DR. ALEX JUSTIN SCHAFFER O.D.
NPI 1538476171
Optometrist in Setauket, NY
Quality Rating: 0 out of 100 score
NPI Status: Active since September 02, 2010
Contact Information
3400 NESCONSET HWY
SUITE 107
SETAUKET, NY
ZIP 11733
Phone: (631) 751-2020
- Individual
- Male
- Years of Experience 16
- Optometrist
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About ALEX SCHAFFER
This page provides the complete NPI Profile along with additional information for Alex Schaffer, a provider established in Setauket, New York with a medical specialization in Optometrist and more than 16 years of experience. He graduated from State University Of New York - State College Optometry in 2010. The healthcare provider is registered in the NPI registry with number 1538476171 assigned on September 2010. The practitioner's primary taxonomy code is 152W00000X with license number 007620 (NY). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1538476171
- Provider Name
- DR. ALEX JUSTIN SCHAFFER O.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3400 NESCONSET HWY SUITE 107 SETAUKET, NY 11733
- Location Phone
- (631) 751-2020
- Mailing Address
- 3400 NESCONSET HWY SUITE 107 SETAUKET, NY 11733
- Medical School Name
- STATE UNIVERSITY OF NEW YORK - STATE COLLEGE OPTOMETRY
- Graduation Year
- 2010
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-02-2010
- Last Update Date
- 09-02-2010
- Code Navigator
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
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 007620
- License State
- NY
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- Blue Precision Bronze HMO? 205 - HMO
- Blue Max 70/50 $6700 - PPO
- Blue Max 90/70 $1500 - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $3300 - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan - PPO
- Blue Saver 60/40 $6100 - PPO
- Blue Saver 90/70 $3200 - PPO
- Blue Focus Bronze POS? 205 - POS
- Blue Focus Bronze POS? 705 - POS
- Blue Focus Bronze POS? Standard - POS
- Blue Focus Gold POS? 207 - POS
- Blue Focus Gold POS? Standard - POS
- Blue Focus Silver POS? 206 - POS
- Blue Focus Silver POS? Standard - POS
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Advantage Bronze PPO? 202 - PPO
- Blue Advantage Bronze PPO? 203 - PPO
- Blue Advantage Bronze PPO? Standard - PPO
- Blue Advantage Gold PPO? 309 - PPO
- Blue Advantage Gold PPO? 604 - PPO
- Blue Advantage Gold PPO? Standard - PPO
- Blue Advantage Silver PPO? 204 - PPO
- Blue Advantage Silver PPO? 501 - PPO
- Blue Advantage Silver PPO? Standard - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- 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
- BlueSelect Bronze Basic - PPO
- BlueSelect Bronze Core - PPO
- BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
- BlueSelect Gold Core - PPO
- BlueSelect Gold HealthPlus - PPO
- BlueSelect Gold Standard without Kid's Dental - PPO
- BlueSelect Silver Classic - PPO
- BlueSelect Silver Classic without Kid's Dental - PPO
- BlueSelect Silver HealthPlus - PPO
- BlueSelect Silver HealthPlus without Kid's Dental - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Alex Schaffer 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.
Alex Schaffer 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) and a Home Health Agency (HHA).
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: 2264728187
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: I20160901000629
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: No
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.
Cataract surgery
Closure of tear duct opening using plug
Ct scan of cornea
Established patient complete exam of visual system
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient problem focused exam of visual system
Exam of the internal drainage system of eye
Exam of visual field with extended testing
Exam to measure eye deviation and range of motion
Extended exam involving color vision testing
Fitting of contact lens for treatment of eye surface disease
Imaging of front third of eye using a special microscope
Imaging of optic nerve
Imaging of retina
Measurement of corneal curvature and depth of eye
New patient complete exam of visual system
New patient office or other outpatient visit, 30-44 minutes
Photography of the retina
Removal of eyelashes using forceps
Removal of foreign body from external eye (conjunctiva)
Ultrasound scan of cornea to determine thickness
Cataract surgery is a procedure to remove the lens of your eye when it becomes cloudy, which is called a cataract. A synthetic lens is then inserted to restore clear vision. The operation is typically done on an outpatient basis and is very safe and effective.
This service was performed for 1-10 patientsClosure of the tear duct opening using a plug is a procedure to address excessive tear production. A small device is inserted into the tear duct to block it, reducing tear flow and relieving symptoms. This is a safe, reversible process, often performed in-office.
This service was performed 16 times for 13 patientsA CT scan of the cornea is a non-invasive imaging test that uses X-rays to capture detailed pictures of your eye's cornea. It helps in diagnosing diseases or damage, planning for surgery, or evaluating the results of a treatment. It's a safe and painless procedure.
This service was performed 135 times for 108 patientsAn established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
This service was performed 584 times for 432 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 402 times for 262 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 169 times for 141 patientsThis is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
This service was performed 103 times for 89 patientsThis is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.
