STEPHEN DYER DOWNS M.D.
NPI 1750389516
Family Medicine in Leesville, LA
Quality Rating: 75 out of 100 score
NPI Status: Active since July 14, 2005
Contact Information
900 S 6TH ST
LEESVILLE, LA
ZIP 71446
Phone: (337) 392-8118
Fax: (817) 284-9859
- Individual
- Male
- Years of Experience 31
- Family Medicine
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About STEPHEN DOWNS
This page provides the complete NPI Profile along with additional information for Stephen Downs, a primary care provider established in Leesville, Louisiana with a medical specialization in Family Medicine and more than 31 years of experience. He graduated from Louisiana State University School Of Medicine In New Orleans in 1995. The healthcare provider is registered in the NPI registry with number 1750389516 assigned on July 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 12683R (LA). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1750389516
- Provider Name
- STEPHEN DYER DOWNS M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 900 S 6TH ST LEESVILLE, LA 71446
- Location Phone
- (337) 392-8118
- Location Fax
- (817) 284-9859
- Mailing Address
- 3704 NORTH BLVD SUITE C ALEXANDRIA, LA 71301
- Mailing Phone
- (318) 443-4576
- Mailing Fax
- (817) 284-9859
- Medical School Name
- LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
- Graduation Year
- 1995
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 07-14-2005
- Last Update Date
- 07-09-2024
- Code Navigator
A primary care provider (PCP) like Stephen Downs sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 12683R
- License State
- LA
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- 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
- CHRISTUS Bronze - HMO
- CHRISTUS Bronze Essential - HMO
- CHRISTUS Bronze Essential Plus - HMO
- CHRISTUS Bronze Plus - HMO
- CHRISTUS Catastrophic - HMO
- CHRISTUS Gold - HMO
- CHRISTUS Gold Essential - HMO
- CHRISTUS Gold Essential Plus - HMO
- CHRISTUS Gold Plus - HMO
- CHRISTUS Silver - HMO
- Blue POS 60/40 $6500 - POS
- Blue POS 70/50 $4550 - POS
- Blue POS 80/60 $3200 - POS
- Blue POS Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - POS
- Blue POS Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - POS
- Blue POS Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan - POS
- Blue POS Copay (PCP, Specialist, Urgent Care) 80/60 $1000 - POS
- Essential Bronze 6500 - POS
- Essential Gold 1500 - POS
- Freedom Silver 4000 - POS
- Savings Bronze 7700 - POS
- Standard Bronze 7500 - POS
- Standard Gold 1500 - POS
- Standard Silver 5000 - POS
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 |
|---|---|---|---|
| 1542857 | MEDICAID (05) | LA |
Medicare Participation & PECOS Enrollment Status
Stephen Downs is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Stephen Downs 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: 2163469693
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: I20050415000072
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Injection of drug or substance under skin or into muscle
Injection, methylprednisolone acetate, 80 mg
New patient office or other outpatient visit, 45-59 minutes
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 136 times for 111 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 488 times for 264 patientsThis procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
This service was performed 27 times for 25 patientsMethylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.
This service was performed 24 times for 21 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 125 times for 125 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 71446 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.6
- Minimum New Patient Price $53.43
- Maximum New Patient Price $164.73
- Average New Patient Copayment $20.9
- Minimum New Patient Copayment $13.35
- Maximum New Patient Copayment $41.18
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.09
- Minimum Established Patient Price $16.64
- Maximum Established Patient Price $133.62
- Average Established Patient Copayment $23.77
- Minimum Established Patient Copayment $4.16
- Maximum Established Patient Copayment $33.4
* 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 75, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 75 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: N/A
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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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: N/A
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
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 |
|---|---|---|
| Care Plan | 100% | 468 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| Documentation of Current Medications in the Medical Record | 100% | 2346 |
| 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 | ||
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 93% | 998 |
| 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: Tobacco Use: Screening and Cessation Intervention | 78% | 94 |
| 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 | ||
| Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 97% | 633 |
| Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol 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. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Stephen Downs is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| CHRISTUS ST FRANCES CABRINI HOSPITAL | 3330 MASONIC DRIVE ALEXANDRIA, LA 71301 | (318) 487-1122 | Acute Care Hospitals | |
| CHRISTUS CENTRAL LOUISIANA SURGICAL HOSPITAL | 651 NORTH BOLTON AVE ALEXANDRIA, LA 71301 | (318) 449-6400 | Acute Care Hospitals |
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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 | 7 | 5 | 0 | 3 | 8 | 9 | 5 | 1 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 10 | 0 | 6 | 8 | 18 | 5 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 0 + 0 + 6 + 8 + 1 + 8 + 5 + 2 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1750389516 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1932196300 | LEESVILLE REHABILITATION HOSPITAL LLC Organization | Rehabilitation Hospital | 900 S 6TH ST LEESVILLE, LA 71446 (337) 392-8118 |
| 1124365226 | MS. VICKI RENEE WILLIAMS LMSW Individual | Social Worker | 900 S 6TH ST LEESVILLE, LA 71446 (337) 392-8118 |
| 1922671395 | POST-ACUTE PHYSICIANS OF LOUISIANA, LLC Organization | Physical Medicine & Rehabilitation | 900 S 6TH ST LEESVILLE, LA 71446 (877) 749-7428 |
| 1750444170 | DR. THOMAS CHARLES LABORDE M.D. Individual | Physical Medicine & Rehabilitation | 900 S 6TH ST LEESVILLE, LA 71446 (877) 749-7428 |
| 1710647532 | ANITA THIBODEAUX NP Individual | Nurse Practitioner | 900 S 6TH ST LEESVILLE, LA 71446 (337) 392-8118 |
| 1992124697 | REHABILITATION HOSPITAL OF LEESVILLE LLC Organization | Rehabilitation Hospital | 900 S 6TH ST LEESVILLE, LA 71446 (337) 392-8118 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750389516, enumerated in the NPI registry as an "individual" on July 14, 2005
The provider is located at 900 S 6th St Leesville, La 71446 and the phone number is (337) 392-8118
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider has more than 31 years of experience. He graduated from Louisiana State University School Of Medicine In New Orleans in 1995.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Louisiana, CHRISTUS. 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.
Medicare beneficiaries should expect a typical cost of $83.6 with an average copayment of $20.9 for new patient appointments. Established patients should expect a typical charge of $95.09 and an average copayment of 23.77. 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, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Injection of drug or substance under skin or into muscle, Injection, methylprednisolone acetate, 80 mg and New patient office or other outpatient visit, 45-59 minutes.
The practitioner is affiliated to the following hospital(s): CHRISTUS ST FRANCES CABRINI HOSPITAL and CHRISTUS CENTRAL LOUISIANA SURGICAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on July 14, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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