MARK A STELLINGWORTH MD
NPI 1003000936
Internal Medicine - Cardiovascular Disease in Hartsville, SC


Quality Rating: 92.07 out of 100 score

NPI Status: Active since September 04, 2007

Contact Information

701 MEDICAL PARK DR STE 301
HARTSVILLE, SC
ZIP 29550
Phone: (843) 383-5978
Fax: (843) 383-5977

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  • Individual
  • Male
  • Years of Experience 24
  • Internal Medicine
  • Cardiovascular Disease
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About MARK STELLINGWORTH

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 2 years ago.

NPI
1003000936
Provider Name
MARK A STELLINGWORTH MD
Gender
Male
Entity Type
Individual
Location Address
701 MEDICAL PARK DR STE 301 HARTSVILLE, SC 29550
Location Phone
(843) 383-5978
Location Fax
(843) 383-5977
Mailing Address
PO BOX 743904 ATLANTA, GA 30374
Mailing Phone
(803) 296-7320
Mailing Fax
(843) 383-5977
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
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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 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.

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.

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 Cardiovascular Disease

Taxonomy Code
207RC0000X
Type
Allopathic & Osteopathic Physicians
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.

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)
1207RA0001XAllopathic & Osteopathic Physicians

Internal Medicine
Advanced Heart Failure and Transplant Cardiology

36377 (SC)
2207RC0000XAllopathic & Osteopathic Physicians

Internal Medicine
Cardiovascular Disease

024969 (LA)

Insurance Plans Accepted

The NPI profile data suggests this provider may be accepting health plans from these insurance companies or healthcare programs:

  • Medicaid
  • Medicare

*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
363779MEDICAID (05)SC 
TL36377OTHER (01)SCMEDICAL LICENSE
024969OTHER (01)LAMEDICAL LICENSE

PECOS Enrollment and Medicare Participation Status

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.

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: 9739278128

    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: I20140108000857

    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

Physician Visit Costs

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 29550 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $128.46
  • Minimum New Patient Price $55.43
  • Maximum New Patient Price $169.76
  • Average New Patient Copayment $32.11
  • Minimum New Patient Copayment $13.85
  • Maximum New Patient Copayment $42.44

Established Patients Visit Costs *

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

  • Average Established Patient Price $99.16
  • Minimum Established Patient Price $17.06
  • Maximum Established Patient Price $138.69
  • Average Established Patient Copayment $24.79
  • Minimum Established Patient Copayment $4.26
  • Maximum Established Patient Copayment $34.67

* 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.

  • Final Score: 92.07 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: 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.

  • Promoting Interoperability Score: 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.

  • 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.

Clinician Services

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 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 466

    Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

  • 419

    Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report (HCPCS:93010)

  • 366

    Insertion of needle into vein for collection of blood sample (HCPCS:36415)

  • 247

    Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)

  • 58

    Remote evaluations of single, dual, or multiple lead pacemaker system with qualified health care professional analysis, review, and report, up to 90 days (HCPCS:93294)

  • 50

    Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes (HCPCS:99152)

  • 42

    Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report (HCPCS:93280)

  • 13

    Exercise 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 Overall Rating
CAROLINA PINES REGIONAL MEDICAL CENTER1304 W BOBO NEWSOM HWY
HARTSVILLE, SC 29550
(864) 339-2100Acute Care Hospitals
MCLEOD REGIONAL MEDICAL CENTER-PEE DEE555 E CHEVES ST BOX 8700
FLORENCE, SC 29506
(843) 777-2900Acute 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.
1003000936
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200300096
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 = 66

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 Practitioner701 MEDICAL PARK DR STE 301
HARTSVILLE, SC 29550
(843) 383-5978
1760979173PALMETTO HEALTH - UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP
Organization
Internal Medicine (Cardiovascular Disease)701 MEDICAL PARK DR STE 301
HARTSVILLE, SC 29550
(843) 383-5978
1396257325MRS. KELLEY HODGE BOSTIC FNP
Individual
Nurse Practitioner (Family)701 MEDICAL PARK DR STE 301
HARTSVILLE, SC 29550
(843) 383-5978

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003000936, enumerated in the NPI registry as an "individual" on September 04, 2007

The provider is located at 701 Medical Park Dr Ste 301 Hartsville, Sc 29550 and the phone number is (843) 383-5978

The provider's speciality is Internal Medicine with taxonomy code 207RC0000X with a focus in Cardiovascular Disease

The provider has more than 24 years of experience. He graduated from Louisiana State University School Of Medicine In New Orleans in 2000.

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.

Yes, as of April 12, 2024 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 , uses technology to exchange and make use of healthcare information.

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.

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.

The practitioner is affiliated to the following hospital(s): CAROLINA PINES REGIONAL MEDICAL CENTER and MCLEOD REGIONAL MEDICAL CENTER-PEE DEE. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

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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