MARK A STELLINGWORTH MD NPI 1003000936
Internal Medicine - Cardiovascular Disease in Hartsville, SC
- NPI Profile Information
- Primary Taxonomy
- Accepted Insurance
- Secondary Locations
- PECOS Enrollment and Medicare Participation Status
- Physician Office Visit Costs
- Overall MIPS Quality Performance
- Clinician Utilization
- Hospital Affiliations
- Secondary Taxonomies
- NPI Validation
- Other Providers Same Location
About MARK A STELLINGWORTH MD
Mark Stellingworth is an internist established in Hartsville, South Carolina and his medical specialization is Internal Medicine with a focus in cardiovascular disease with more than 24 years of experience. He graduated from Louisiana State University School Of Medicine In New Orleans in 2000. The healthcare provider is registered in the NPI registry with number 1003000936 assigned on September 2007. The practitioner's primary taxonomy code is 207RC0000X with license number 36377 (SC). The provider is registered as an individual and his NPI record was last updated one year ago.
| NPI | 1003000936 |
| Provider Name | MARK A STELLINGWORTH MD |
| Location Address | 701 MEDICAL PARK DR STE 301 HARTSVILLE, SC 29550 |
| Location Phone | (843) 383-5978 |
| Mailing Address | PO BOX 743904 ATLANTA, GA 30374 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduation Year | 2000 |
| Is Sole Proprietor? | No |
| Enumeration Date | 09-04-2007 |
| Last Update Date | 06-13-2022 |
An internist like Mark Stellingworth 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.Mark Stellingworth 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.
Mark Stellingworth 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. According to claims data he has hospital affiliations with Carolina Pines Regional Medical Center, Mcleod Regional Medical Center-pee Dee and Musc Health Florence Medical Center.
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.07, 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: $32.11 for a new patient copayment and $24.79 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 | 207RC0000X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | Cardiovascular Disease |
| License No. | 36377 |
| License State | SC |
| Taxonomy Description | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
701 MEDICAL PARK DR STE 301
HARTSVILLE, SC
ZIP 29550
Phone: (843) 383-5978
Fax: (843) 383-5977
Mailing Address
PO BOX 743904
ATLANTA, GA
ZIP 30374
Phone: (803) 296-7320
Fax: (803) 296-7330
Secondary Locations
8 Richland Medical Park Dr Suite 100
Columbia, SC 29203
(803) 434-3800
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 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.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 9739278128 |
| PECOS Enrollment ID | I20140108000857 |
| 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, beneficiaries under these health plans should not be billed for more than the approved deductible and coinsurance amounts. The tables below display 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 29550 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 |
| $55.43 | $169.76 | $128.46 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $13.85 | $42.44 | $32.11 |
| 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 |
| $17.06 | $138.69 | $99.16 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.26 | $34.67 | $24.79 |
* 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 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.
| MIPS Measure | Score Weight | Score | |
|---|---|---|---|
| Quality | 40% | 96.12 | |
|
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% | 80.05 | |
|
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 | - | 92.07 | |
| 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 specialty, excluding evaluation and management codes.
