JOHN P GALAN MD
NPI 1528069440
Internal Medicine in San Antonio, TX
Quality Rating: 89.98 out of 100 score
NPI Status: Active since August 02, 2005
Contact Information
4410 MEDICAL DR
STE #100
SAN ANTONIO, TX
ZIP 78229
Phone: (210) 614-4000
Fax: (210) 614-9114
- Individual
- Male
- Years of Experience 31
- Internal Medicine
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About JOHN GALAN
This page provides the complete NPI Profile along with additional information for John Galan, an internist established in San Antonio, Texas with a medical specialization in Internal Medicine and more than 31 years of experience. He graduated from University Of Texas Medical School At San Antonio in 1995. The healthcare provider is registered in the NPI registry with number 1528069440 assigned on August 2005. The practitioner's primary taxonomy code is 207R00000X with license number K0471 (TX). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1528069440
- Provider Name
- JOHN P GALAN MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4410 MEDICAL DR STE #100 SAN ANTONIO, TX 78229
- Location Phone
- (210) 614-4000
- Location Fax
- (210) 614-9114
- Mailing Address
- 4410 MEDICAL DR STE #100 SAN ANTONIO, TX 78229
- Mailing Phone
- (210) 614-4000
- Mailing Fax
- (210) 614-9114
- Medical School Name
- UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
- Graduation Year
- 1995
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-02-2005
- Last Update Date
- 02-01-2010
- Code Navigator
An internist like John Galan 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
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
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- K0471
- License State
- TX
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Standard - HMO
- UHC Gold Standard $0 Indiv Ded ($0 Virtual Urgent Care) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 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.
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 |
---|---|---|---|
110231815 | OTHER (01) | RAILROAD MEDICARE | |
88571J | MEDICARE ID-TYPE UNSPECIFIED (04) | ||
G70168 | MEDICARE UPIN (02) | ||
116217402 | MEDICAID (05) | TX |
Medicare Participation & PECOS Enrollment Status
John Galan is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
John Galan 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: 7517094436
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: I20100426000369
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? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
4 DME suppliers used 14 Medicare Claims 37 Services Paid
DME-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
3 DME suppliers used 18 Medicare Claims 18 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)
2 DME suppliers used 15 Medicare Claims 15 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
3 DME suppliers used 15 Medicare Claims 90 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Administration of influenza virus vaccine
Administration of pneumococcal vaccine
Administration of vaccine
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Bacterial colony count, urine
Blood test, comprehensive group of blood chemicals
Blood test, lipids (cholesterol and triglycerides)
Blood test, thyroid stimulating hormone (tsh)
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
Creatine kinase (cardiac enzyme) level, total
Creatinine level to test for kidney function or muscle injury
Cyanocobalamin (vitamin b-12) level
Detection test by immunoassay with direct visual observation for influenza virus
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)
Dxa bone density measurement of hip, pelvis, spine
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Ferritin (blood protein) level
Glutamyltransferase (liver enzyme) level
Hemoglobin a1c level
Influenza vaccine split virus, preservative free
Insertion of needle into vein for collection of blood sample
Iron binding capacity
Iron level
Ldl cholesterol level
Manual urinalysis test with examination using microscope, non-automated
New patient office or other outpatient visit, 60-74 minutes
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use
Pneumococcal vaccine, 23-valent
Prostate cancer screening; prostate specific antigen test (psa)
Psa (prostate specific antigen) measurement, total
Red blood cell sedimentation rate, to detect inflammation, non-automated
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Stool analysis for blood to screen for colon tumors
Testosterone (hormone) level, total
Thyroid hormone evaluation
Thyroxine (thyroid chemical), total
Uric acid level, blood
Urine microalbumin (protein) level
Vitamin d-3 level
X-ray of chest, 2 views
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 97 times for 97 patientsThe pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
This service was performed 52 times for 52 patientsAdministering a vaccine involves injecting a small, safe piece of a virus or bacteria into your body. This triggers your immune system to recognize and fight off the disease in the future. It's a vital tool in preventing serious illnesses and maintaining public health.
