ASHLEY HOUGHTON MD
NPI 1720173834
Internal Medicine - Pulmonary Disease in Pittsburgh, PA


Quality Rating: 95.34 out of 100 score

NPI Status: Active since October 04, 2006

Contact Information

200 LOTHROP ST
PITTSBURGH, PA
ZIP 15213
Phone: (412) 647-3087

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  • Individual
  • Male
  • Years of Experience 30
  • Internal Medicine
  • Pulmonary Disease
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ASHLEY HOUGHTON

This page provides the complete NPI Profile along with additional information for Ashley Houghton, an internist established in Pittsburgh, Pennsylvania with a medical specialization in Internal Medicine, focusing in pulmonary disease and more than 30 years of experience. He graduated from Georgetown University School Of Medicine in 1996. The healthcare provider is registered in the NPI registry with number 1720173834 assigned on October 2006. The practitioner's primary taxonomy code is 207RP1001X with license number MD430091 (PA). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI
1720173834
Provider Name
ASHLEY HOUGHTON MD
Gender
Male
Entity Type
Individual
Location Address
200 LOTHROP ST PITTSBURGH, PA 15213
Location Phone
(412) 647-3087
Mailing Address
3601 5TH AVE PITTSBURGH, PA 15213
Mailing Phone
(412) 648-6161
Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
1996
Is Sole Proprietor?
No
Enumeration Date
10-04-2006
Last Update Date
07-08-2007
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An internist like Ashley Houghton 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.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Pulmonary Disease

Taxonomy Code
207RP1001X
Type
Allopathic & Osteopathic Physicians
License No.
MD430091
License State
PA
Taxonomy Description
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Insurance Plans Accepted

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

  • Premera Blue Cross Alaska One Gold - PPO
  • Premera Blue Cross Preferred Bronze 5800 HSA - PPO
  • Premera Blue Cross Preferred Bronze 6350 - PPO
  • Premera Blue Cross Preferred Gold 1500 - PPO
  • Premera Blue Cross Preferred Silver 4500 - PPO
  • Premera Blue Cross Standard Bronze II - PPO
  • Premera Blue Cross Standard Gold - PPO
  • Premera Blue Cross Standard Silver - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Ashley Houghton 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.

Ashley Houghton 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: 840186078

    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: I20120522001131

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 35 times for 33 patients

New patient office or other outpatient visit, 60-74 minutes

This 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 12 times for 12 patients

Test to determine lung volumes using sensors

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

This service was performed 20 times for 20 patients

Test to examine how well the lungs exchange gases

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

This service was performed 25 times for 25 patients

Test to measure expiratory airflow and volume

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

This service was performed 26 times for 25 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.58 for a new patient copayment and $24.2 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 15213 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $126.34
  • Minimum New Patient Price $54.64
  • Maximum New Patient Price $166.87
  • Average New Patient Copayment $31.58
  • Minimum New Patient Copayment $13.66
  • Maximum New Patient Copayment $41.71

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $96.82
  • Minimum Established Patient Price $17.33
  • Maximum Established Patient Price $135.84
  • Average Established Patient Copayment $24.2
  • Minimum Established Patient Copayment $4.33
  • Maximum Established Patient Copayment $33.96

* 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 95.34, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 95.34 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 75.69

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    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: 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.

