SALONA SHRESTHA MD NPI 1003002379
Internal Medicine in Portland, OR
NPI Profile for SALONA SHRESTHA MD
Salona Shrestha is an internal medicine provider established in Portland, Oregon and her medical specialization is internal medicine with more than 20 years of experience. The NPI number of Salona Shrestha is 1003002379 and was assigned on September 2007. The practitioner's primary taxonomy code is 207R00000X with license number MD160505 (OR). The provider is registered as an individual and her NPI record was last updated 3 years ago.
An internist like Salona Shrestha Md 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.
Salona Shrestha 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.
Salona Shrestha 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 Providence Portland 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 91.8, 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: $34.53 for a new patient copayment and $26.82 for an established patient copayment.
| NPI | 1003002379 |
| Provider Name | SALONA SHRESTHA MD |
| Provider Location Address | 4805 NE GLISAN ST PORTLAND, OR 97213 |
| Provider Mailing Address | PO BOX 3158 PORTLAND, OR 97208 |
| Gender | Female |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 2003 |
| Is Sole Proprietor? | No |
| Is Organization Subpart? | N/A |
| Enumeration Date | 09-20-2007 |
| Last Update Date | 12-06-2019 |
Primary Taxonomy
| Taxonomy Code | 207R00000X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| License No. | MD160505 |
| License State | OR |
| 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
SALONA SHRESTHA MD
4805 NE GLISAN ST
PORTLAND, OR
ZIP 97213
Phone: (503) 215-2392
Mailing Address
SALONA SHRESTHA MD
PO BOX 3158
PORTLAND, OR
ZIP 97208
Phone: (503) 215-6494
Secondary Locations
Vancouver, WA 98664
(360) 514-3727
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 | 5496842486 |
| PECOS Enrollment ID | I20131101000541 |
| 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 97213 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 |
| $60.52 | $182.22 | $138.14 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $15.13 | $45.55 | $34.53 |
| 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 |
| $19.23 | $149.48 | $107.31 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.8 | $37.37 | $26.82 |
* 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. |
|||
| Promoting Interoperability (PI) | 25% | 70 | |
|
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% | 80.2 | |
|
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 | - | 91.8 | |
| 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. | |||
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. Salona Shrestha is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| PROVIDENCE PORTLAND MEDICAL CENTER | 4805 NE GLISAN STREET PORTLAND, OR 97213 | (503) 215-1111 | Acute Care Hospitals | 380061 |
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | MD00048484 | WA | No | |
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. | |||||||
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 |
|---|---|---|---|
| 8389686 | MEDICAID (05) | WA | |
| P00468662 | OTHER (01) | WA | RR MEDICARE |
| P0048662 | OTHER (01) | WA | RR MEDICARE |
| 8497232 | MEDICAID (05) | WA |
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. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 0 | 2 | 3 | 7 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 0 | 4 | 3 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 0 + 0 + 4 + 3 + 1 + 4 + 24 = 41 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 41 = 9 | 9 | ||||||||
The NPI number 1003002379 is valid because the calculated check digit 9 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 |
|---|---|---|---|
| 1831187657 | DR. CHRISTOPHER MICHAEL BARONE Individual | Internal Medicine | 4805 NE GLISAN ST SUITE BG05 PORTLAND, OR 97213 (503) 215-2392 |
| 1588653737 | DR. EUGENE LESTER BORKAN MD Individual | Psychiatry & Neurology (Child & Adolescent Psychiatry) | 4805 NE GLISAN ST PORTLAND, OR 97213 (503) 215-6840 |
| 1336130806 | TODD SHANE CROCENZI M.D. Individual | Internal Medicine (Medical Oncology) | 4805 NE GLISAN ST 6N40 PORTLAND, OR 97213 (503) 215-5696 |
| 1912933557 | PETER D O'HANLEY MD Individual | Internal Medicine | 4805 NE GLISAN ST SUITE BG05 PORTLAND, OR 97213 (503) 215-2392 |
| 1316977903 | SHARON D KENNEDY NP Individual | Registered Nurse (General Practice) | 4805 NE GLISAN ST 3E PORTLAND, OR 97213 (503) 215-6494 |
| 1770513368 | REBECCA E CHANDLER MD Individual | Internal Medicine | 4805 NE GLISAN ST SUITE BG05 PORTLAND, OR 97213 (503) 215-2392 |
| 1497785786 | MICHAEL J CLAYTON MD Individual | Internal Medicine | 4805 NE GLISAN ST SUITE BG05 PORTLAND, OR 97213 (503) 215-2392 |
| 1336179274 | JAMES STUART MORGAN MD Individual | Internal Medicine | 4805 NE GLISAN ST BG05 PORTLAND, OR 97213 (503) 215-2392 |
| 1346272770 | NANCY A PHILLIPS MD Individual | Psychiatry & Neurology (Psychiatry) | 4805 NE GLISAN ST 5L PORTLAND, OR 97213 (503) 215-7669 |
| 1144255175 | VICKI COLLISTER ANP Individual | Registered Nurse | 4805 NE GLISAN ST PORTLAND, OR 97213 (503) 215-4620 |
| 1497760300 | EUGENE BORKAN, MD, PC Organization | Psychiatry & Neurology (Psychiatry) | 4805 NE GLISAN ST 3E PORTLAND, OR 97213 (503) 215-6840 |
| 1497767735 | DAWN LANE MARTINEZ F.N.P. Individual | Personal Emergency Response Attendant | 4805 NE GLISAN ST PORTLAND, OR 97213 (503) 297-6334 |
| 1851303291 | DENNIS STEPHEN GREY F.N.P. Individual | Nurse Practitioner (Family) | 4805 NE GLISAN ST PORTLAND, OR 97213 (503) 297-6334 |
| 1184636482 | MARCIA THERESA LYNCH M.S.N., F.N.P. Individual | Nurse Practitioner (Family) | 4805 NE GLISAN ST PORTLAND, OR 97213 (503) 297-6334 |
| 1497862833 | SUZANNE T. BROWN CRNA Individual | Nurse Anesthetist, Certified Registered | 4805 NE GLISAN ST PROVIDENCE PORTLAND MEDICAL CENTER PORTLAND, OR 97213 (503) 942-0977 |
| 1174620942 | LAURA TOPP MAHAR ANP Individual | Nurse Practitioner (Adult Health) | 4805 NE GLISAN ST STE 6N50 PORTLAND, OR 97213 (503) 215-1350 |
| 1316038631 | PROVIDENCE HEALTH & SERVICES - OREGON Organization | Clinic/Center | 4805 NE GLISAN ST 3E PORTLAND, OR 97213 (503) 216-2028 |
| 1588750798 | DR. JAMES E. DUGONI M.D. Individual | Emergency Medicine | 4805 NE GLISAN ST PORTLAND, OR 97213 (503) 297-6334 |
| 1932295292 | DR. TIMOTHY WADE LEWIS M.D. Individual | Emergency Medicine | 4805 NE GLISAN ST PORTLAND, OR 97213 (503) 297-6334 |
| 1568550671 | DR. GREGORY BYRON LORTS M.D. Individual | Emergency Medicine | 4805 NE GLISAN ST PORTLAND, OR 97213 (503) 297-6334 |
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
Salona Shrestha Md 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.