HUTTON P. BRANTLEY D.O
NPI 1558540864
Internal Medicine - Cardiovascular Disease in Birmingham, AL
Quality Rating: 86.55 out of 100 score
NPI Status: Active since November 02, 2007
Contact Information
801 PRINCETON AVE SW
SUITE 707
BIRMINGHAM, AL
ZIP 35211
Phone: (205) 780-4330
Fax: (205) 780-7775
- Individual
- Male
- Years of Experience 21
- Internal Medicine
- Cardiovascular Disease
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About HUTTON BRANTLEY
This page provides the complete NPI Profile along with additional information for Hutton Brantley, an internist established in Birmingham, Alabama with a medical specialization in Internal Medicine, focusing in cardiovascular disease and more than 21 years of experience. He graduated from Kansas City College Of Medicine And Surgery in 2005. The healthcare provider is registered in the NPI registry with number 1558540864 assigned on November 2007. The practitioner's primary taxonomy code is 207RC0000X with license number DO956 (AL). The provider is registered as an individual and his NPI record was last updated 12 years ago.
- NPI
- 1558540864
- Provider Name
- HUTTON P. BRANTLEY D.O
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 801 PRINCETON AVE SW SUITE 707 BIRMINGHAM, AL 35211
- Location Phone
- (205) 780-4330
- Location Fax
- (205) 780-7775
- Mailing Address
- 801 PRINCETON AVE SW SUITE 707 BIRMINGHAM, AL 35211
- Mailing Phone
- (205) 780-4330
- Mailing Fax
- (205) 780-7775
- Medical School Name
- KANSAS CITY COLLEGE OF MEDICINE AND SURGERY
- Graduation Year
- 2005
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-02-2007
- Last Update Date
- 05-08-2013
- Code Navigator
An internist like Hutton Brantley 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 Cardiovascular Disease
- Taxonomy Code
- 207RC0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- DO956
- License State
- AL
- Taxonomy Description
- An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Blue HSA Bronze - PPO
- Blue Protect - PPO
- Blue Saver Bronze - PPO
- Blue Saver Silver EPO - EPO
- Blue Standardized Silver EPO - EPO
- Blue Value Gold - PPO
- Blue Value Silver - PPO
- Blue Access Gold for Business - PPO
- Blue Choice Platinum for Business - PPO
- Blue HSA Silver for Business - PPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Bronze Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Bronze Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - 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 |
---|---|---|---|
1558540864 | MEDICAID (05) | AL |
Medicare Participation & PECOS Enrollment Status
Hutton Brantley 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.
Hutton Brantley 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: 3375616956
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: I20080715000372, I20120425000012
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
1 DME suppliers used 12 Medicare Claims 12 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.
Coronary angioplasty and stenting
Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 30-39 minutes
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days
Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Heart rhythm recording continous external ekg over more than 48 hours up to 7 days
Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
Injection, regadenoson, 0.1 mg
Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch
Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist
Leg revascularization (restoring blood flow)
New patient office or other outpatient visit, 45-59 minutes
Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan
Nuclear medicine studies of heart muscle at rest and with stress and spect
Pacemaker insertion or repair
Programming of dual lead pacemaker system
Review by radiologist of abdominal aorta image
Review by radiologist of both arms or legs arteries image
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries
Technetium tc-99m tetrofosmin, diagnostic, per study dose
Thallium tl-201 thallous chloride, diagnostic, per millicurie
Ultrasound of both sides of head and neck blood flow
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart, follow-up
Ultrasound of leg arteries or artery grafts
Ultrasound study of arm and leg arteries
Ultrasound study of one arm or leg veins with compression and maneuvers
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes
Coronary angioplasty and stenting is a procedure to open narrowed or blocked heart arteries. A thin tube is inserted into a blood vessel, usually in the leg or arm, and guided to the heart. A small balloon at the end of the tube is inflated to widen the artery. A stent, a small wire mesh tube, may be placed in the artery to keep it open.
This service was performed for 46 patientsAn Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.
This service was performed 13 times for 13 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 16 times for 15 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 799 times for 508 patientsThis procedure involves remotely monitoring your pacemaker or implantable defibrillator system. Over a 90-day period, we check the device's performance and your heart's activity. This helps ensure the device is functioning properly and providing the best possible support for your heart health.
