FL 33511
(813) 872-4992
1902382898MS. PEARL FOX ARNP
Individual
Nurse Practitioner (Family)403 S KINGS AVE STE 201
BRANDON, FL 33511
(813) 872-4492
1326715145 MARTHA L CLAPP APRN
Individual
Nurse Practitioner (Family)403 S KINGS AVE STE 201
BRANDON, FL 33511
(813) 872-4492

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1467553966, enumerated in the NPI registry as an "individual" on September 26, 2006

The provider is located at 403 S Kings Ave Ste 201 Brandon, Fl 33511 and the phone number is (813) 872-4492

The provider's speciality is Specialist with taxonomy code 174400000X

The provider has more than 27 years of experience.

The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Superior. 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 most common procedures or services performed by this practitioner are: Aspiration and/or injection of fluid from large joint, Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint, Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level, Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance, Injection of lower or sacral spine facet joint using imaging guidance, second level, Injection of lower or sacral spine facet joint using imaging guidance, single level, Injection of substance into lower spine canal using imaging guidance, Injection of substance into middle or upper spine canal using imaging guidance, Injection, ketorolac tromethamine, per 15 mg, Injection, triamcinolone acetonide, not otherwise specified, 10 mg, Insertion of spinal neurostimulator generator or receiver, Needle measurement of electrical activity in arm or leg muscles, complete study, Nerve conduction, 13 or more studies, New patient office or other outpatient visit, 45-59 minutes and Testing for presence of drug, by chemistry analyzers.

This NPI record was last updated on September 26, 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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