ANITA GILL M.D. NPI 1003003070

Psychiatry & Neurology (Neurology) in Port Jefferson, NY

NPI 1003003070 Individual Female Years of Experience 23 Psychiatry & Neurology Neurology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 68.9

NPI Profile for ANITA GILL M.D.

Anita Gill is a provider established in Port Jefferson, New York and her medical specialization is psychiatry & neurology (neurology) with more than 23 years of experience. The NPI number of Anita Gill is 1003003070 and was assigned on October 2007. The practitioner's primary taxonomy code is 2084N0400X with license number 246379 (NY). The provider is registered as an individual and her NPI record was last updated 7 years ago.

Anita Gill 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.

Anita Gill 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 John T Mather Memorial Hospital Of Port Jefferson and St Charles Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 68.9, 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: $40.72 for a new patient copayment and $31.16 for an established patient copayment.

NPI

1003003070

Provider Name ANITA GILL M.D.
Provider Location Address70 N COUNTRY RD PORT JEFFERSON, NY 11777
Provider Mailing Address70 N COUNTRY RD PORT JEFFERSON, NY 11777
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2000
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date10-03-2007
Last Update Date11-23-2015


Primary Taxonomy

Taxonomy Code2084N0400X
ClassificationPsychiatry & Neurology
TypeAllopathic & Osteopathic Physicians
SpecializationNeurology
License No.246379
License StateNY
Taxonomy DescriptionA Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Business Address

ANITA GILL M.D.
70 N COUNTRY RD
PORT JEFFERSON, NY
ZIP 11777
Phone: (631) 686-7970
Fax: (631) 686-7831

Get Directions


Mailing Address

ANITA GILL M.D.
70 N COUNTRY RD
PORT JEFFERSON, NY
ZIP 11777
Phone: (631) 686-7970
Fax: (631) 686-7831



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 ID7012089626
PECOS Enrollment IDI20080626000268
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

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 11777 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
$71.49 $215.02 $162.91
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$17.87 $53.75 $40.72
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
$22.05 $174.06 $124.65
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.51 $43.51 $31.16

* 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% 54.1
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% 69
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% 65.1
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 - 68.9
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 Medicare specialty, excluding evaluation and management codes.

  • 22Measurement and recording of brain wave (EEG) activity, awake and asleep (HCPCS:95819)
  • 17Measurement and recording of brain wave (EEG) activity, awake and drowsy (HCPCS:95816)

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. Anita Gill is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON75 NORTH COUNTRY ROAD
PORT JEFFERSON, NY 11777
(631) 473-1320Acute Care Hospitals330185
ST CHARLES HOSPITAL200 BELLE TERRE ROAD
PORT JEFFERSON, NY 11777
(631) 474-6000Acute Care Hospitals330246

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
12084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology246379NYNo

Taxonomy Description: clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS).

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.
1003003070
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003006014
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 0 + 6 + 0 + 1 + 4 + 24 = 40
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1003003070 is valid because the calculated check digit 0 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
1144306341DR. RHONDA S BURMEISTER DO
Individual
Family Medicine70 N COUNTRY RD SUITE 105
PORT JEFFERSON, NY 11777
(631) 642-0609
1508943317DR. JAMES THOMAS KELLY DO
Individual
Family Medicine70 N COUNTRY RD SUITE 105
PORT JEFFERSON, NY 11777
(631) 642-0609
1376789271FRANK P LUNATI JR MD PC
Organization
Surgery70 N COUNTRY RD SUITE 201
PORT JEFFERSON, NY 11777
(631) 403-4310
1831324532ADVANCED GASTROENTEROLOGY AND ENDOSCOPY, P.C.
Organization
Internal Medicine (Gastroenterology)70 N COUNTRY RD SUITE 201
PORT JEFFERSON, NY 11777
(631) 479-3744
1154632172 MARKELLA MICHAEL CHRISTAKIS M.D.
Individual
Surgery70 N COUNTRY RD SUITE 201
PORT JEFFERSON, NY 11777
(631) 403-4310
1891090759MARKELLA CHRISTAKIS MD PC
Organization
Surgery70 N COUNTRY RD SUITE 201
PORT JEFFERSON, NY 11777
(631) 403-4310
1225399884NORTH SHORE PROCEDURES, LLC
Organization
Clinic/Center (Endoscopy)70 N COUNTRY RD SUITE 201
PORT JEFFERSON, NY 11777
(631) 331-0200
1275570285DR. ALI S KARAKURUM
Individual
Internal Medicine (Gastroenterology)70 N COUNTRY RD SUITE-201
PORT JEFFERSON, NY 11777
(631) 331-0200
1306908314 MARITZA LASTRA GROTH MD
Individual
Internal Medicine (Pulmonary Disease)70 N COUNTRY RD SUITE 101
PORT JEFFERSON, NY 11777
(631) 473-0037
1407194855MISS ALISA CALIENDO ANP, MSN, BSN, RN
Individual
Nurse Practitioner (Adult Health)70 N COUNTRY RD 201
PORT JEFFERSON, NY 11777
(631) 331-0200
1770801920DR. ANNA LESKIV M.D.
Individual
Psychiatry & Neurology (Neurology)70 N COUNTRY RD SUITE 102
PORT JEFFERSON, NY 11777
(631) 686-7970
1659761450MS. JEANNE ARAUJO PHYSICIAN ASSISTANT
Individual
Physician Assistant70 N COUNTRY RD SUITE 203
PORT JEFFERSON, NY 11777
(631) 474-0707
1972522811 EVAN GELLER
Individual
Surgery70 N COUNTRY RD SUITE 203
PORT JEFFERSON, NY 11777
(631) 474-0707
1154372233 FRANK P LUNATI JR. MD
Individual
Surgery70 N COUNTRY RD STE 201
PORT JEFFERSON, NY 11777
(631) 403-4310
1790765675MR. ROBERT KLARE PT, CHT
Individual
Physical Therapist70 N COUNTRY RD SUITE 103
PORT JEFFERSON, NY 11777
(631) 331-3608
1063469054MRS. LAURA A RAYMOND PT, CHT
Individual
Physical Therapist70 N COUNTRY RD SUITE 103
PORT JEFFERSON, NY 11777
(631) 331-3608
1700832417MR. ROBERT STEVEN WILUTIS MS OTR CHT
Individual
Occupational Therapist70 N COUNTRY RD SUITE 103
PORT JEFFERSON, NY 11777
(631) 331-3608
1861642522 TULSI DESAI PT
Individual
Physical Therapist (Orthopedic)70 N COUNTRY RD
PORT JEFFERSON, NY 11777
(631) 331-3608
1952833568 PURVI PATEL
Individual
Student in an Organized Health Care Education/Training Program70 N COUNTRY RD
PORT JEFFERSON, NY 11777
(631) 686-2549
1386096881 THERESA AIELLO NP
Individual
Nurse Practitioner (Adult Health)70 N COUNTRY RD
PORT JEFFERSON, NY 11777
(631) 642-0609

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
Anita Gill 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.