This service was performed 16 times for 16 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 238 times for 238 patientsA bacterial colony count, urine, is a laboratory test that checks a urine sample for bacteria. It helps to identify if an infection is present in the urinary system. High numbers of bacteria in the urine can indicate a urinary tract infection (UTI).
This service was performed 51 times for 44 patientsA comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
This service was performed 748 times for 321 patientsA lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
This service was performed 569 times for 316 patientsA TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.
This service was performed 393 times for 283 patientsA Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
This service was performed 701 times for 321 patientsThe total Creatine Kinase (CK) level test is a blood test that helps assess the health of your heart. It measures an enzyme called CK that's released into the bloodstream when heart or other muscle tissue is damaged. High levels may indicate a heart attack or muscle disorder.
This service was performed 506 times for 282 patientsA creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.
This service was performed 33 times for 32 patientsA Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.
This service was performed 279 times for 262 patientsThis is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
This service was performed 22 times for 11 patientsThis is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
This service was performed 12 times for 11 patientsA DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.
This service was performed 101 times for 101 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 246 times for 243 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 518 times for 286 patientsA Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.
This service was performed 140 times for 77 patientsGlutamyltransferase (GGT) level is a blood test that helps check your liver's health. High GGT levels may indicate liver disease or damage. The test involves a simple blood draw and results help your doctor understand your liver's condition better.
This service was performed 15 times for 11 patientsHemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
This service was performed 607 times for 316 patientsThe Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
This service was performed 89 times for 89 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 782 times for 319 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 138 times for 77 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 139 times for 77 patientsThe LDL cholesterol level is a test that measures the amount of low-density lipoprotein (LDL) in your blood. LDL is often referred to as 'bad cholesterol' because high levels can lead to heart disease. Regular testing helps monitor and manage your heart health.
This service was performed 51 times for 46 patientsA manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.
This service was performed 318 times for 269 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 11 times for 11 patientsThe Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
This service was performed 39 times for 39 patientsThe 23-valent pneumococcal vaccine is an injection that helps protect against serious infections caused by 23 types of pneumococcal bacteria. It's vital for those at risk, like older adults or people with certain health conditions, to prevent pneumonia, meningitis, and bloodstream infections.
This service was performed 12 times for 12 patientsProstate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.
This service was performed 53 times for 53 patientsPSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.
This service was performed 39 times for 30 patientsThe Red Blood Cell Sedimentation Rate test measures how quickly red blood cells settle at the bottom of a test tube. If they settle faster than normal, it may indicate inflammation in the body. This test is non-automated, meaning it's manually performed by a lab technician.
This service was performed 274 times for 248 patientsAn electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
This service was performed 191 times for 180 patientsA stool analysis for blood is a non-invasive procedure used to check for the presence of hidden blood in your stool. This can be an early sign of colon tumors. The test involves collecting a small sample of stool at home and sending it to a lab for analysis.
This service was performed 62 times for 62 patientsA total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.
This service was performed 103 times for 70 patientsA thyroid hormone evaluation is a test that measures the levels of thyroid hormones in your body. These hormones regulate energy and metabolism. If they're too high or too low, it could indicate a thyroid disorder. This test helps in diagnosing and managing such conditions.
This service was performed 389 times for 282 patientsA Thyroxine (thyroid chemical) total test measures the amount of thyroxine, a hormone produced by your thyroid gland, in your blood. This hormone helps regulate your body's metabolism. The test can help diagnose thyroid disorders, such as hypothyroidism or hyperthyroidism.
This service was performed 389 times for 282 patientsA blood uric acid level test measures the amount of uric acid in your blood. Uric acid is a waste product that your body produces when it breaks down purines, substances found in your body and in certain foods. High levels may lead to gout or kidney stones.