This service was performed 15 times for 15 patientsAn extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
This service was performed 62 times for 53 patientsThis is an eye exam that checks for any misalignment in your eyes, also known as deviation. It also assesses the movement range of your eyes. The procedure is painless and helps in detecting conditions like strabismus or other vision issues.
This service was performed 82 times for 57 patientsAn extended exam involving color vision testing helps identify any difficulties in distinguishing colors, often due to genetic conditions or health problems. This non-invasive test involves identifying different colored numbers or patterns.
This service was performed 64 times for 56 patientsFitting of contact lenses for eye surface disease involves a specialist assessing your eye condition and prescribing special lenses. These lenses help protect the eye surface, promote healing, and improve vision. It's a safe, non-invasive treatment.
This service was performed 17 times for 15 patientsThis procedure involves capturing detailed images of the front part of your eye using a specialized microscope. It helps in identifying any eye abnormalities or issues, improving the accuracy of diagnosis and treatment planning.
This service was performed 46 times for 46 patientsImaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
This service was performed 39 times for 34 patientsImaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
This service was performed 119 times for 106 patientsThis procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
This service was performed 49 times for 48 patientsA new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
This service was performed 58 times for 58 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 12 times for 12 patientsPhotography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
This service was performed 502 times for 416 patientsThe removal of eyelashes using forceps is a simple procedure where a medical professional gently extracts unwanted or problematic eyelashes with a specialized tool. This is often done to alleviate discomfort or to treat conditions like trichiasis, where eyelashes grow inward.
This service was performed 35 times for 28 patientsThis procedure involves the careful extraction of a foreign object from the surface of your eye, specifically the conjunctiva. This could be dust, metal, or any small particle. A healthcare professional uses specialized tools to gently remove the object, thus alleviating discomfort and preventing potential damage to your eye.
This service was performed 13 times for 13 patientsAn ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.
This service was performed 21 times for 21 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $38.57 for a new patient copayment and $20.86 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 11733 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $154.28
- Minimum New Patient Price $67.4
- Maximum New Patient Price $203.53
- Average New Patient Copayment $38.57
- Minimum New Patient Copayment $16.85
- Maximum New Patient Copayment $50.88
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $83.44
- Minimum Established Patient Price $21.66
- Maximum Established Patient Price $164.45
- Average Established Patient Copayment $20.86
- Minimum Established Patient Copayment $5.41
- Maximum Established Patient Copayment $41.11
* 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 0, 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: 0 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: 0
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: 0
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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 83% | 122 |
| Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for preventing progression of AMD | ||
| Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 100% | 122 |
| Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage AND the level of macular degeneration severity during one or more office visits within 12 months | ||
| Diabetes: Eye Exam | 99% | 157 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care | 100% | 30 |
| Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months | ||
| Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy | 100% | 30 |
| Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months | ||
| Documentation of Current Medications in the Medical Record | 100% | 5220 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| e-Prescribing | 98% | 4612 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Falls: Screening for Future Fall Risk | 2% | 810 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Medication Reconciliation | 100% | 2356 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 75% | 3246 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 1% | 158 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 9% | 47 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 99% | 77 |
| Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 95% | 3246 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 0% | 3246 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Tobacco use | Yes | N/A |
| Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. | ||
| Use of High-Risk Medications in the Elderly | 0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 810 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
