JULIETTE A. ZUMWALT P.A. NPI 1003000738
Physician Assistant in Houston, TX
About JULIETTE A. ZUMWALT P.A.
Juliette Zumwalt is a primary care provider established in Houston, Texas and her medical specialization is Physician Assistant with more than 17 years of experience. The healthcare provider is registered in the NPI registry with number 1003000738 assigned on September 2007. The practitioner's primary taxonomy code is 363A00000X with license number PA05374 (TX). The provider is registered as an individual and her NPI record was last updated 13 years ago.
| NPI | 1003000738 |
| Provider Name | JULIETTE A. ZUMWALT P.A. |
| Location Address | 7401 S. MAIN HOUSTON, TX 77030 |
| Location Phone | (713) 799-2300 |
| Mailing Address | 7401 S. MAIN HOUSTON, TX 77030 |
| Gender | Female |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 2007 |
| Is Sole Proprietor? | No |
| Enumeration Date | 09-06-2007 |
| Last Update Date | 08-11-2010 |
A primary care provider (PCP) like Juliette Zumwalt sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc Juliette Zumwalt 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.
Juliette Zumwalt 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 Texas Orthopedic Hospital.
The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: documentation of current medications in the medical record, engagement of patients through implementation of improvements in patient portal, improved practices that engage patients pre-visit, medication reconciliation, patient-specific education, preventive care and screening: body mass index (bmi) screening and follow-up plan, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, provide patient access, secure messaging and security risk analysis. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.
The typical physician office visit costs for Medicare beneficiaries in this area are: $23.3 for a new patient copayment and $18.96 for an established patient copayment.
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.
| Taxonomy Code | 363A00000X |
| Classification | Physician Assistant |
| Type | Physician Assistants & Advanced Practice Nursing Providers |
| License No. | PA05374 |
| License State | TX |
| Taxonomy Description | A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Blue Cross Blue Shield
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
7401 S. MAIN
HOUSTON, TX
ZIP 77030
Phone: (713) 799-2300
Fax: (713) 794-3380
Mailing Address
7401 S. MAIN
HOUSTON, TX
ZIP 77030
Phone: (713) 799-2300
Fax: (713) 794-3380
Location Map
PECOS Enrollment and Medicare Participation Status
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 Medicare providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in the Medicare program need to enroll in PECOS with their NPI number to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 941399836 |
| PECOS Enrollment ID | I20071129000552 |
| 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 or refer Durable Medical Equipment (DMEPOS) | Yes |
| Eligible order r refer Home Health Agency (HHA) | Yes |
| Eligible order r 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 77030 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99203 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $60.64 | $183.87 | $93.23 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $15.16 | $45.96 | $23.3 |
| Established Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for established patients office visits: 99213 | ||
| Minimum Established Patient Pricing | Maximum Established Patient Pricing | Typical Established Patient Pricing |
| $18.93 | $150.28 | $75.86 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.73 | $37.57 | $18.96 |
* 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.
Quality Reporting
The following quality measures meet Medicare's statistical reporting standards for the year 2018. 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 |
|---|---|---|
| Documentation of Current Medications in the Medical Record | 98% | 430 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Engagement of patients through implementation of improvements in patient portal | Yes | N/A |
| Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence. | ||
| Improved Practices that Engage Patients Pre-Visit | Yes | N/A |
| Implementation of workflow changes that engage patients prior to the visit, such as a pre-visit development of a shared visit agenda with the patient, or targeted pre-visit laboratory testing that will be resulted and available to the MIPS eligible clinician to review and discuss during the patient’s appointment.. | ||
| Medication Reconciliation | 97% | 660 |
| 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 | 0% | 805 |
| 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. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 17% | 64 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| 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 | 76% | 805 |
| 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. | ||
| Secure Messaging | 77% | 805 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| 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. | ||
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.