This service was performed 251 times for 78 patientsThis procedure evaluates your pacemaker system remotely for up to 90 days. It checks whether single, dual, multiple lead, or leadless pacemakers are working properly. It's a safe, convenient way to ensure your heart device is functioning optimally.
This service was performed 180 times for 55 patientsThis procedure involves remotely monitoring your implantable defibrillator system, which can have single, dual, or multiple leads. Over a period of up to 90 days, the system's performance is evaluated to ensure it's working properly and providing the necessary heart rhythm support.
This service was performed 72 times for 23 patientsAn exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.
This service was performed 171 times for 170 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 276 times for 141 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 280 times for 112 patientsThis procedure involves wearing a device, an external EKG, for up to 7 days to continuously monitor your heart rhythm. It helps detect irregularities that may not occur during a standard EKG. The device is non-invasive and safe.
This service was performed 11 times for 11 patientsA heart rhythm review involves monitoring your heart's electrical activity for more than 48 hours up to 7 days. Using a device called an external EKG, doctors can track your heartbeats to detect irregularities and help diagnose heart conditions.
This service was performed 11 times for 11 patientsInitial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
This service was performed 15 times for 15 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 180 times for 164 patientsRegadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.
This service was performed 652 times for 162 patientsThis procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.
This service was performed 14 times for 11 patientsThis procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.
This service was performed 66 times for 66 patientsLeg revascularization is a procedure aimed at restoring proper blood flow to your legs. It's often needed when blood vessels in your legs are blocked or narrowed. The process may involve surgery or less invasive methods to remove or bypass blockages, helping to alleviate pain and prevent serious complications.
This service was performed for 31 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 101 times for 101 patientsThis is a diagnostic test where a tiny amount of radioactive material is used to examine your heart's blood flow at rest & during stress, alongside a CT scan for detailed images. It helps identify any heart-related issues like blockages or damage.
This service was performed 149 times for 148 patientsNuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.
This service was performed 23 times for 23 patientsPacemaker insertion or repair is a procedure to help regulate your heartbeat. A small device, called a pacemaker, is implanted under the skin near your heart. This device sends electrical signals to prompt your heart to beat at a normal rate. In a repair procedure, the pacemaker may be adjusted, replaced, or the wires connecting it to your heart may be fixed.
This service was performed for 1-10 patientsProgramming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.
This service was performed 23 times for 16 patientsThis is a procedure where a radiologist, a doctor specialized in medical imaging, examines an image of your abdominal aorta. The abdominal aorta is the large blood vessel that carries blood to your lower body. The radiologist checks for any abnormalities to ensure your overall vascular health.
This service was performed 22 times for 22 patientsThis procedure involves a radiologist examining images of your arm or leg arteries. These images help identify any blockages or abnormalities in the blood vessels that could affect circulation. It's a vital step in diagnosing conditions related to blood flow.
This service was performed 17 times for 17 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 817 times for 520 patientsRubidium Rb-82 is a radioactive drug used in a PET scan to help visualize the heart. It helps detect areas with poor blood flow, aiding in diagnosing heart conditions. The dose is up to 60 millicuries per study.
This service was performed 296 times for 147 patientsTechnetium Tc-99m Tetrofosmin is a radiopharmaceutical used in diagnostic imaging. It helps highlight areas of concern in the heart by emitting signals captured by a special camera. This assists doctors in detecting heart conditions.
This service was performed 35 times for 23 patientsThallium Tl-201 Thallous Chloride is a radioactive substance used in medical imaging. It's administered into your body to highlight areas of abnormal cell activity during scans. This helps in diagnosing conditions like heart disease or cancer.
This service was performed 33 times for 11 patientsAn ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.
This service was performed 44 times for 44 patientsThis is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
This service was performed 208 times for 204 patientsThis is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
This service was performed 196 times for 192 patientsA follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.
This service was performed 12 times for 12 patientsAn ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.
This service was performed 24 times for 24 patientsAn ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.
This service was performed 12 times for 12 patientsThis is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.
This service was performed 24 times for 23 patientsThis procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.