This service was performed 53 times for 35 patientsThe urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.
This service was performed 37 times for 35 patientsA Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.
This service was performed 275 times for 266 patientsA chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
This service was performed 151 times for 140 patientsPhysician Visit Costs
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 89.98, 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 provider also has detailed performance information the following quality measures: .
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: 89.98 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 100
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 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: 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: 66.6
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: 66.6
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.
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
Quality Measure | Performance | Number of Patients |
---|---|---|
Breast Cancer Screening | 100% | 50 |
Documentation of Current Medications in the Medical Record | 99% | 1734 |
Falls: Screening for Future Fall Risk | 94% | 399 |
Pneumococcal Vaccination Status for Older Adults | 92% | 382 |
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 91% | 825 |
Preventive Care and Screening: Influenza Immunization | 80% | 636 |
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented | 100% | 762 |
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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 | 5 | 2 | 8 | 0 | 6 | 9 | 4 | 4 | 0 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 5 | 4 | 8 | 0 | 6 | 18 | 4 | 8 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 5 + 4 + 8 + 0 + 6 + 1 + 8 + 4 + 8 + 24 = 70 | |||||||||
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
0 |
The NPI number 1528069440 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 |
---|---|---|---|
1639171929 | JOHN RAYMOND SEALS MD Individual | Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology) | 4410 MEDICAL DR STE 400 SAN ANTONIO, TX 78229 (210) 615-2255 |
1275534109 | MICHELLE C SCANLAN MD Individual | Internal Medicine | 4410 MEDICAL DR STE 100 SAN ANTONIO, TX 78229 (210) 614-4000 |
1285635110 | BRADLEY B KAYSER MD Individual | Internal Medicine | 4410 MEDICAL DR STE 100 SAN ANTONIO, TX 78229 (210) 614-4000 |
1629079298 | ROBERTO JOSE ARANIBAR MD Individual | Neurological Surgery | 4410 MEDICAL DR STE 610 SAN ANTONIO, TX 78229 (210) 614-2453 |
1538160106 | CHRISTOPHER AYRES BOGAEV MD Individual | Neurological Surgery | 4410 MEDICAL DR STE 610 SAN ANTONIO, TX 78229 (210) 614-2453 |
1245231729 | DONALD PAUL ATKINS MD Individual | Neurological Surgery | 4410 MEDICAL DR STE 610 SAN ANTONIO, TX 78229 (210) 614-2453 |
1770584203 | ROBERTO A NEGRON MD Individual | Neurological Surgery | 4410 MEDICAL DR SUITE 610 SAN ANTONIO, TX 78229 (210) 614-2453 |
1760483291 | DONALD LONG HILTON JR. MD Individual | Neurological Surgery | 4410 MEDICAL DR STE 610 SAN ANTONIO, TX 78229 (210) 614-2453 |
1710988274 | JERALD WINAKUR MD Individual | Internal Medicine | 4410 MEDICAL DR STE#100 SAN ANTONIO, TX 78229 (210) 614-4000 |
1689675142 | ROBERT GORDON JOHNSON MD Individual | Orthopaedic Surgery (Orthopaedic Surgery of the Spine) | 4410 MEDICAL DR SUITE 610 SAN ANTONIO, TX 78229 (210) 614-2453 |
1497756951 | KARL WINSTON SWANN MD Individual | Neurological Surgery | 4410 MEDICAL DR SUITE 610 SAN ANTONIO, TX 78229 (210) 614-2453 |
1346241817 | ARNOLD BRADLEY VARDIMAN MD Individual | Neurological Surgery | 4410 MEDICAL DR SUITE 610 SAN ANTONIO, TX 78229 (210) 614-2453 |
1508867987 | LLOYD ANGUS YOUNGBLOOD MD Individual | Neurological Surgery | 4410 MEDICAL DR STE 610 SAN ANTONIO, TX 78229 (210) 614-2453 |
1396792065 | JAIME ESTRADA MD Individual | Pediatrics (Pediatric Hematology-Oncology) | 4410 MEDICAL DR STE 540 SAN ANTONIO, TX 78229 (210) 575-6240 |
