DR. NICHOLAS AARON FETTMAN MD NPI 1003005109
Otolaryngology in Oxnard, CA

Individual Male Otolaryngology PECOS Enrolled MIPS Quality Score 86.3 Medicare Quality Reporting

About DR. NICHOLAS AARON FETTMAN MD

Nicholas Fettman is a provider established in Oxnard, California and his medical specialization is Otolaryngology. The NPI number of Nicholas Fettman is 1003005109 and was assigned on October 2007. The practitioner's primary taxonomy code is 207Y00000X with license number A116624 (CA). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1003005109
Provider NameDR. NICHOLAS AARON FETTMAN MD
Provider Location Address1700 N ROSE AVE SUITE 460 OXNARD, CA 93030
Provider Mailing Address2876 SYCAMORE DR SUITE 303 SIMI VALLEY, CA 93065
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Enumeration Date10-15-2007
Last Update Date11-27-2019

Nicholas Fettman 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..

Nicholas Fettman is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 86.3, 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: collection and follow-up on patient experience and satisfaction data on beneficiary engagement, collection and use of patient experience and satisfaction data on access, engagement of patients through implementation of improvements in patient portal, e-prescribing, implementation of improvements that contribute to more timely communication of test results, provide patients electronic access to their health information, query of the prescription drug monitoring program (pdmp), security risk analysis, tobacco use and use of telehealth services that expand practice access.



Primary Taxonomy

Taxonomy Code207Y00000X
ClassificationOtolaryngology
TypeAllopathic & Osteopathic Physicians
License No.A116624
License StateCA
Taxonomy DescriptionAn otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Business Address

DR. NICHOLAS AARON FETTMAN MD
1700 N ROSE AVE
SUITE 460
OXNARD, CA
ZIP 93030
Phone: (805) 983-0395
Fax: (805) 983-0463

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Mailing Address

DR. NICHOLAS AARON FETTMAN MD
2876 SYCAMORE DR
SUITE 303
SIMI VALLEY, CA
ZIP 93065
Phone: (805) 527-7320
Fax: (805) 527-2426


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
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% 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% 46.9
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 - 86.3
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
Collection and follow-up on patient experience and satisfaction data on beneficiary engagementYesN/A
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan.
Collection and use of patient experience and satisfaction data on accessYesN/A
Collection of patient experience and satisfaction data on access to care and development of an improvement plan, such as outlining steps for improving communications with patients to help understanding of urgent access needs.
Engagement of patients through implementation of improvements in patient portalYesN/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
e-Prescribing 100% 1411
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT.
Implementation of improvements that contribute to more timely communication of test resultsYesN/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Provide Patients Electronic Access to Their Health Information 35% 1402
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified electronic health record technology (CEHRT).
Query of the Prescription Drug Monitoring Program (PDMP)YesN/A
For at least one Schedule II opioid electronically prescribed using CEHRT during the performance period, the MIPS eligible clinician uses data from CEHRT to conduct a query of a Prescription Drug Monitoring Program (PDMP) for prescription drug history, except where prohibited and in accordance with applicable law.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified electronic health record technology (CEHRT) in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 164.306(d)(3), implement security updates as necessary, and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Tobacco useYesN/A
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence.
Use of telehealth services that expand practice accessYesN/A
Use of telehealth services and analysis of data for quality improvement, such as participation in remote specialty care consults or teleaudiology pilots that assess ability to still deliver quality care to patients.

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.

  • 246Removal of impact ear wax, one ear (HCPCS:69210)
  • 154Diagnostic examination of voice box using flexible endoscope (HCPCS:31575)
  • 41Diagnostic examination of nasal passages using an endoscope (HCPCS:31231)

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.
1003005109
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003001010
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 0 + 1 + 0 + 1 + 0 + 24 = 31
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
40 - 31 = 99

The NPI number 1003005109 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
1699778712DR. SUCKCHAI TULATHIMUTTE M.D.
Individual
Surgery1700 N ROSE AVE STE 430
OXNARD, CA 93030
(805) 485-8722
1568465649DR. LISA LOUISE BABASHOFF M.D.
Individual
Surgery1700 N ROSE AVE STE 430
OXNARD, CA 93030
(805) 485-8722
1164425245DR. TIMOTHY GORDON BRYANT M.D.
Individual
Surgery1700 N ROSE AVE STE 430
OXNARD, CA 93030
(805) 485-8722
1881697951DR. JOSEPH SALVATORE LOPRESTI M.D.
Individual
Surgery1700 N ROSE AVE STE 430
OXNARD, CA 93030
(805) 485-8722
1497758569DR. BRIAN CHIEN TUAI M.D.
Individual
Surgery1700 N ROSE AVE STE 430
OXNARD, CA 93030
(805) 485-8722
1275511644GENERAL SURGERY MEDICAL GROUP OF VENTURA COUNTY
Organization
Surgery1700 N ROSE AVE SUITE 430
OXNARD, CA 93030
(805) 485-8722
1982669396DR. TIMOTHY A. OCONNOR M.D.
Individual
Radiology (Radiation Oncology)1700 N ROSE AVE SUITE 120
OXNARD, CA 93030
(805) 988-2657
1376592733 GRETCHEN H. JACOBSON MD
Individual
Neurological Surgery1700 N ROSE AVE #250
OXNARD, CA 93030
(805) 983-1700
1093767469 JU-SUNG WU M.D.
Individual
Specialist1700 N ROSE AVE SUITE 220
OXNARD, CA 93030
(805) 983-1009
1245284686 SHAHRAM FATEMI M.D.
Individual
Family Medicine1700 N ROSE AVE SUITE 210
OXNARD, CA 93030
(805) 988-8058
1952356933DR. LYNN R KONG MD
Individual
Internal Medicine (Hematology & Oncology)1700 N ROSE AVE SUITE 320
OXNARD, CA 93030
(805) 485-8709
1619916772DR. ROSEMARY E MCINTYRE MD
Individual
Internal Medicine (Hematology & Oncology)1700 N ROSE AVE SUITE 320
OXNARD, CA 93030
(805) 485-8709
1629017801DR. KOOROS PARSA MD
Individual
Internal Medicine (Hematology & Oncology)1700 N ROSE AVE SUITE 320
OXNARD, CA 93030
(805) 485-8709
1649219452DR. KEVIN Q CHANG MD
Individual
Internal Medicine (Hematology & Oncology)1700 N ROSE AVE SUITE 320
OXNARD, CA 93030
(805) 485-8709
1407891971 ANDREW WILLARD JEFFERS M.D.
Individual
Orthopaedic Surgery1700 N ROSE AVE #135
OXNARD, CA 93030
(805) 981-1788
1104855600DR. ANTOINE THOMAS HANNA MD
Individual
Obstetrics & Gynecology1700 N ROSE AVE 230
OXNARD, CA 93030
(805) 988-2811
1295745180DR. KOJI KUBO M.D.
Individual
Family Medicine1700 N ROSE AVE SUITE 210
OXNARD, CA 93030
(805) 988-8058
1346253689 CARY DAVID ALBERSTONE MD
Individual
Neurological Surgery1700 N ROSE AVE SUITE 250
OXNARD, CA 93030
(805) 983-1700
1922102029DR. YUCHENG JORDAN LIAO MD PHD
Individual
Psychiatry & Neurology (Neurology)1700 N ROSE AVE #480
OXNARD, CA 93030
(805) 983-6929
1972664183 SAL C SANTANGELO M.D.
Individual
Surgery1700 N ROSE AVE STE 470
OXNARD, CA 93030
(805) 983-0707

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. Nicholas Aaron Fettman 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.