- 56Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
- 40Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance (HCPCS:20611)
- 14X-ray of shoulder, minimum of 2 views (HCPCS:73030)
- 14X-ray of knee, 3 views (HCPCS:73562)
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. Juliette Zumwalt is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| TEXAS ORTHOPEDIC HOSPITAL | 7401 SOUTH MAIN STREET HOUSTON, TX 77030 | (713) 799-8600 | Acute Care Hospitals | 450804 |
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 |
|---|---|---|---|
| 191576101 | MEDICAID (05) | TX | |
| 8Y2794 | OTHER (01) | TX | BCBS |
| 8K0536 | MEDICARE PIN (08) | TX |
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 | 7 | 3 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 0 | 0 | 7 | 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 + 7 + 6 + 24 = 42 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 42 = 8 | 8 | ||||||||
The NPI number 1003000738 is valid because the calculated check digit 8 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 |
|---|---|---|---|
| 1952399347 | DR. ALAN E HEILMAN M.D. Individual | Orthopaedic Surgery (Orthopaedic Surgery of the Spine) | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1689664732 | SONIA LYNN RICH R.N.F.A.,O.P.A.C. Individual | Registered Nurse (Orthopedic) | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1376585851 | YOMNA T MONLA M.D. Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1013021534 | KAREN ANN GUNTER P.A. Individual | Physician Assistant (Surgical) | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1881865574 | JOHN O BISHOP M.D. Individual | Orthopaedic Surgery (Foot and Ankle Surgery) | 7401 S. MAIN HOUSTON, TX 77030 (713) 794-3339 |
| 1518100684 | CHARLES E BAKER M.D. Individual | Orthopaedic Surgery | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1164721460 | ALISHA SMITH PTA Individual | Physical Therapist | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1376832329 | SAMANTHA NEDELMAN LEE P.A. Individual | Physician Assistant | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1063797538 | BABAK SHERKAT R.N. Individual | Registered Nurse | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1831466820 | NIZAR MOUGHRABI NP, RN Individual | Nurse Practitioner (Family) | 7401 S. MAIN FONDREN ORTHOPEDIC GROUP L.L.P. HOUSTON, TX 77030 (713) 799-2300 |
| 1467782284 | MR. STEVEN RAMON GOLDHOFF P.A.-C Individual | Physician Assistant | 7401 S. MAIN FONDREN ORTHOPEDIC GROUP L.L.P. HOUSTON, TX 77030 (713) 799-2300 |
| 1346581469 | DARREN DOWNING GORE PA Individual | Physician Assistant | 7401 S. MAIN FONDREN ORTHOPEDIC GROUP L.L.P. HOUSTON, TX 77030 (713) 799-2300 |
| 1992731392 | IDRIS GHARBAOUI M.D. Individual | Orthopaedic Surgery | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1396044798 | SARAH ZAPALAC REBER P.A. Individual | Physician Assistant | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1528088622 | ARTHUR F. CHAU MD Individual | Orthopaedic Surgery | 7401 S. MAIN FONDREN ORTHOPEDIC GROUP L.L.P. HOUSTON, TX 77030 (713) 799-2300 |
| 1912283870 | MRS. KATHERINE BELL LOVERIN P.A.-C. Individual | Physician Assistant (Surgical) | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1851364327 | SEEMA SHAH M.D. Individual | Internal Medicine (Infectious Disease) | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1801061908 | MUFADDAL MUSTAFA GOMBERA MD Individual | Orthopaedic Surgery (Sports Medicine) | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1831187236 | RICHARD J KEARNS M.D. Individual | Orthopaedic Surgery | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
| 1538284534 | ROBIN NESTOR GOYTIA M.D. Individual | Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery) | 7401 S. MAIN HOUSTON, TX 77030 (713) 799-2300 |
Frequently Asked Questions
What is Juliette Zumwalt P.A. NPI number?
The NPI number assigned to this healthcare provider is 1003000738, enumerated in the NPI registry as an "individual" on September 06, 2007
Where is the provider located?
The provider is located at 7401 S. Main Houston, Tx 77030 and the phone number is (713) 799-2300
What is the provider specialty code?
The provider's speciality is Physician Assistant with taxonomy code 363A00000X
How many years of experience does Juliette Zumwalt P.A. have?
The provider has more than 17 years of experience.
What insurance does Juliette Zumwalt P.A. accept?
The provider might be accepting Blue Cross Blue Shield, Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Juliette Zumwalt P.A. registered in PECOS?
Yes, as of September 14, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare 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.
How much is a visit to Juliette Zumwalt P.A.?
Medicare beneficiaries should expect a typical cost of $93.23 with an average copayment of $23.3 for new patient appointments. Established patients should expect a typical charge of $75.86 and an average copayment of 18.96. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Juliette Zumwalt P.A.?
The most common procedures or services performed by this practitioner are: Aspiration and/or injection of large joint or joint capsule, Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance, X-ray of shoulder, minimum of 2 views and X-ray of knee, 3 views.
Is Juliette Zumwalt P.A. affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: TEXAS ORTHOPEDIC HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
This NPI record was last updated on September 06, 2007. 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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