1356382071 | J. SCOTT LUTHER MD Individual | Psychiatry & Neurology (Neurology) | 4410 MEDICAL DR SUITE 240 SAN ANTONIO, TX 78229 (210) 615-8070 |
1447295753 | NEUROSURGICAL ASSOCIATES OF SAN ANTONIO, P.A. Organization | Neurological Surgery | 4410 MEDICAL DR SUITE 610 SAN ANTONIO, TX 78229 (210) 477-5733 |
1326071861 | PULMONARY PHYSICIANS PA Organization | Internal Medicine (Pulmonary Disease) | 4410 MEDICAL DR SUITE 440 SAN ANTONIO, TX 78229 (210) 692-9400 |
1659489243 | WILLIAM W. ROBBINS D.O. Individual | Pain Medicine (Interventional Pain Medicine) | 4410 MEDICAL DR SUITE 390 SAN ANTONIO, TX 78229 (210) 614-9955 |
1205944808 | WILLIAM W. ROBBINS, D.O.,P.A. Organization | Pain Medicine (Interventional Pain Medicine) | 4410 MEDICAL DR SUITE 390 SAN ANTONIO, TX 78229 (210) 614-9955 |
1912191552 | PULMONARY PHYSICIANS, L.L.C. Organization | Specialist | 4410 MEDICAL DR SUITE 440 SAN ANTONIO, TX 78229 (210) 692-9400 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1528069440, enumerated in the NPI registry as an "individual" on August 02, 2005
The provider is located at 4410 Medical Dr Ste #100 San Antonio, Tx 78229 and the phone number is (210) 614-4000
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider has more than 31 years of experience. He graduated from University Of Texas Medical School At San Antonio in 1995.
The provider might be accepting Accepts: UnitedHealthcare, Railroad Medicare, Medicare and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences. The provider obtained a high score in the following performance measures: Breast Cancer Screening, Documentation of Current Medications in the Medical Record, Falls: Screening for Future Fall Risk, Pneumococcal Vaccination Status for Older Adults, Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan, Preventive Care and Screening: Influenza Immunization , Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented. The quality ratings are based on unbiased reviews and reported submissions to Medicare's Quality Payment Program.
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: Administration of influenza virus vaccine, Administration of pneumococcal vaccine, Administration of vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Bacterial colony count, urine, Blood test, comprehensive group of blood chemicals, Blood test, lipids (cholesterol and triglycerides), Blood test, thyroid stimulating hormone (tsh), Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count, Creatine kinase (cardiac enzyme) level, total, Creatinine level to test for kidney function or muscle injury, Cyanocobalamin (vitamin b-12) level, Detection test by immunoassay with direct visual observation for influenza virus, Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19), Dxa bone density measurement of hip, pelvis, spine, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Ferritin (blood protein) level, Glutamyltransferase (liver enzyme) level, Hemoglobin a1c level, Influenza vaccine split virus, preservative free, Insertion of needle into vein for collection of blood sample, Iron binding capacity, Iron level, Ldl cholesterol level, Manual urinalysis test with examination using microscope, non-automated, New patient office or other outpatient visit, 60-74 minutes, Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use, Pneumococcal vaccine, 23-valent, Prostate cancer screening; prostate specific antigen test (psa), Psa (prostate specific antigen) measurement, total, Red blood cell sedimentation rate, to detect inflammation, non-automated, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report, Stool analysis for blood to screen for colon tumors, Testosterone (hormone) level, total, Thyroid hormone evaluation, Thyroxine (thyroid chemical), total, Uric acid level, blood, Urine microalbumin (protein) level, Vitamin d-3 level and X-ray of chest, 2 views.
This NPI record was last updated on August 02, 2005. 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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