MICHELE LYNN O'HARA NP
NPI 1770590911
Nurse Practitioner - Acute Care in Columbia, SC
Quality Rating: 98.29 out of 100 score
NPI Status: Active since August 01, 2006
Contact Information
1850 LAUREL ST
COLUMBIA, SC
ZIP 29201
Phone: (803) 256-3400
Fax: (803) 256-2039
- Individual
- Female
- Years of Experience 30
- Nurse Practitioner
- Acute Care
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MICHELE O'HARA
This page provides the complete NPI Profile along with additional information for Michele O'hara, a provider established in Columbia, South Carolina with a medical specialization in Nurse Practitioner, focusing in acute care and more than 30 years of experience. She graduated from University Of Connecticut School Of Medicine in 1996. The healthcare provider is registered in the NPI registry with number 1770590911 assigned on August 2006. The practitioner's primary taxonomy code is 363LA2100X with license number 226 (SC). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1770590911
- Provider Name
- MICHELE LYNN O'HARA NP
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1850 LAUREL ST COLUMBIA, SC 29201
- Location Phone
- (803) 256-3400
- Location Fax
- (803) 256-2039
- Mailing Address
- PO BOX 743904 ATLANTA, GA 30374
- Mailing Phone
- (803) 296-7329
- Mailing Fax
- (803) 256-2039
- Medical School Name
- UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
- Graduation Year
- 1996
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-01-2006
- Last Update Date
- 09-06-2018
- Code Navigator
A nurse practitioner (NP) like Michele O'hara is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, 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
Nurse Practitioner Acute Care
- Taxonomy Code
- 363LA2100X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 226
- License State
- SC
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 364SA2100X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | R80085 (SC) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Complete Silver with Atrium Health - HMO
- Complete Silver with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Blue Direction Silver 1 - POS
- Blue Direction Silver 1 + Adult Vision - POS
- Blue Direction Silver 2 - POS
- Blue Direction Standard Gold - POS
- Blue Direction Standard Silver - POS
- Blue VirtuConnect Bronze 1 - EPO
- Blue VirtuConnect Gold 1 - EPO
- Blue VirtuConnect Silver 1 - EPO
- BlueEssentials Bronze 4 - EPO
- BlueEssentials Bronze 6 - EPO
- Standard Expanded Bronze WellCare - PPO
- Standard Gold WellCare - PPO
- Standard Silver WellCare - PPO
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 |
---|---|---|---|
NP0321 | MEDICAID (05) | SC |
Medicare Participation & PECOS Enrollment Status
Michele O'hara 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.
Michele O'hara 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: 5890968341
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: I20111028000683
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
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.79 for a new patient copayment and $23.78 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 29201 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.18
- Minimum New Patient Price $53.57
- Maximum New Patient Price $163.84
- Average New Patient Copayment $20.79
- Minimum New Patient Copayment $13.39
- Maximum New Patient Copayment $40.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.12
- Minimum Established Patient Price $16.96
- Maximum Established Patient Price $133.52
- Average Established Patient Copayment $23.78
- Minimum Established Patient Copayment $4.24
- Maximum Established Patient Copayment $33.38
* 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 98.29, 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: 98.29 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: 87.84
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: 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.
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. Michele O'hara is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
PRISMA HEALTH RICHLAND HOSPITAL | 5 MEDICAL PARK COLUMBIA, SC 29203 | (803) 296-2548 | Acute Care Hospitals | |
PRISMA HEALTH TUOMEY HOSPITAL | 129 N WASHINGTON ST SUMTER, SC 29150 | (803) 296-2548 | Acute Care Hospitals | |
PRISMA HEALTH BAPTIST | 1330 TAYLOR AT MARION ST COLUMBIA, SC 29220 | (803) 296-5678 | 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 | 7 | 0 | 5 | 9 | 0 | 9 | 1 | 1 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 7 | 14 | 0 | 10 | 9 | 0 | 9 | 2 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 7 + 1 + 4 + 0 + 1 + 0 + 9 + 0 + 9 + 2 + 24 = 59 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 59 = 1 | 1 |
The NPI number 1770590911 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 14 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1972509925 | DR. DONEN DAVIS M.D. Individual | Plastic Surgery | 1850 LAUREL ST STE B COLUMBIA, SC 29201 (803) 929-1901 |
1588642169 | ROBERT HOLT BUNCH M.D., F.A.C.S. Individual | Surgery | 1850 LAUREL ST COLUMBIA, SC 29201 (803) 256-3400 |
1285612739 | CARL ALDEN SWEATMAN JR. MD, FACS Individual | Surgery | 1850 LAUREL ST COLUMBIA, SC 29201 (803) 256-3400 |
1508094871 | PALMETTO HEALTH Organization | Surgery | 1850 LAUREL ST SUITE 1A COLUMBIA, SC 29201 (803) 296-7305 |
1699953331 | DONEN DAVIS PLASTIC SURGERY, LLC Organization | Plastic Surgery | 1850 LAUREL ST SUITE B COLUMBIA, SC 29201 (803) 929-1901 |
1144467051 | PALMETTO HEALTH Organization | Surgery | 1850 LAUREL ST COLUMBIA, SC 29201 (803) 256-3400 |
1467971473 | JILLIAN CLINTON Individual | Dietitian, Registered | 1850 LAUREL ST COLUMBIA, SC 29201 (803) 376-4982 |
1619468774 | PALMETTO HEALTH - UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP Organization | Surgery | 1850 LAUREL ST COLUMBIA, SC 29201 (803) 256-3400 |
1245218700 | JAMES BENJAMIN TRIBBLE M.D .F.A.C.S. Individual | Surgery | 1850 LAUREL ST COLUMBIA, SC 29201 (803) 256-3400 |
1043298516 | DALTON SHULER PRICKETT M.D. F.A.C.S. Individual | Surgery | 1850 LAUREL ST COLUMBIA, SC 29201 (803) 256-3400 |
1811975253 | SURGICAL ASSOCIATES OF SOUTH CAROLINA P.A. Organization | Surgery | 1850 LAUREL ST COLUMBIA, SC 29201 (803) 256-3400 |
1053752105 | DR. IGBAGBOYEMI TEMIDAYO OLATUNDE M.D Individual | Internal Medicine | 1850 LAUREL ST COLUMBIA, SC 29201 (803) 376-5982 |
1629228549 | DR. RATNAKISHORE PALLAPOTHU MD Individual | Surgery | 1850 LAUREL ST COLUMBIA, SC 29201 (803) 256-3400 |
1750488490 | MRS. SANDI R. VANHOOSIER PHYSICIAN ASSISTANT Individual | Physician Assistant | 1850 LAUREL ST COLUMBIA, SC 29201 (803) 256-3400 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770590911, enumerated in the NPI registry as an "individual" on August 01, 2006
The provider is located at 1850 Laurel St Columbia, Sc 29201 and the phone number is (803) 256-3400
The provider's speciality is Nurse Practitioner with taxonomy code 363LA2100X with a focus in Acute Care
The provider has more than 30 years of experience. She graduated from University Of Connecticut School Of Medicine in 1996.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. 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 , uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $83.18 with an average copayment of $20.79 for new patient appointments. Established patients should expect a typical charge of $95.12 and an average copayment of 23.78. Please review your insurance plan or contact the provider directly to determine your specific costs.
The practitioner is affiliated to the following hospital(s): PRISMA HEALTH RICHLAND HOSPITAL, PRISMA HEALTH TUOMEY HOSPITAL and PRISMA HEALTH BAPTIST. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on August 01, 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].
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