LEILANI NORTON M.D.
NPI 1942215629
Ophthalmology in Placerville, CA
Quality Rating: 86.26 out of 100 score
NPI Status: Active since July 30, 2006
Contact Information
4300 GOLDEN CENTER DR
STE A
PLACERVILLE, CA
ZIP 95667
Phone: (530) 344-2020
Fax: (530) 622-9613
- NPI Profile Information
- Primary Taxonomy
- Group Taxonomy
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Overall Quality Performance
- Quality Reporting
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Female
- Years of Experience 44
- Ophthalmology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About LEILANI NORTON
This page provides the complete NPI Profile along with additional information for Leilani Norton, a provider established in Placerville, California with a medical specialization in Ophthalmology and more than 44 years of experience. She graduated from Loma Linda University School Of Medicine in 1982. The healthcare provider is registered in the NPI registry with number 1942215629 assigned on July 2006. The practitioner's primary taxonomy code is 207W00000X with license number G50455 (CA). The provider is registered as an individual and her NPI record was last updated 18 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization.
- NPI
- 1942215629
- Provider Name
- LEILANI NORTON M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4300 GOLDEN CENTER DR STE A PLACERVILLE, CA 95667
- Location Phone
- (530) 344-2020
- Location Fax
- (530) 622-9613
- Mailing Address
- 4300 GOLDEN CENTER DR STE A PLACERVILLE, CA 95667
- Mailing Phone
- (530) 344-2020
- Mailing Fax
- (530) 622-9613
- Medical School Name
- LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 1982
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 07-30-2006
- Last Update Date
- 07-09-2007
- Code Navigator
Ophthalmologists like Leilani Norton specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
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
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- G50455
- License State
- CA
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- Blue Precision Bronze HMO? 205 - HMO
- Blue Focus Bronze POS? 205 - POS
- Blue Focus Bronze POS? 705 - POS
- Blue Focus Bronze POS? Standard - POS
- Blue Focus Gold POS? 207 - POS
- Blue Focus Gold POS? Standard - POS
- Blue Focus Silver POS? 206 - POS
- Blue Focus Silver POS? Standard - POS
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Advantage Bronze PPO? 202 - PPO
- Blue Advantage Bronze PPO? 203 - PPO
- Blue Advantage Bronze PPO? Standard - PPO
- Blue Advantage Gold PPO? 309 - PPO
- Blue Advantage Gold PPO? 604 - PPO
- Blue Advantage Gold PPO? Standard - PPO
- Blue Advantage Silver PPO? 204 - PPO
- Blue Advantage Silver PPO? 501 - PPO
- Blue Advantage Silver PPO? Standard - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
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 |
|---|---|---|---|
| G50455 | OTHER (01) | CA | CA STATE LICENSE |
| ZZZ00637Z | MEDICARE ID-TYPE UNSPECIFIED (04) | CA | MEDICARE GROUP ID |
| GR0065830 | MEDICAID (05) | CA |
Medicare Participation & PECOS Enrollment Status
Leilani Norton 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.
Leilani Norton 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: 7719032424
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: I20090902000186
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.
Unknown
Other-Vision, Hearing, and Speech Services (OC000N)
Frames, purchases (HCPCS:V2020)
3 DME suppliers used 16 Medicare Claims 16 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.
Cataract surgery
Complex removal of cataract with insertion of prosthetic lens
Established patient complete exam of visual system
Established patient office or other outpatient visit, 20-29 minutes
Established patient problem focused exam of visual system
Exam of visual field with extended testing
Extended exam involving color vision testing
Imaging of optic nerve
Imaging of retina
Measurement of corneal curvature and depth of eye
New patient complete exam of visual system
New patient office or other outpatient visit, 30-44 minutes
Photography of the retina
Removal of cataract with insertion of prosthetic lens
Removal of eyelashes using forceps
Removal of recurring cataract in lens capsule using a laser
Ultrasound scan of cornea to determine thickness
Cataract surgery is a procedure to remove the lens of your eye when it becomes cloudy, which is called a cataract. A synthetic lens is then inserted to restore clear vision. The operation is typically done on an outpatient basis and is very safe and effective.
This service was performed for 246 patientsThis procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.
