DR. DAVID PAUL COHEN M.D
NPI 1972504611
Internal Medicine - Gastroenterology in Gloversville, NY


Quality Rating: 92.04 out of 100 score

NPI Status: Active since August 03, 2005

Contact Information

99 E STATE ST
GLOVERSVILLE, NY
ZIP 12078
Phone: (518) 773-8896

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  • Individual
  • Male
  • Years of Experience 38
  • Internal Medicine
  • Gastroenterology
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About DAVID COHEN

This page provides the complete NPI Profile along with additional information for David Cohen, an internist established in Gloversville, New York with a medical specialization in Internal Medicine, focusing in gastroenterology and more than 38 years of experience. He graduated from State University Of New York Downstate Medical Center in 1988. The healthcare provider is registered in the NPI registry with number 1972504611 assigned on August 2005. The practitioner's primary taxonomy code is 207RG0100X with license number 180164 (NY). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI
1972504611
Provider Name
DR. DAVID PAUL COHEN M.D
Gender
Male
Entity Type
Individual
Location Address
99 E STATE ST GLOVERSVILLE, NY 12078
Location Phone
(518) 773-8896
Mailing Address
99 E STATE ST GLOVERSVILLE, NY 12078
Medical School Name
STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Graduation Year
1988
Is Sole Proprietor?
No
Enumeration Date
08-03-2005
Last Update Date
11-03-2021
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An internist like David Cohen 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 Gastroenterology

Taxonomy Code
207RG0100X
Type
Allopathic & Osteopathic Physicians
License No.
180164
License State
NY
Taxonomy Description
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Insurance Plans Accepted

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

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
01412615MEDICAID (05)NY 
10000358OTHER (01)NYCDPHP
10111OTHER (01)NYMOHAWK VALLEY PHYSICIANS

Medicare Participation & PECOS Enrollment Status

David Cohen 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.

David Cohen 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: 3173688892

    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: I20100907000989

    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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

This service was performed 26 times for 26 patients

Biopsy of large bowel using a flexible endoscope

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

This service was performed 24 times for 24 patients

Colonoscopy

A colonoscopy is a medical procedure that allows your doctor to examine your colon (the large intestine). It utilizes a thin, flexible tube with a tiny camera on the end, which is inserted through the rectum. This procedure can help identify issues such as polyps, inflammation, or early signs of cancer. It's usually recommended for people over 50 or those with specific risk factors.

This service was performed for 228 patients

Established patient office or other outpatient visit, 20-29 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 52 times for 36 patients

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 18 times for 18 patients

New patient office or other outpatient visit, 30-44 minutes

This 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 26 times for 26 patients

New patient office or other outpatient visit, 45-59 minutes

This 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 23 times for 23 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

This service was performed 17 times for 17 patients

Upper gastrointestinal (GI) endoscopy for acid reflux

An upper GI endoscopy is a procedure to examine your esophagus and stomach using a thin, flexible tube called an endoscope. It helps diagnose conditions like acid reflux by identifying any inflammation or damage. It's generally safe, performed under sedation, and takes about 15-30 minutes.

This service was performed for 164 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.6 for a new patient copayment and $24.27 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 12078 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $126.4
  • Minimum New Patient Price $54.87
  • Maximum New Patient Price $166.88
  • Average New Patient Copayment $31.6
  • Minimum New Patient Copayment $13.71
  • Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

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

  • Average Established Patient Price $97.08
  • Minimum Established Patient Price $17.54
  • Maximum Established Patient Price $136.14
  • Average Established Patient Copayment $24.27
  • Minimum Established Patient Copayment $4.38
  • Maximum Established Patient Copayment $34.03

* 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 92.04, 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: 92.04 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: 78.2

    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.

