AMANDA MARIE SEMONCHE DO NPI 1003000530
Internal Medicine in Quakertown, PA
About AMANDA MARIE SEMONCHE DO
Amanda Semonche is an internist established in Quakertown, Pennsylvania and her medical specialization is Internal Medicine with more than 17 years of experience. She graduated from Lake Erie College Of Osteopathic Medicine, Erie in 2006. The NPI number of Amanda Semonche is 1003000530 and was assigned on August 2007. The practitioner's primary taxonomy code is 207R00000X with license number OS014260 (PA). The provider is registered as an individual and her NPI record was last updated 10 years ago.
| NPI | 1003000530 |
| Provider Name | AMANDA MARIE SEMONCHE DO |
| Provider Location Address | 1021 PARK AVE SUITE 203 QUAKERTOWN, PA 18951 |
| Provider Mailing Address | 1021 PARK AVE SUITE 203 QUAKERTOWN, PA 18951 |
| Gender | Female |
| NPI Entity Type | Individual |
| Medical School Name | LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE |
| Graduation Year | 2006 |
| Is Sole Proprietor? | Yes |
| Enumeration Date | 08-28-2007 |
| Last Update Date | 09-14-2012 |
An internist like Amanda Marie Semonche Do 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.Amanda Semonche 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.
Amanda Semonche is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with St Lukes Quakertown Hospital, St Luke's Hospital-easton Campus, St Luke's Hospital Bethlehem and Grand View Health.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 96.4, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $35.88 for a new patient copayment and $27.71 for an established patient copayment.
Primary Taxonomy
| Taxonomy Code | 207R00000X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| License No. | OS014260 |
| License State | PA |
| Taxonomy Description | A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Business Address
AMANDA MARIE SEMONCHE DO
1021 PARK AVE
SUITE 203
QUAKERTOWN, PA
ZIP 18951
Phone: (215) 536-7998
Mailing Address
AMANDA MARIE SEMONCHE DO
1021 PARK AVE
SUITE 203
QUAKERTOWN, PA
ZIP 18951
Phone: (215) 536-7998
PECOS Enrollment and Medicare Participation
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 2163575663 |
| PECOS Enrollment ID | I20090731000112 |
| 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 order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 18951 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99204 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $62.8 | $189.43 | $143.54 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $15.7 | $47.35 | $35.88 |
| Established Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for established patients office visits: 99214 | ||
| Minimum Established Patient Pricing | Maximum Established Patient Pricing | Typical Established Patient Pricing |
| $19.68 | $154.62 | $110.85 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.92 | $38.65 | $27.71 |
* The physician office visit costs information is obtained by Medicare's 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 Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's 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.
| MIPS Measure | Score Weight | Score | |
|---|---|---|---|
| Quality | 40% | 100 | |
|
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 (PI) | 25% | 77.9 | |
|
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. |
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| Improvement Activities | 15% | 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 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. |
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| Cost | 20% | 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. |
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| MIPS Final Score | - | 96.4 | |
| 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. | |||
Clinician Utilization
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 105Administration of influenza virus vaccine (HCPCS:G0008)
- 103Administration of pneumococcal vaccine (HCPCS:G0009)
- 100Pneumococcal vaccine for injection into muscle (HCPCS:90670)
- 24Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
- 19Urinalysis, manual test (HCPCS:81002)
- 11Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