This service was performed 98 times for 93 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $30.57 for a new patient copayment and $16.52 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 35211 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $122.31
- Minimum New Patient Price $52.65
- Maximum New Patient Price $161.63
- Average New Patient Copayment $30.57
- Minimum New Patient Copayment $13.16
- Maximum New Patient Copayment $40.4
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.08
- Minimum Established Patient Price $16.56
- Maximum Established Patient Price $131.65
- Average Established Patient Copayment $16.52
- Minimum Established Patient Copayment $4.14
- Maximum Established Patient Copayment $32.91
* 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 86.55, 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: 86.55 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: 93.31
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: 58.07
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: 58.07
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 |
---|---|---|
Colorectal Cancer Screening | 6% | 1092 |
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
Diabetes: Medical Attention for Nephropathy | 85% | 336 |
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period | ||
Documentation of Current Medications in the Medical Record | 99% | 3267 |
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 | 96% | 3306 |
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
Medication Reconciliation | 93% | 636 |
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 | 100% | 1936 |
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. | ||
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 84% | 1689 |
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
Preventive Care and Screening: Influenza Immunization | 90% | 1049 |
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 70% | 196 |
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 | ||
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 | 97% | 1936 |
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 | 1% | 1936 |
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. | ||
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 86% | 975 |
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD); OR - Adults aged >=21 years who have ever had a fasting or direct low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL; OR - Adults aged 40-75 years with a diagnosis of diabetes with a fasting or direct LDL-C level of 70-189 mg/dL | ||
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. | 896 |
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 | 5 | 8 | 5 | 4 | 0 | 8 | 6 | 4 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 5 | 10 | 8 | 10 | 4 | 0 | 8 | 12 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 5 + 1 + 0 + 8 + 1 + 0 + 4 + 0 + 8 + 1 + 2 + 24 = 56 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 56 = 4 | 4 |
The NPI number 1558540864 is valid because the calculated check digit 4 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 |
---|---|---|---|
1366426322 | ELIAS CALVIN WATSON III MD Individual | Dermatology | 801 PRINCETON AVE SW SUITE 520 BIRMINGHAM, AL 35211 (205) 780-5995 |
1972571891 | JOHN PHILLIP FEATHERINGILL MD Individual | Orthopaedic Surgery | 801 PRINCETON AVE SW POB 1 SUITE 710 BIRMINGHAM, AL 35211 (205) 781-1950 |
1770548307 | FARRELL O MENDELSOHN MD Individual | Internal Medicine (Cardiovascular Disease) | 801 PRINCETON AVE SW SUTE 706 BIRMINGHAM, AL 35211 (205) 780-4330 |
1659336014 | MARTIN T. BAILEY M.D. Individual | Internal Medicine (Cardiovascular Disease) | 801 PRINCETON AVE SW SUITE 707 BIRMINGHAM, AL 35211 (205) 780-4330 |
1649235938 | ROBERT GARY MARTIN MD Individual | Internal Medicine (Cardiovascular Disease) | 801 PRINCETON AVE SW SUITE706 BIRMINGHAM, AL 35211 (205) 780-4330 |
1538124722 | RICHARD I KIM MD Individual | Internal Medicine (Cardiovascular Disease) | 801 PRINCETON AVE SW SUITE 707 BIRMINGHAM, AL 35211 (205) 780-4330 |
1760447932 | ALLAN S WILENSKY MD Individual | Internal Medicine (Cardiovascular Disease) | 801 PRINCETON AVE SW SUITE 707 BIRMINGHAM, AL 35211 (205) 780-4330 |
1114982261 | DAVID H SIBLEY MD Individual | Internal Medicine (Cardiovascular Disease) | 801 PRINCETON AVE SW SUITE 706 BIRMINGHAM, AL 35211 (205) 780-4330 |
1184680647 | ALABAMA EYE SURGERY PC Organization | Ophthalmology | 801 PRINCETON AVE SW STE 530 BIRMINGHAM, AL 35211 (205) 787-1411 |
1518905116 | DR. RESIT CEM CEZAYIRLI M.D. Individual | Specialist | 801 PRINCETON AVE SW BIRMINGHAM, AL 35211 (205) 787-8676 |