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. David Cohen is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ST MARY'S HEALTHCARE427 GUY PARK AVENUE
AMSTERDAM, NY 12010
(518) 841-7101Acute Care Hospitals
NATHAN LITTAUER HOSPITAL99 EAST STATE STREET
GLOVERSVILLE, NY 12078
(518) 725-8621Acute 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.
1972504611
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
29142100862
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 4 + 2 + 1 + 0 + 0 + 8 + 6 + 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 = 11

The NPI number 1972504611 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 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1154393593 DAVID G HANDRON MD
Individual
Specialist99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 725-0657
1366411068MRS. BETSY MARIE BECKER RPA-C
Individual
Physician Assistant99 E STATE ST NATHAN LITTAUER HOSPITAL & NURSING HOME
GLOVERSVILLE, NY 12078
(518) 775-4205
1669548137MR. CLIFFORD KEITH BALCH RPH
Individual
Pharmacist99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-5577
1609925270 SHANTA VEMUGANTI MD
Individual
Anesthesiology99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-5758
1871644542MRS. LISA ANN FINKENBINDER RD
Individual
Dietitian, Registered99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-5411
1013106111ANESTHESIA ASSOCIATES
Organization
Anesthesiology99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 775-4208
1710116488 MARY CONSTANTINO NP
Individual
Nurse Practitioner99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-5780
1285866616MRS. SANDRA ELLAN BALDWIN MS, RD
Individual
Dietitian, Registered99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-5411
1730404898MR. MICHAEL A STURGESS PHARMD
Individual
Pharmacist99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-5580
1538484258DR. KRISTA KATHRYN KELLY PHARMD
Individual
Pharmacist99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-5580
1750607883MR. ROBERT J STANKES RPH
Individual
Pharmacist99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-5583
1033472295KAMINI S. RAMANI M.D., P.C
Organization
Specialist99 E STATE ST MEDCIAL ARTS BUILDING STE 102
GLOVERSVILLE, NY 12078
(518) 725-6080
1750653044MS. SUSAN LAPORTA PA
Individual
Physician Assistant (Medical)99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-4205
1972842961MS. KATHRYN M TERRY RD
Individual
Dietitian, Registered99 E STATE ST NUTRITION SERVICES
GLOVERSVILLE, NY 12078
(518) 773-5411
1831439280MS. SANDRA LEE BOYD PA-C
Individual
Physician Assistant99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 725-8621
1215350616 OLIVIA BASSETT R.D.
Individual
Dietitian, Registered99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-5284
1407268865 RAKHI KUMAR TANTUWAYA RPH
Individual
Pharmacist99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-5581
1275813123DR. KELSEY E REYNOLDS R.PH
Individual
Pharmacist99 E STATE ST
GLOVERSVILLE, NY 12078
(518) 773-5581
1104804947DR. JOHN A MYCEK MD
Individual
Obstetrics & Gynecology99 E STATE ST MAB SUITE 101
GLOVERSVILLE, NY 12078
(518) 775-4360
1952373144DR. PETER EDWARD DOWLING M.D.
Individual
Obstetrics & Gynecology99 E STATE ST MAB-GPCC
GLOVERSVILLE, NY 12078
(518) 773-5729

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1972504611, enumerated in the NPI registry as an "individual" on August 03, 2005

The provider is located at 99 E State St Gloversville, Ny 12078 and the phone number is (518) 773-8896

The provider's speciality is Internal Medicine with taxonomy code 207RG0100X with a focus in Gastroenterology

The provider has more than 38 years of experience. He graduated from State University Of New York Downstate Medical Center in 1988.

The provider might be accepting Accepts: Medicare and Medicaid. 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 $126.4 with an average copayment of $31.6 for new patient appointments. Established patients should expect a typical charge of $97.08 and an average copayment of 24.27. 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: Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope, Biopsy of large bowel using a flexible endoscope, Colonoscopy, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, New patient office or other outpatient visit, 30-44 minutes, New patient office or other outpatient visit, 45-59 minutes, Removal of polyps or growths of large bowel using an endoscope with mechanical snare and Upper gastrointestinal (GI) endoscopy for acid reflux.

The practitioner is affiliated to the following hospital(s): ST MARY'S HEALTHCARE and NATHAN LITTAUER 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 August 03, 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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