- 466Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)
- 419Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report (HCPCS:93010)
- 366Insertion of needle into vein for collection of blood sample (HCPCS:36415)
- 247Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)
- 58Remote evaluations of single, dual, or multiple lead pacemaker system with qualified health care professional analysis, review, and report, up to 90 days (HCPCS:93294)
- 50Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes (HCPCS:99152)
- 42Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report (HCPCS:93280)
- 13Exercise or drug-induced heart and blood vessel stress test with ekg monitoring, physician interpretation and report (HCPCS:93018)
Hospital Affiliations
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. Mark Stellingworth is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| CAROLINA PINES REGIONAL MEDICAL CENTER | 1304 W BOBO NEWSOM HWY HARTSVILLE, SC 29550 | (864) 339-2100 | Acute Care Hospitals | 420010 | |
| MCLEOD REGIONAL MEDICAL CENTER-PEE DEE | 555 E CHEVES ST BOX 8700 FLORENCE, SC 29506 | (843) 777-2900 | Acute Care Hospitals | 420051 | |
| MUSC HEALTH FLORENCE MEDICAL CENTER | 805 PAMPLICO HWY BOX 100550 FLORENCE, SC 29505 | (843) 674-2500 | Acute Care Hospitals | 420091 |
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 207RA0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Advanced Heart Failure and Transplant Cardiology | 36377 | SC | No |
Taxonomy Description: specialists in Advanced Heart Failure and Transplant Cardiology would participate in the inpatient and outpatient management of patients with advanced heart failure across the spectrum from consideration for high-risk cardiac surgery, cardiac transplantation, or mechanical circulatory support, to pre-and post-operative evaluation and management of patients with cardiac transplants and mechanical support devices, and end-of-life care for patients with end-stage heart failure. | |||||||
| 2 | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 024969 | LA | No |
Taxonomy Description: an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. | |||||||
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 |
|---|---|---|---|
| 363779 | MEDICAID (05) | SC | |
| TL36377 | OTHER (01) | SC | MEDICAL LICENSE |
| 024969 | OTHER (01) | LA | MEDICAL LICENSE |
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 | 9 | 3 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 0 | 0 | 9 | 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 + 9 + 6 + 24 = 44 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 44 = 6 | 6 | ||||||||
The NPI number 1003000936 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1467819748 | MELISSA YVETTE TURNER FNP-C Individual | Nurse Practitioner | 701 MEDICAL PARK DR STE 301 HARTSVILLE, SC 29550 (843) 383-5978 |
| 1760979173 | PALMETTO HEALTH - UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP Organization | Internal Medicine (Cardiovascular Disease) | 701 MEDICAL PARK DR STE 301 HARTSVILLE, SC 29550 (843) 383-5978 |
| 1396257325 | MRS. KELLEY HODGE BOSTIC FNP Individual | Nurse Practitioner (Family) | 701 MEDICAL PARK DR STE 301 HARTSVILLE, SC 29550 (843) 383-5978 |
Frequently Asked Questions
What is Mark Stellingworth MD NPI number?
The NPI number assigned to this healthcare provider is 1003000936, enumerated in the NPI registry as an "individual" on September 04, 2007
Where is the provider located?
The provider is located at 701 Medical Park Dr Ste 301 Hartsville, Sc 29550 and the phone number is (843) 383-5978
What is the provider specialty code?
The provider's speciality is Internal Medicine with taxonomy code 207RC0000X with a focus in Cardiovascular Disease
How many years of experience does Mark Stellingworth MD have?
The provider has more than 24 years of experience. He graduated from Louisiana State University School Of Medicine In New Orleans in 2000.
What insurance does Mark Stellingworth MD accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Mark Stellingworth MD 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 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.
What are Mark Stellingworth MD Quality Ratings?
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.
How much is a visit to Mark Stellingworth MD?
Medicare beneficiaries should expect a typical cost of $128.46 with an average copayment of $32.11 for new patient appointments. Established patients should expect a typical charge of $99.16 and an average copayment of 24.79. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Mark Stellingworth MD?
The most common procedures or services performed by this practitioner are: Routine ekg using at least 12 leads including interpretation and report, Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report, Insertion of needle into vein for collection of blood sample, Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function, Remote evaluations of single, dual, or multiple lead pacemaker system with qualified health care professional analysis, review, and report, up to 90 days, Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes, Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report and Exercise or drug-induced heart and blood vessel stress test with ekg monitoring, physician interpretation and report.
Is Mark Stellingworth MD affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: CAROLINA PINES REGIONAL MEDICAL CENTER, MCLEOD REGIONAL MEDICAL CENTER-PEE DEE and MUSC HEALTH FLORENCE MEDICAL CENTER. 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 04, 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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