1093754947 | MS. THERESA M. WADAS CRNP Individual | Nurse Practitioner (Adult Health) | 801 PRINCETON AVE SW SUITE 707 BIRMINGHAM, AL 35211 (205) 934-9309 |
1134160112 | DR. ARUNJOTI A REDDY MD Individual | Internal Medicine | 801 PRINCETON AVE SW PROFESSIONAL OFFICE BLDG ONE SUITE 210 BIRMINGHAM, AL 35211 (205) 788-7988 |
1902849300 | DR. ROBERT J JOHNSON JR. M.D, Individual | Specialist | 801 PRINCETON AVE SW BIRMINGHAM, AL 35211 (205) 787-8676 |
1770686198 | MRS. JACQUELINE BELINDA LEWIS MD Individual | Surgery | 801 PRINCETON AVE SW PROFESSIONAL OFFICE BLDG I STE 108 BIRMINGHAM, AL 35211 (205) 780-6090 |
1306907696 | DR. JAMES G LANGAN MD Individual | Internal Medicine | 801 PRINCETON AVE SW POB I SUITE 406 BIRMINGHAM, AL 35211 (205) 788-6688 |
1851439582 | METRO WEST MEDICAL GROUP PC Organization | Internal Medicine | 801 PRINCETON AVE SW POB I SUITE 406 BIRMINGHAM, AL 35211 (205) 788-6688 |
1306973060 | HAYNES NEUROSUGICAL GROUP, P.A. Organization | Neurological Surgery | 801 PRINCETON AVE SW SUITE 310 BIRMINGHAM, AL 35211 (205) 787-8676 |
1740314194 | PRIMARY CARE MEDICINE HDL CLINIC LLC Organization | Internal Medicine | 801 PRINCETON AVE SW PROFESSIONAL OFFICE BUILDING ONE SUITE 210 BIRMINGHAM, AL 35211 (205) 788-7988 |
1306965066 | STEVEN M. SOKELL, DPM, PC Organization | Podiatrist (Primary Podiatric Medicine) | 801 PRINCETON AVE SW SUITE 630 BIRMINGHAM, AL 35211 (205) 780-7712 |
1134327240 | R JAY SMITH MD PC Organization | Surgery | 801 PRINCETON AVE SW PROF BUILDING 1 STE 330 BIRMINGHAM, AL 35211 (205) 788-7136 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1558540864, enumerated in the NPI registry as an "individual" on November 02, 2007
The provider is located at 801 Princeton Ave Sw Suite 707 Birmingham, Al 35211 and the phone number is (205) 780-4330
The provider's speciality is Internal Medicine with taxonomy code 207RC0000X with a focus in Cardiovascular Disease
The provider has more than 21 years of experience. He graduated from Kansas City College Of Medicine And Surgery in 2005.
The provider might be accepting Accepts: Ambetter from Magnolia Health, Ambetter Health,. 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.
Medicare beneficiaries should expect a typical cost of $122.31 with an average copayment of $30.57 for new patient appointments. Established patients should expect a typical charge of $66.08 and an average copayment of 16.52. 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: Coronary angioplasty and stenting, Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional, Established patient office or other outpatient visit, 10-19 minutes, Established patient office or other outpatient visit, 30-39 minutes, Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days, Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days, Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days, Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician, Follow-up hospital inpatient care per day, typically 25 minutes, Follow-up hospital inpatient care per day, typically 35 minutes, Heart rhythm recording continous external ekg over more than 48 hours up to 7 days, Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days, Initial hospital inpatient care per day, typically 50 minutes, Initial hospital inpatient care per day, typically 70 minutes, Injection, regadenoson, 0.1 mg, Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch, Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist, Leg revascularization (restoring blood flow), New patient office or other outpatient visit, 45-59 minutes, Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan, Nuclear medicine studies of heart muscle at rest and with stress and spect, Pacemaker insertion or repair, Programming of dual lead pacemaker system, Review by radiologist of abdominal aorta image, Review by radiologist of both arms or legs arteries image, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report, Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries, Technetium tc-99m tetrofosmin, diagnostic, per study dose, Thallium tl-201 thallous chloride, diagnostic, per millicurie, Ultrasound of both sides of head and neck blood flow, Ultrasound of heart with color-depicted blood flow, rate, direction and valve function, Ultrasound of heart with color-depicted blood flow, rate, direction and valve function, Ultrasound of heart, follow-up, Ultrasound of leg arteries or artery grafts, Ultrasound study of arm and leg arteries, Ultrasound study of one arm or leg veins with compression and maneuvers and Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes.
This NPI record was last updated on November 02, 2007. 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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