This service was performed 19 times for 12 patientsAn established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
This service was performed 530 times for 520 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 102 times for 95 patientsThis is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
This service was performed 572 times for 397 patientsAn extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
This service was performed 214 times for 209 patientsAn extended exam involving color vision testing helps identify any difficulties in distinguishing colors, often due to genetic conditions or health problems. This non-invasive test involves identifying different colored numbers or patterns.
This service was performed 12 times for 12 patientsImaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
This service was performed 411 times for 206 patientsImaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
This service was performed 43 times for 22 patientsThis procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
This service was performed 210 times for 134 patientsA new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
This service was performed 98 times for 98 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 18 times for 18 patientsPhotography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
This service was performed 212 times for 206 patientsThis is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
This service was performed 167 times for 105 patientsThe removal of eyelashes using forceps is a simple procedure where a medical professional gently extracts unwanted or problematic eyelashes with a specialized tool. This is often done to alleviate discomfort or to treat conditions like trichiasis, where eyelashes grow inward.
This service was performed 64 times for 34 patientsThis procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
This service was performed 67 times for 57 patientsAn ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.
This service was performed 19 times for 19 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $34.3 for a new patient copayment and $18.75 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 95667 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $137.2
- Minimum New Patient Price $60.44
- Maximum New Patient Price $180.85
- Average New Patient Copayment $34.3
- Minimum New Patient Copayment $15.11
- Maximum New Patient Copayment $45.21
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $75.03
- Minimum Established Patient Price $19.88
- Maximum Established Patient Price $148.15
- Average Established Patient Copayment $18.75
- Minimum Established Patient Copayment $4.97
- Maximum Established Patient Copayment $37.03
* 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 86.26, 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: 86.26 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: 89.99
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: 67.54
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: 67.54
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 76% | 266 |
| Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for preventing progression of AMD | ||
| Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 79% | 266 |
| Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage AND the level of macular degeneration severity during one or more office visits within 12 months | ||
| Closing the Referral Loop: Receipt of Specialist Report | 83% | 83 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred | ||
| Diabetes: Eye Exam | 91% | 206 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care | 92% | 38 |
| Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months | ||
| Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy | 82% | 44 |
| Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months | ||
| Documentation of Current Medications in the Medical Record | 94% | 4819 |
| 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 | 85% | 462 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 34% | 58 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Medication Reconciliation | 97% | 29 |
| 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 | 72% | 1781 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 51% | 100 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 49% | 45 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 91% | 397 |
| Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 100% | 1781 |
| 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. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| 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. | 1398 |
| 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 | 9 | 4 | 2 | 2 | 1 | 5 | 6 | 2 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 8 | 2 | 4 | 1 | 10 | 6 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 8 + 2 + 4 + 1 + 1 + 0 + 6 + 4 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1942215629 is valid because the calculated check digit 9 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 |