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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 | 3 | 8 | 4 | 7 | 6 | 1 | 7 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 6 | 8 | 8 | 7 | 12 | 1 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 6 + 8 + 8 + 7 + 1 + 2 + 1 + 1 + 4 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1538476171 is valid because the calculated check digit 1 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 |
|---|---|---|---|
| 1659399806 | DR. MICHAEL MAKRIDES M.D. Individual | Internal Medicine | 3400 NESCONSET HWY SUITE 102 EAST SETAUKET, NY 11733 (631) 751-5700 |
| 1306931373 | DR. DEBRA A MESSINA M.D. Individual | Ophthalmology | 3400 NESCONSET HWY SUITE 107 EAST SETAUKET, NY 11733 (631) 751-2020 |
| 1043347164 | DEBORAH A LUPO NP Individual | Nurse Practitioner (Adult Health) | 3400 NESCONSET HWY STE 101 EAST SETAUKET, NY 11733 (631) 751-8700 |
| 1003944943 | MARGARET A CARIOLA NP Individual | Nurse Practitioner (Adult Health) | 3400 NESCONSET HWY STE 101 EAST SETAUKET, NY 11733 (631) 751-8700 |
| 1093849838 | EYE-Q CORPORATION OF AMERICA Organization | Durable Medical Equipment & Medical Supplies (Customized Equipment) | 3400 NESCONSET HWY SUITE 107 EAST SETAUKET, NY 11733 (631) 751-2020 |
| 1427239987 | DR. ROSE SCHWARZBERG ED.D. Individual | Psychologist | 3400 NESCONSET HWY STE 101 SETAUKET, NY 11733 (631) 751-8550 |
| 1194900365 | DR. ALEXANDER LLINAS M.D., PH.D. Individual | Ophthalmology | 3400 NESCONSET HWY SUITE 107 EAST SETAUKET, NY 11733 (631) 751-2020 |
| 1114165909 | COLON AND RECTAL SURGEONS OF LONG ISLAND, P.C. Organization | Colon & Rectal Surgery | 3400 NESCONSET HWY SUITE 100 EAST SETAUKET, NY 11733 (631) 689-2600 |
| 1437481744 | SUFFOL PULMONARY AND SLEEP DISORDERS Organization | Specialist | 3400 NESCONSET HWY EAST SETAUKET, NY 11733 (631) 675-9393 |
| 1518233287 | SUFFOLK PULMONARY AND SLEEP DISORDER, PC Organization | Specialist | 3400 NESCONSET HWY 8 TECHNOLOGY DRIVE SUITE 103 EAST SETAUKET, NY 11733 (631) 675-9393 |
| 1205892205 | DR. ROBERT JOHN BARANOWSKI MD Individual | Internal Medicine (Gastroenterology) | 3400 NESCONSET HWY SUITE 101 EAST SETAUKET, NY 11733 (631) 751-8700 |
| 1861459208 | DR. WILLIAM J COHN MD Individual | Internal Medicine (Gastroenterology) | 3400 NESCONSET HWY SUITE 101 EAST SETAUKET, NY 11733 (631) 751-8700 |
| 1407813579 | DR. GARY RICHARD BERNSTEIN MD Individual | Internal Medicine (Gastroenterology) | 3400 NESCONSET HWY SUITE 101 EAST SETAUKET, NY 11733 (631) 751-8711 |
| 1508823600 | DR. SETH EVAN PERSKY MD Individual | Internal Medicine (Gastroenterology) | 3400 NESCONSET HWY SUITE 101 EAST SETAUKET, NY 11733 (631) 751-8700 |
| 1871551879 | DR. HOWARD ADAM KESCHNER MD Individual | Internal Medicine (Gastroenterology) | 3400 NESCONSET HWY SUITE 101 EAST SETAUKET, NY 11733 (631) 751-8700 |
| 1497713887 | DR. EUGENE ANTHONY COMAN MD Individual | Internal Medicine (Gastroenterology) | 3400 NESCONSET HWY SUITE 101 EAST SETAUKET, NY 11733 (631) 751-8700 |
| 1881765014 | DR. EMILY GLAZER MD Individual | Internal Medicine (Gastroenterology) | 3400 NESCONSET HWY STE 101 EAST SETAUKET, NY 11733 (631) 751-8700 |
| 1902929706 | DR. STEVEN M ZOVE DDS Individual | Dentist (Periodontics) | 3400 NESCONSET HWY SUITE 109 EAST SETAUKET, NY 11733 (631) 751-6700 |
| 1497772958 | DR. MICHAEL S CONNERS MD Individual | Ophthalmology | 3400 NESCONSET HWY TECHNOLOGY DRIVE, SUITE 107 EAST SETAUKET, NY 11733 (631) 751-2020 |
| 1164593414 | LONG ISLAND DIGESTIVE DISEASE CONSULTANTS, PC Organization | Internal Medicine (Gastroenterology) | 3400 NESCONSET HWY STE 101 EAST SETAUKET, NY 11733 (631) 751-8700 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1538476171, enumerated in the NPI registry as an "individual" on September 02, 2010
The provider is located at 3400 Nesconset Hwy Suite 107 Setauket, Ny 11733 and the phone number is (631) 751-2020
The provider's speciality is Optometrist with taxonomy code 152W00000X
The provider has more than 16 years of experience. He graduated from State University Of New York - State College Optometry in 2010.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Blue Cross. 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) and a Home Health Agency (HHA).
Medicare beneficiaries should expect a typical cost of $154.28 with an average copayment of $38.57 for new patient appointments. Established patients should expect a typical charge of $83.44 and an average copayment of 20.86. 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: Cataract surgery, Closure of tear duct opening using plug, Ct scan of cornea, Established patient complete exam of visual system, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Established patient problem focused exam of visual system, Exam of the internal drainage system of eye, Exam of visual field with extended testing, Exam to measure eye deviation and range of motion, Extended exam involving color vision testing, Fitting of contact lens for treatment of eye surface disease, Imaging of front third of eye using a special microscope, Imaging of optic nerve, Imaging of retina, Measurement of corneal curvature and depth of eye, New patient complete exam of visual system, New patient office or other outpatient visit, 30-44 minutes, Photography of the retina, Removal of eyelashes using forceps, Removal of foreign body from external eye (conjunctiva) and Ultrasound scan of cornea to determine thickness.
This NPI record was last updated on September 02, 2010. 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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