WADE WALNOHA P.A.-C. NPI 1003005729

Physician Assistant in Westerville, OH

NPI 1003005729 Individual Male Years of Experience 16 Physician Assistant PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 34.6 Medicare Quality Reporting

NPI Profile for WADE WALNOHA P.A.-C.

Wade Walnoha is a primary care provider established in Westerville, Ohio and his medical specialization is physician assistant with more than 16 years of experience. The NPI number of Wade Walnoha is 1003005729 and was assigned on October 2007. The practitioner's primary taxonomy code is 363A00000X with license number 0010-3187 (NC). The provider is registered as an individual and his NPI record was last updated 10 years ago.

A primary care provider (PCP) like Wade Walnoha P.a.-c. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Wade Walnoha 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.

Wade Walnoha 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.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 34.6, 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 following quality measures were reported for this provider: annual registration in the prescription drug monitoring program, implementation of an asp, implementation of improvements that contribute to more timely communication of test results and use of decision support and standardized treatment protocols.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.93 for a new patient copayment and $17.8 for an established patient copayment.

NPI

1003005729

Provider Name WADE WALNOHA P.A.-C.
Provider Location Address500 S CLEVELAND AVE WESTERVILLE, OH 43081
Provider Mailing Address575 COPELAND MILL RD SUITE 1D WESTERVILLE, OH 43081
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2007
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date10-18-2007
Last Update Date01-31-2012


Primary Taxonomy

Taxonomy Code363A00000X
ClassificationPhysician Assistant
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.0010-3187
License StateNC
Taxonomy DescriptionA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Business Address

WADE WALNOHA P.A.-C.
500 S CLEVELAND AVE
WESTERVILLE, OH
ZIP 43081
Phone: (614) 794-0481
Fax: (614) 794-3711

Get Directions


Mailing Address

WADE WALNOHA P.A.-C.
575 COPELAND MILL RD
SUITE 1D
WESTERVILLE, OH
ZIP 43081
Phone: (614) 794-0481
Fax: (614) 794-3711



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 ID648337857
PECOS Enrollment IDI20120319000043
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 43081 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$56.74 $173.94 $87.72
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.18 $43.48 $21.93
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.31 $141.66 $71.2
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.32 $35.41 $17.8

* 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% 15
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% 40.3
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 - 34.6
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.

Quality Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Annual registration in the Prescription Drug Monitoring ProgramYesN/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Implementation of an ASPYesN/A
Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance
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.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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
1363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant50.002685OHNo

Taxonomy Description: a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

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.
1003005729
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003001074
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 + 7 + 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 = 99

The NPI number 1003005729 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
1386647204MS. JEANNE ELIZABETH BAUER CNM
Individual
Advanced Practice Midwife500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 898-4605
1366441586CENTRAL OHIO ANESTHESIA INC
Organization
Anesthesiology500 S CLEVELAND AVE ST. ANN'S HOSPITAL ANESTHESIA DEPT
WESTERVILLE, OH 43081
(614) 898-6659
1396745709 LORNA J GRIM CRNA
Individual
Nurse Anesthetist, Certified Registered500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 898-6659
1568462968MR. WILLIAM D CALHOON CRNA
Individual
Nurse Anesthetist, Certified Registered500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 898-6659
1528068780 ROSANN R MALENFANT CRNA
Individual
Nurse Anesthetist, Certified Registered500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 898-6659
1336141043 MICHAEL F CARTER MD
Individual
Anesthesiology500 S CLEVELAND AVE ST. ANN'S HOSPITAL ANESTHESIA DEPT
WESTERVILLE, OH 43081
(614) 898-6659
1730181371 THEODORE H NICOL CRNA
Individual
Nurse Anesthetist, Certified Registered500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 898-6659
1699769679 MARY PATRICIA MCHUGH MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)500 S CLEVELAND AVE ST. ANN'S HOSPITAL PATHOLOGY DEPT
WESTERVILLE, OH 43081
(614) 898-5568
1699733170HOSPITALIST ASSOCIATES
Organization
Internal Medicine (Critical Care Medicine)500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(740) 323-0272
1942268107 GEOFFREY M POLEN MD
Individual
Internal Medicine (Critical Care Medicine)500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(740) 323-0272
1245298843 EMAL SHERZAI M.D.
Individual
Internal Medicine500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 235-2326
1639123193IMMEDIATE HEALTH ASSOCIATES
Organization
Emergency Medicine500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 839-5233
1063467462 GERALD J GIRARDI MD
Individual
Obstetrics & Gynecology500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 898-4000
1770538951 PHILLIP JOSEPH SHUBERT MD
Individual
Obstetrics & Gynecology500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 898-4000
1447205562 KIMBERLY JO CULL MD
Individual
Obstetrics & Gynecology500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 898-4000
1528014461DR. EDWARD DAVID BOUDREAU D.O.
Individual
Emergency Medicine500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 794-0481
1477509099 J.KEVIN KINGTON MD
Individual
Obstetrics & Gynecology500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 898-4000
1538108840 HILARY LEIGH VAUGHN MD
Individual
Internal Medicine500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 898-4000
1871532911 ROBERT J THOMAS DO
Individual
Obstetrics & Gynecology500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 898-4000
1225077712DR. CYNTHIA CURL D.O.
Individual
Emergency Medicine500 S CLEVELAND AVE
WESTERVILLE, OH 43081
(614) 794-0481

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
Wade Walnoha P.a.-c. 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.