|---|---|---|---|
| 1033108394 | MR. RONALD EUGENE THOMPSON PT Individual | Physical Therapist | 4300 GOLDEN CENTER DR SUITE B PLACERVILLE, CA 95667 (530) 344-2045 |
| 1003867359 | ROBERT JARKA M.D. Individual | Anesthesiology (Pain Medicine) | 4300 GOLDEN CENTER DR SUITE E PLACERVILLE, CA 95667 (530) 344-1680 |
| 1457393639 | WESTERN SIERRA ORTHOPAEDIC CENTER INC Organization | Orthopaedic Surgery | 4300 GOLDEN CENTER DR SUITE C PLACERVILLE, CA 95667 (530) 344-2070 |
| 1972546752 | MR. RON L KOPITZKE P.T., DPT., OCS Individual | Physical Therapist | 4300 GOLDEN CENTER DR SUITE B PLACERVILLE, CA 95667 (530) 344-2045 |
| 1093721938 | DOUGLAS S BISHOP M.D. Individual | Ophthalmology | 4300 GOLDEN CENTER DR STE A PLACERVILLE, CA 95667 (530) 344-2020 |
| 1891701744 | RONALD C EVANS M.D. Individual | Ophthalmology | 4300 GOLDEN CENTER DR STE A PLACERVILLE, CA 95667 (530) 344-2020 |
| 1821008236 | RON L KOPITZKE PT, DPT OCS Organization | Specialist | 4300 GOLDEN CENTER DR SUITE B PLACERVILLE, CA 95667 (530) 344-2045 |
| 1457571846 | DR. ROBERT EMMETT ANDERSON DDS Individual | Dentist (General Practice) | 4300 GOLDEN CENTER DR SUITE G PLACERVILLE, CA 95667 (530) 622-9068 |
| 1962793968 | ROBERT E ANDERSON DDS A PROFESSIONAL DENTAL CORP Organization | Dentist (General Practice) | 4300 GOLDEN CENTER DR SUITE G PLACERVILLE, CA 95667 (530) 622-9068 |
| 1508861881 | EL DORADO SURGERY CENTER, INC. Organization | Clinic/Center (Ambulatory Surgical) | 4300 GOLDEN CENTER DR STE E PLACERVILLE, CA 95667 (530) 344-1687 |
| 1700900966 | CEDAR EYE CENTER MEDICAL GROUP Organization | Ophthalmology | 4300 GOLDEN CENTER DR SUITE A PLACERVILLE, CA 95667 (530) 344-2020 |
| 1063880276 | BAKER MEDICAL MANAGEMENT, INC. Organization | Nurse Anesthetist, Certified Registered | 4300 GOLDEN CENTER DR SUITE E PLACERVILLE, CA 95667 (530) 344-1680 |
| 1063454445 | TROY S DICKSON M.D. Individual | Orthopaedic Surgery | 4300 GOLDEN CENTER DR SUITE C PLACERVILLE, CA 95667 (530) 344-2070 |
| 1407890924 | CHRISTOPHER J MOLITOR M.D. Individual | Orthopaedic Surgery | 4300 GOLDEN CENTER DR SUITE C PLACERVILLE, CA 95667 (530) 344-2070 |
| 1821034539 | STEPHEN M CYPHERS M. D. Individual | Orthopaedic Surgery | 4300 GOLDEN CENTER DR SUITE C PLACERVILLE, CA 95667 (530) 344-2070 |
| 1932145265 | WARREN TAYLOR VANCE M. D. Individual | Orthopaedic Surgery | 4300 GOLDEN CENTER DR SUITE C PLACERVILLE, CA 95667 (530) 344-2070 |
| 1710936976 | DR. REGINALD DIETEL RICE JR. M.D. Individual | Otolaryngology (Otolaryngology/Facial Plastic Surgery) | 4300 GOLDEN CENTER DR SUITE D PLACERVILLE, CA 95667 (530) 344-2000 |
| 1487757779 | ROBERT A CHASE M.D. Individual | Otolaryngology | 4300 GOLDEN CENTER DR SUITE D PLACERVILLE, CA 95667 (530) 344-2000 |
| 1942323464 | MICHELLE ANN THROP M.S. Individual | Audiologist | 4300 GOLDEN CENTER DR SUITE D PLACERVILLE, CA 95667 (530) 344-2000 |
| 1578872784 | MARSHALL MEDICAL CENTER Organization | Otolaryngology | 4300 GOLDEN CENTER DR SUITE D PLACERVILLE, CA 95667 (530) 344-2000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1942215629, enumerated in the NPI registry as an "individual" on July 30, 2006
The provider is located at 4300 Golden Center Dr Ste A Placerville, Ca 95667 and the phone number is (530) 344-2020
The provider's speciality is Ophthalmology with taxonomy code 207W00000X
The provider has more than 44 years of experience. She graduated from Loma Linda University School Of Medicine in 1982.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Blue Cross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), 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 $137.2 with an average copayment of $34.3 for new patient appointments. Established patients should expect a typical charge of $75.03 and an average copayment of 18.75. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Cataract surgery, Complex removal of cataract with insertion of prosthetic lens, Established patient complete exam of visual system, Established patient office or other outpatient visit, 20-29 minutes, Established patient problem focused exam of visual system, Exam of visual field with extended testing, Extended exam involving color vision testing, Imaging of optic nerve, Imaging of retina, Measurement of corneal curvature and depth of eye, New patient complete exam of visual system, New patient office or other outpatient visit, 30-44 minutes, Photography of the retina, Removal of cataract with insertion of prosthetic lens, Removal of eyelashes using forceps, Removal of recurring cataract in lens capsule using a laser and Ultrasound scan of cornea to determine thickness.
This NPI record was last updated on July 30, 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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