WILLIAM D. HOLMES JR. M.D. NPI 1003007998
Family Medicine in Luling, LA
About WILLIAM D. HOLMES JR. M.D.
William Holmes is a primary care provider established in Luling, Louisiana and his medical specialization is Family Medicine. The NPI number of this provider is 1003007998 and was assigned on August 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 201191 (LA). The provider is registered as an individual and his NPI record was last updated 8 years ago.
| NPI | 1003007998 |
| Provider Name | WILLIAM D. HOLMES JR. M.D. |
| Location Address | 843 MILLING AVE LULING, LA 70070 |
| Location Phone | (985) 785-5800 |
| Mailing Address | 843 MILLING AVE LULING, LA 70070 |
| Gender | Male |
| NPI Entity Type | Individual |
| Is Sole Proprietor? | No |
| Enumeration Date | 08-06-2007 |
| Last Update Date | 09-28-2015 |
A primary care provider (PCP) like William Holmes 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 William Holmes 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..
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 94.5, 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: adult major depressive disorder (mdd): suicide risk assessment, breast cancer screening, chronic care and preventative care management for empaneled patients, closing the referral loop: receipt of specialist report, colorectal cancer screening, consultation of the prescription drug monitoring program, depression screening, diabetes: eye exam, diabetes: medical attention for nephropathy, documentation of current medications in the medical record, engagement of patients through implementation of improvements in patient portal, falls: screening for future fall risk, implementation of fall screening and assessment programs, implementation of medication management practice improvements, pneumococcal vaccination status for older adults, preventive care and screening: body mass index (bmi) screening and follow-up plan, preventive care and screening: influenza immunization, preventive care and screening: tobacco use: screening and cessation intervention, tobacco use, use of decision support and standardized treatment protocols and use of high-risk medications in the elderly.
Primary Taxonomy
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.
| Taxonomy Code | 207Q00000X |
| Classification | Family Medicine |
| Type | Allopathic & Osteopathic Physicians |
| License No. | 201191 |
| License State | LA |
| Taxonomy Description | Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
843 MILLING AVE
LULING, LA
ZIP 70070
Phone: (985) 785-5800
Fax: (985) 785-5811
Mailing Address
843 MILLING AVE
LULING, LA
ZIP 70070
Phone: (985) 785-5800
Fax: (985) 785-5811
Location Map
PECOS Enrollment and Medicare Participation Status
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 Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
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% | 98.9 | |
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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. |
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| Promoting Interoperability (PI) | 25% | 83.5 | |
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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. |
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| Improvement Activities | 15% | 40 | |
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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. |
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| Cost | 20% | N/A | |
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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. |
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| MIPS Final Score | - | 94.5 | |
| 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 |
|---|---|---|
| Adult Major Depressive Disorder (MDD): Suicide Risk Assessment | 0% | 132 |
| Percentage of patients aged 18 years and older with a diagnosis of major depressive disorder (MDD) with a suicide risk assessment completed during the visit in which a new diagnosis or recurrent episode was identified. | ||
| Breast Cancer Screening | 62% | 610 |
| Percentage of women 50 - 74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the measurement period. | ||
| Cervical Cancer Screening | 42% | 1263 |
| Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:* Women age 21-64 who had cervical cytology performed every 3 years* Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years. | ||
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| In order to receive credit for this activity, a MIPS eligible clinician must manage chronic and preventive care for empaneled patients (that is, patients assigned to care teams for the purpose of population health management), which could include one or more of the following actions:- Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions;- Use evidence based, condition-specific pathways for care of chronic conditions (for example, hypertension, diabetes, depression, asthma, and heart failure). These might include, but are not limited to, the NCQA Diabetes Recognition Program (DRP) and the NCQA Heart/Stroke Recognition Program (HSRP);- Use pre-visit planning, that is, preparations for conversations or actions to propose with patient before an in-office visit to optimize preventive care and team management of patients with chronic conditions;- Use panel support tools, (that is, registry functionality) or other technology that can use clinical data to identify trends or data points in patient records to identify services due;- Use predictive analytical models to predict risk, onset and progression of chronic diseases; and/orUse reminders and outreach (e.g., phone calls, emails, postcards, patient portals, and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Closing the Referral Loop: Receipt of Specialist Report | 11% | 885 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred. | ||
| Colorectal Cancer Screening | 44% | 1198 |
| Percentage of patients 50-75 years of age who had appropriate screening for colorectal cancer. | ||
| Consultation of the Prescription Drug Monitoring Program | Yes | N/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. | ||
| Controlling High Blood Pressure | 48% | 1172 |
| Percentage of patients 18-85 years of age who had a diagnosis of hypertension overlapping the measurement period and whose most recent blood pressure was adequately controlled (<140/90mmHg) during the measurement period. | ||
| Depression Remission at Twelve Months | 1% | 152 |
| The percentage of adolescent patients 12 to 17 years of age and adult patients 18 years of age or older with major depression or dysthymia who reached remission 12 months (+/- 60 days) after an index event date. | ||
| Depression screening | Yes | N/A |
| Depression screening and follow-up plan: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including depression screening and follow-up plan (refer to NQF #0418) for patients with co-occurring conditions of behavioral or mental health conditions. | ||
| Diabetes: Eye Exam | 43% | 522 |
| Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period. | ||
| Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) | 36% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 522 |
| Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period. | ||
| Diabetes: Medical Attention for Nephropathy | 88% | 522 |
| 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. | ||
| Documentation of Current Medications in the Medical Record | 96% | 5071 |
| Percentage of visits for patients aged 18 years and older for which the MIPS eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration. | ||
