DR. ERIC R. GINN M.D. NPI 1003008574
Hospitalist in Bryn Mawr, PA
NPI Profile for DR. ERIC R. GINN M.D.
Eric Ginn is a provider established in Bryn Mawr, Pennsylvania and his medical specialization is hospitalist with more than 18 years of experience. The NPI number of Eric Ginn is 1003008574 and was assigned on August 2007. The practitioner's primary taxonomy code is 208M00000X with license number MD440496 (PA). The provider is registered as an individual and his NPI record was last updated 5 years ago.
Eric Ginn 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.
Eric Ginn 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 he has hospital affiliations with Bryn Mawr Hospital and Main Line Hospital Lankenau.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 97.8, 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: $35.88 for a new patient copayment and $27.71 for an established patient copayment.
| NPI | 1003008574 |
| Provider Name | DR. ERIC R. GINN M.D. |
| Provider Location Address | 130 S BRYN MAWR AVE SUITE H321 BRYN MAWR, PA 19010 |
| Provider Mailing Address | 130 S BRYN MAWR AVE SUITE H321 BRYN MAWR, PA 19010 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 2005 |
| Is Sole Proprietor? | No |
| Is Organization Subpart? | N/A |
| Enumeration Date | 08-17-2007 |
| Last Update Date | 05-01-2017 |
Primary Taxonomy
| Taxonomy Code | 208M00000X |
| Classification | Hospitalist |
| Type | Allopathic & Osteopathic Physicians |
| License No. | MD440496 |
| License State | PA |
| Taxonomy Description | Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
Business Address
DR. ERIC R. GINN M.D.
130 S BRYN MAWR AVE
SUITE H321
BRYN MAWR, PA
ZIP 19010
Phone: (484) 337-4097
Fax: (484) 337-4082
Mailing Address
DR. ERIC R. GINN M.D.
130 S BRYN MAWR AVE
SUITE H321
BRYN MAWR, PA
ZIP 19010
Phone: (484) 337-4097
Fax: (484) 337-4082
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 | 5890987804 |
| PECOS Enrollment ID | I20101008000938 |
| 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 19010 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 |
| $62.8 | $189.43 | $143.54 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $15.7 | $47.35 | $35.88 |
| 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 |
| $19.68 | $154.62 | $110.85 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.92 | $38.65 | $27.71 |
* 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. |
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| Promoting Interoperability (PI) | 25% | 82.5 | |
|
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. |
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| 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 | - | 97.8 | |
| 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. Eric Ginn is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| BRYN MAWR HOSPITAL | 130 SOUTH BRYN MAWR AVE BRYN MAWR, PA 19010 | (610) 526-3000 | Acute Care Hospitals | 390139 | |
| MAIN LINE HOSPITAL LANKENAU | 100 LANCASTER AVE WYNNEWOOD, PA 19096 | (610) 645-2000 | Acute Care Hospitals | 390195 |
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 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | MD440496 | PA | No | |
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. | |||||||
