DR. CHARLES RAYMOND STEVENS M.D. NPI 1003001363

Anesthesiology (Pain Medicine) in El Centro, CA

NPI 1003001363 Individual Male Years of Experience 20 Anesthesiology Pain Medicine PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 67.6 Medicare Quality Reporting

NPI Profile for DR. CHARLES RAYMOND STEVENS M.D.

Charles Stevens is a provider established in El Centro, California and his medical specialization is anesthesiology (pain medicine) with more than 20 years of experience. He graduated from University Of Arkansas College Of Medicine in 2003. The NPI number of Charles Stevens is 1003001363 and was assigned on September 2007. The practitioner's primary taxonomy code is 207LP2900X with license number A104563 (CA). The provider is registered as an individual and his NPI record was last updated one year ago.

Charles Stevens 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.

Charles Stevens 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 he has hospital affiliations with Yuma Regional Medical Center.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 67.6, 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 provider also has detailed performance information the following quality measures: consultation of the prescription drug monitoring program, diabetes: medical attention for nephropathy and preventive care and screening: body mass index (bmi) screening and follow-up plan.

NPI

1003001363

Provider NameDR. CHARLES RAYMOND STEVENS M.D.
Provider Location Address1665 S IMPERIAL AVE STE D EL CENTRO, CA 92243
Provider Mailing Address1665 S IMPERIAL AVE STE D EL CENTRO, CA 92243
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduation Year2003
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date09-10-2007
Last Update Date05-11-2021


Primary Taxonomy

Taxonomy Code207LP2900X
ClassificationAnesthesiology
TypeAllopathic & Osteopathic Physicians
SpecializationPain Medicine
License No.A104563
License StateCA
Taxonomy DescriptionAn anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

Business Address

DR. CHARLES RAYMOND STEVENS M.D.
1665 S IMPERIAL AVE STE D
EL CENTRO, CA
ZIP 92243
Phone: (760) 482-0212
Fax: (760) 482-0166

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Mailing Address

DR. CHARLES RAYMOND STEVENS M.D.
1665 S IMPERIAL AVE STE D
EL CENTRO, CA
ZIP 92243
Phone: (760) 482-0212
Fax: (760) 482-0166



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 ID446319719
PECOS Enrollment IDI20081103000096, I20120216000149, I20120718000803
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 ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

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% 56
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 (PI) 25% N/A
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 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.
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.
MIPS Final Score - 67.6
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.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Consultation of the Prescription Drug Monitoring ProgramYesN/A
Clinicians would attest to reviewing the patients' history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient's history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient's history performance.
Diabetes: Medical Attention for Nephropathy 46% 94
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 19% 462
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 encounterNormal Parameters: Age 18 years and older BMI => 18.5 and < 25 kg/m2

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.

  • 4567Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • 1915Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter (HCPCS:G0434)
  • 1054Injection, dexamethasone sodium phosphate, 1mg (HCPCS:J1100)
  • 686Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance (HCPCS:64483)
  • 154Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance (HCPCS:20611)
  • 83Ultrasonic guidance imaging supervision and interpretation for insertion of needle (HCPCS:76942)
  • 29Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
  • 12Ultrasound study of arteries of both arms and legs (HCPCS:93922)

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. Charles Stevens is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
YUMA REGIONAL MEDICAL CENTER2400 SOUTH AVENUE A
YUMA, AZ 85364
(928) 336-7600Acute Care Hospitals30013

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
7096338MEDICAID (05)CA

NPI Validation Check Digit Calculation


The following table explains step by step the 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.
1003001363
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003002312
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 0 + 2 + 3 + 1 + 2 + 24 = 37
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
40 - 37 = 33

The NPI number 1003001363 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1104018159ADVANCED PAIN ASSOCIATES, A.P.C.
Organization
Anesthesiology (Pain Medicine)1665 S IMPERIAL AVE STE D
EL CENTRO, CA 92243
(760) 482-0212
1316323736 ARTURO GARCIA PA-C
Individual
Physician Assistant (Medical)1665 S IMPERIAL AVE STE D
EL CENTRO, CA 92243
(760) 482-0212

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
Dr. Charles Raymond Stevens M.d. 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.