Reviews for ASHLEY HOUGHTON MD

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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.
1720173834
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
274027686
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 4 + 0 + 2 + 7 + 6 + 8 + 6 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1720173834 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
1467452011SELECT SPECIALTY HOSPITAL - PITTSBURGH/UPMC INC
Organization
Long Term Care Hospital200 LOTHROP ST MUH E824
PITTSBURGH, PA 15213
(412) 586-9821
1609862796DR. ANNE C VUJEVICH-WARD D.O.
Individual
Anesthesiology200 LOTHROP ST
PITTSBURGH, PA 15213
(412) 647-5909
1609867498DR. ANTHONY F PIZON MD
Individual
Emergency Medicine200 LOTHROP ST FORBES TOWER 9055
PITTSBURGH, PA 15213
(412) 647-7594
1689644460MR. SHAWN PATRICK WEBER CRNA
Individual
Nurse Anesthetist, Certified Registered200 LOTHROP ST
PITTSBURGH, PA 15213
(412) 647-2808
1770554123DR. ADAM S AKERS MD
Individual
Internal Medicine (Critical Care Medicine)200 LOTHROP ST
PITTSBURGH, PA 15213
(412) 647-3136
1356312797DR. ADNAN ADIB ABLA MD
Individual
Neurological Surgery200 LOTHROP ST SUITE 5C
PITTSBURGH, PA 15213
(412) 647-3604
1992776348DR. ALI HUSSAIN AL-KHAFAJI MD
Individual
Specialist200 LOTHROP ST
PITTSBURGH, PA 15213
(412) 647-3136
1124090345DR. DAVID G BEAUDREAU MD
Individual
Specialist200 LOTHROP ST
PITTSBURGH, PA 15213
(412) 647-3260
1962474353DR. RAED SAID ABDULLAH MD
Individual
Specialist200 LOTHROP ST
PITTSBURGH, PA 15213
(412) 647-3396
1710959770DR. ADEEL AJWAD BUTT MD
Individual
Specialist200 LOTHROP ST SUITE 3A, FALK MEDICAL BUILDING
PITTSBURGH, PA 15213
(412) 648-6401
1427020502DR. UBAID AHMAD AKHTAR MD
Individual
Specialist200 LOTHROP ST ROOM 3950 CHP CMT
PITTSBURGH, PA 15213
(412) 647-3510
1740252832DR. ARTHUR J BOUJOUKOS MD
Individual
Specialist200 LOTHROP ST
PITTSBURGH, PA 15213
(412) 647-3136
1275505265DR. FERNANDO L AREVALO MD
Individual
Radiology (Diagnostic Radiology)200 LOTHROP ST ROOM 3950 CHP CMT
PITTSBURGH, PA 15213
(412) 647-3553
1164494175DR. ROBERT MARSHALL AUSTIN MD
Individual
Specialist200 LOTHROP ST BST, SUITE S424
PITTSBURGH, PA 15213
(412) 648-9466
1376515221DR. VICTOR JOHN CATULLO MD
Individual
Specialist200 LOTHROP ST ROOM 3950 CHP CMT
PITTSBURGH, PA 15213
(412) 647-3553
1730151580DR. NEIL ALEXANDER CHRISTIE MD
Individual
Specialist200 LOTHROP ST SUITE 9055
PITTSBURGH, PA 15213
(412) 623-2025
1669444345PROF. JEFFREY A BLACKHURST CRNA
Individual
Nurse Anesthetist, Certified Registered200 LOTHROP ST
PITTSBURGH, PA 15213
(412) 647-5909
1265404941PROF. KATHY R CLAYPOOLE CRNA
Individual
Nurse Anesthetist, Certified Registered200 LOTHROP ST
PITTSBURGH, PA 15213
(412) 647-5909
1528030111DR. DAVID WAYNE CRIPPEN MD
Individual
Specialist200 LOTHROP ST
PITTSBURGH, PA 15213
(412) 647-3136
1083686638DR. GILLES CLERMONT MD
Individual
Specialist200 LOTHROP ST
PITTSBURGH, PA 15213
(412) 647-3136

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720173834, enumerated in the NPI registry as an "individual" on October 04, 2006

The provider is located at 200 Lothrop St Pittsburgh, Pa 15213 and the phone number is (412) 647-3087

The provider's speciality is Internal Medicine with taxonomy code 207RP1001X with a focus in Pulmonary Disease

The provider has more than 30 years of experience. He graduated from Georgetown University School Of Medicine in 1996.

The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska. 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: uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $126.34 with an average copayment of $31.58 for new patient appointments. Established patients should expect a typical charge of $96.82 and an average copayment of 24.2. 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: Established patient office or other outpatient visit, 30-39 minutes, New patient office or other outpatient visit, 60-74 minutes, Test to determine lung volumes using sensors, Test to examine how well the lungs exchange gases and Test to measure expiratory airflow and volume.

This NPI record was last updated on October 04, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.