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 | 8 | 5 | 7 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 0 | 16 | 5 | 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 + 1 + 6 + 5 + 1 + 4 + 24 = 46 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 46 = 4 | 4 | ||||||||
The NPI number 1003008574 is valid because the calculated check digit 4 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 |
|---|---|---|---|
| 1770589459 | DR. WILLIAM H PFEFFER M.D. Individual | Obstetrics & Gynecology (Reproductive Endocrinology) | 130 S BRYN MAWR AVE SUITE 1000 D WING BRYN MAWR, PA 19010 (610) 527-0800 |
| 1487650214 | JOHN J ORRIS D.O. Individual | Obstetrics & Gynecology (Reproductive Endocrinology) | 130 S BRYN MAWR AVE SUITE 1000 D WING BRYN MAWR, PA 19010 (610) 527-0800 |
| 1740286426 | MICHAEL J GLASSNER M.D. Individual | Obstetrics & Gynecology (Reproductive Endocrinology) | 130 S BRYN MAWR AVE SUITE 1000 D WING BRYN MAWR, PA 19010 (610) 527-0800 |
| 1982683207 | MARINA JEAN COONEY MD Individual | Psychiatry & Neurology (Psychiatry) | 130 S BRYN MAWR AVE BRYN MAWR HOSPITAL PSYCHIATRIC UNIT BRYN MAWR, PA 19010 (484) 337-4286 |
| 1770553661 | JAMES H RIGSBEE PAC Individual | Physician Assistant | 130 S BRYN MAWR AVE BRYN MAWR, PA 19010 (610) 526-3583 |
| 1790759306 | DR. SHALINI HARIGOVIND MD Individual | Internal Medicine | 130 S BRYN MAWR AVE SUITE H-321 BRYN MAWR, PA 19010 (610) 526-4097 |
| 1558335919 | DR. SIVASANKARA RAO KOSARAJU MD Individual | Internal Medicine | 130 S BRYN MAWR AVE SUITE H-321 BRYN MAWR, PA 19010 (610) 526-4097 |
| 1013981166 | DR. LAWRENCE K MCKNIGHT MD Individual | Internal Medicine | 130 S BRYN MAWR AVE SUITE H-321 BRYN MAWR, PA 19010 (610) 526-4097 |
| 1063486827 | WILLIAM S DREW PAC Individual | Physician Assistant | 130 S BRYN MAWR AVE BRYN MAWR, PA 19010 (610) 526-3583 |
| 1932174257 | GODFFERY R TANG MD Individual | Internal Medicine | 130 S BRYN MAWR AVE SUITE H-321 BRYN MAWR, PA 19010 (484) 337-4097 |
| 1760457998 | ANNE B MITCHELL CRNP Individual | Nurse Practitioner (Family) | 130 S BRYN MAWR AVE BRYN MAWR, PA 19010 (610) 325-1390 |
| 1225098064 | DR. LINDA A RYAN MD Individual | Psychiatry & Neurology (Psychiatry) | 130 S BRYN MAWR AVE PSYCHIATRIC UNIT BRYN MAWR, PA 19010 (484) 337-4286 |
| 1053366062 | UNITED ANESTHESIA SERVICES PC Organization | Anesthesiology | 130 S BRYN MAWR AVE BRYN MAWR, PA 19010 (610) 526-3000 |
| 1306891338 | ERIK D ASSARSSON MD Individual | Radiology (Radiation Oncology) | 130 S BRYN MAWR AVE BRYN MAWR, PA 19010 (610) 526-8693 |
| 1386683670 | RICHARD CARELLA MD Individual | Radiology (Radiation Oncology) | 130 S BRYN MAWR AVE BRYN MAWR, PA 19010 (610) 523-8695 |
| 1326080375 | DR. ANGUS GILLIS MD Individual | Specialist | 130 S BRYN MAWR AVE BRYN MAWR, PA 19010 (610) 526-3000 |
| 1275575078 | DR. DMITRI CHAMCHAD MD Individual | Specialist | 130 S BRYN MAWR AVE BRYN MAWR, PA 19010 (610) 526-3000 |
| 1972546729 | DR. KIRK P LINDVIG MD Individual | Specialist | 130 S BRYN MAWR AVE BRYN MAWR HOSPITAL ANESTHESIA DEPT. BRYN MAWR, PA 19010 (610) 526-3000 |
| 1528003357 | DR. SAPNA HAVILDAR MD Individual | Anesthesiology | 130 S BRYN MAWR AVE BRYN MAWR HOSPITAL ANESTHESIA DEPT. BRYN MAWR, PA 19010 (610) 526-3000 |
| 1679518419 | SCOTT MARBURGER CRNA, BSN, MS Individual | Nurse Anesthetist, Certified Registered | 130 S BRYN MAWR AVE BRYN MAWR HOSPITAL ANESTHESIA DEPT. BRYN MAWR, PA 19010 (610) 526-3000 |
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. Eric R. Ginn 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.