Hospital Affiliations
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Amanda Semonche is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| ST LUKES QUAKERTOWN HOSPITAL | 3000 ST. LUKE'S DRIVE QUAKERTOWN, PA 18951 | (267) 985-1000 | Acute Care Hospitals | 390035 | |
| ST LUKE'S HOSPITAL-EASTON CAMPUS | 250 SOUTH 21ST STREET EASTON, PA 18042 | (610) 250-4076 | Acute Care Hospitals | 390162 | |
| ST LUKE'S HOSPITAL BETHLEHEM | 801 OSTRUM STREET BETHLEHEM, PA 18015 | (610) 954-4000 | Acute Care Hospitals | 390049 | |
| GRAND VIEW HEALTH | 700 LAWN AVENUE SELLERSVILLE, PA 18960 | (215) 453-4615 | Acute Care Hospitals | 390057 |
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| OS014260 | OTHER (01) | PA | MEDICAL LICENSE NUMBER |
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 | 0 | 0 | 3 | 0 | 0 | 0 | 5 | 3 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 0 | 0 | 5 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 0 + 0 + 0 + 5 + 6 + 24 = 40 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1003000530 is valid because the calculated check digit 0 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 |
|---|---|---|---|
| 1346249208 | JOSEPH P CAMPBELL III DPM Individual | Podiatrist (Foot & Ankle Surgery) | 1021 PARK AVE SUITE 100A QUAKERTOWN, PA 18951 (215) 538-1660 |
| 1215937305 | JAY MARK SPRINGER MD Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 1021 PARK AVE SUITE 200 QUAKERTOWN, PA 18951 (215) 538-2004 |
| 1366435554 | WAYNE C STUART MD Individual | Orthopaedic Surgery | 1021 PARK AVE QUAKERTOWN, PA 18951 (215) 538-4500 |
| 1477542512 | DR. ERIN MARIE FLY D.O. Individual | Internal Medicine | 1021 PARK AVE SUITE 101 QUAKERTOWN, PA 18951 (215) 538-1111 |
| 1780673822 | QUAKERTOWN INTERNAL MEDICINE ASSOCIATES, INC. Organization | Internal Medicine | 1021 PARK AVE SUITE 101 QUAKERTOWN, PA 18951 (215) 538-1111 |
| 1346230174 | DR. JON HOWARD SCHWARTZ M.D. Individual | Internal Medicine | 1021 PARK AVE SUITE 101 QUAKERTOWN, PA 18951 (215) 538-1111 |
| 1700876653 | DR. PAUL WESLEY WEIBEL JR. Individual | Internal Medicine | 1021 PARK AVE SUITE 101 QUAKERTOWN, PA 18951 (215) 538-1111 |
| 1689664542 | DR. GERRIANNE BURKE M.D. Individual | Internal Medicine | 1021 PARK AVE SUITE 101 QUAKERTOWN, PA 18951 (215) 538-1111 |
| 1982694840 | DR. CSABA G BERCES M.D. Individual | Internal Medicine | 1021 PARK AVE SUITE 101 QUAKERTOWN, PA 18951 (215) 538-1111 |
| 1750336772 | JUDITH M ILLINGWORTH LCSW Individual | Social Worker (Clinical) | 1021 PARK AVE SUITE 10 QUAKERTOWN, PA 18951 (215) 529-9240 |
| 1912944935 | BUXMONT ENDOCRINOLOGY PC Organization | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 1021 PARK AVE SUITE 200 QUAKERTOWN, PA 18951 (215) 538-2004 |
| 1225052616 | ST. LUKE'S QUAKERTOWN HOSPITAL Organization | Pathology (Anatomic Pathology & Clinical Pathology) | 1021 PARK AVE QUAKERTOWN, PA 18951 (610) 954-4558 |
| 1487667176 | ST. LUKE'S PHYSICIAN GROUP, INC. Organization | Radiology (Diagnostic Radiology) | 1021 PARK AVE QUAKERTOWN, PA 18951 (215) 538-4610 |
| 1831204437 | DONNA DISPAS-GEBERT R.D.,CDE,LDN Individual | Dietitian, Registered | 1021 PARK AVE SAINT LUKE'S QUAKERTOWN HOSPITAL QUAKERTOWN, PA 18951 (215) 538-4621 |
| 1891807475 | DR. THOMAS ALAN FILIPOWICZ MD Individual | Emergency Medicine | 1021 PARK AVE ST. LUKE'S QUAKERTOWN HOSPITAL QUAKERTOWN, PA 18951 (215) 538-4561 |
| 1841388659 | BRUCE T. EISENHARDT DO Individual | Emergency Medicine | 1021 PARK AVE QUAKERTOWN, PA 18951 (215) 538-4561 |
| 1437247152 | ANA MARIA PEREZ M.D. Individual | Emergency Medicine | 1021 PARK AVE QUAKERTOWN, PA 18951 (215) 538-4561 |
| 1740378462 | DARWIN L. KENEPP M.D. Individual | Emergency Medicine | 1021 PARK AVE QUAKERTOWN, PA 18951 (215) 538-4561 |
| 1033296157 | ST. LUKE'S QUAKERTOWN HOSPITAL Organization | Emergency Medicine | 1021 PARK AVE QUAKERTOWN, PA 18951 (215) 538-4561 |
| 1457422925 | DR. DAVID EDWARD TWARDZIK M.D. Individual | Dermatology | 1021 PARK AVE SUITE 30 QUAKERTOWN, PA 18951 (215) 538-2500 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
Amanda Marie Semonche Do is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:
- 1 = Person: individual human being who furnishes health care.
- 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.