| Engagement of patients through implementation of improvements in patient portal | Yes | N/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. | ||
| Falls: Screening for Future Fall Risk | 17% | 298 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period. | ||
| Implementation of fall screening and assessment programs | Yes | N/A |
| Implementation of fall screening and assessment programs to identify patients at risk for falls and address modifiable risk factors (e.g., Clinical decision support/prompts in the electronic health record that help manage the use of medications, such as benzodiazepines, that increase fall risk). | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following:Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups;Integrate a pharmacist into the care team; and/orConduct periodic, structured medication reviews. | ||
| Pneumococcal Vaccination Status for Older Adults | 57% | 298 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 84% | 2702 |
| 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 encounter. | ||
| Preventive Care and Screening: Influenza Immunization | 28% | 2048 |
| Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization. | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 67% | 513 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco usera. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months.b. Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention.c. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user. | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 74% | 2188 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco usera. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months.b. Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention.c. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user. | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 66% | 2188 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco usera. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months.b. Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention.c. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user. | ||
| Tobacco use | Yes | N/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 decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
| Use of High-Risk Medications in the Elderly | 10% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 298 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted.1) Percentage of patients who were ordered at least one high-risk medication.2) Percentage of patients who were ordered at least two of the same high-risk medications. | ||
| Use of High-Risk Medications in the Elderly | 19% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 298 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted.1) Percentage of patients who were ordered at least one high-risk medication.2) Percentage of patients who were ordered at least two of the same high-risk medications. | ||
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 |
|---|---|---|
| 1479322 | MEDICAID (05) | LA |
| 1444642 | MEDICAID (05) | LA |
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. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 0 | 7 | 9 | 9 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 0 | 14 | 9 | 18 | |
| 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 + 4 + 9 + 1 + 8 + 24 = 52 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 52 = 8 | 8 | ||||||||
The NPI number 1003007998 is valid because the calculated check digit 8 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 |
|---|---|---|---|
| 1619960432 | BAHRAM SADEGHPOUR M.D. Individual | Specialist | 843 MILLING AVE LULING, LA 70070 (985) 785-5852 |
| 1336132190 | MARY KAY HARTMAN N.P. Individual | Nurse Practitioner | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1942275367 | DR. YACARA TABB DPM Individual | Podiatrist | 843 MILLING AVE PODIATRY DEPT LULING, LA 70070 (985) 785-5800 |
| 1487629804 | NORMAN R SEDLANDER LCSW Individual | Counselor (Mental Health) | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1366417339 | MOHAN D GANDHI M.D. Individual | Specialist | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1073588042 | JAMES G COMEAUX LCSW Individual | Counselor (Mental Health) | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1245208131 | MYRA D NOUSTENS LCSW Individual | Counselor (Mental Health) | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1215999057 | MOUSTAFA NACHABE MD Individual | Pediatrics | 843 MILLING AVE LULING, LA 70070 (985) 785-5852 |
| 1942316450 | DR. BRYAN BERTUCCI M.D. Individual | Family Medicine | 843 MILLING AVE LULING, LA 70070 (985) 785-5851 |
| 1144336652 | DR. JOHN TU THIEN M.D. Individual | Internal Medicine | 843 MILLING AVE LULING, LA 70070 (504) 271-8952 |
| 1407963150 | MR. CHRIS JOSEPH LEDET APRN Individual | Nurse Practitioner (Family) | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1659482610 | DR. ELICIA NICOLE THOMPSON D.D.S. Individual | Dentist (General Practice) | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1992800189 | ROBERT EARL DAWSON MD Individual | Internal Medicine | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1346332699 | DR. VADAKKIPALAYAM N. DEVARAJAN Individual | Specialist | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1225115348 | MICHELLE M COMBOY FNP Individual | Nurse Practitioner | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1851423974 | MISS BRIDGET MARIE CAMERON M.S.W. Individual | Social Worker (Clinical) | 843 MILLING AVE LULING, LA 70070 (985) 785-5852 |
| 1609095512 | JAMES SCOTT SIGRIST M.D. Individual | Psychiatry & Neurology (Psychiatry) | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1134309040 | DR. CYNTHIA L CALDWELL D.D.S. Individual | Dentist (General Practice) | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1518110055 | REBECCA HAGEMAN MIDWIFE Individual | Midwife | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
| 1205081429 | TARA H WILLIAMS LCSW Individual | Social Worker | 843 MILLING AVE LULING, LA 70070 (985) 785-5800 |
Frequently Asked Questions
What is William Holmes JR. M.D. NPI number?
The NPI number assigned to this healthcare provider is 1003007998, registered as an "individual" on August 06, 2007
Where is William Holmes JR. M.D. located?
The provider is located at 843 Milling Ave Luling, La 70070 and the phone number is (985) 785-5800
Which is William Holmes JR. M.D. specialty?
The provider's speciality is Family Medicine
What insurance does William Holmes JR. M.D. accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is William Holmes JR. M.D. registered in PECOS?
Yes, as of May 11, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary 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.
What are William Holmes JR. M.D. Quality Ratings?
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information. The provider obtained a high score in the following performance measures: Diabetes: Medical Attention for Nephropathy, Documentation of Current Medications in the Medical Record , Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. The quality ratings are based on unbiased reviews and reported submissions to Medicare's Quality Payment Program.
How much is a visit to William Holmes JR. M.D.?
Medicare beneficiaries should expect a typical cost of $86.88 with an average copayment of $21.72 for new patient appointments. Established patients should expect a typical charge of $100.08 and an average copayment of 25.02. Please review your insurance plan or contact the provider directly to determine your specific costs.
How do I update my NPI information?
The NPI record of William Holmes JR. M.D. was last updated on August 06, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
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