RADHA CHIRUMAMILLA M.D. NPI 1003008590

Hospitalist in Modesto, CA

NPI 1003008590 Individual Female Years of Experience 28 Hospitalist PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 90.9

About RADHA CHIRUMAMILLA

Radha Chirumamilla is a provider established in Modesto, California and her medical specialization is hospitalist with more than 28 years of experience. The NPI number of Radha Chirumamilla is 1003008590 and was assigned on August 2007. The practitioner's primary taxonomy code is 208M00000X with license number A102181 (CA). The provider is registered as an individual and her NPI record was last updated 11 years ago.

Radha Chirumamilla is enrolled in PECOS and is eligible to order or refer healthcare 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

Radha Chirumamilla 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 Memorial Medical Center.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90.9, 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: $34.75 for a new patient copayment and $26.97 for an established patient copayment.

NPI

1003008590

Provider Name RADHA CHIRUMAMILLA M.D.
Provider Location Address600 COFFEE RD MODESTO, CA 95355
Provider Mailing Address600 COFFEE RD MODESTO, CA 95355
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1994
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date08-17-2007
Last Update Date03-25-2011


Primary Taxonomy

Taxonomy Code208M00000X
ClassificationHospitalist
TypeAllopathic & Osteopathic Physicians
License No.A102181
License StateCA
Taxonomy DescriptionHospitalists 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

RADHA CHIRUMAMILLA M.D.
600 COFFEE RD
MODESTO, CA
ZIP 95355
Phone: (209) 524-1211

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Mailing Address

RADHA CHIRUMAMILLA M.D.
600 COFFEE RD
MODESTO, CA
ZIP 95355
Phone: (209) 524-1211



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 ID4486739463
PECOS Enrollment IDI20080314000515
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 95355 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
$60.86 $183.39 $139.01
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.21 $45.84 $34.75
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
$19.29 $150.36 $107.91
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.82 $37.59 $26.97

* 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.
Promoting Interoperability (PI) 25% 72
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% 69.6
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 - 90.9
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.

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. Radha Chirumamilla is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
MEMORIAL MEDICAL CENTER1700 COFFEE RD
MODESTO, CA 95355
(209) 526-4500Acute Care Hospitals50557

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
1207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineA102181CANo

Taxonomy Description: a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1740286640 VICTOR M ARROYO M.D.
Individual
Urology600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1922095132 MARIA GO MD
Individual
Internal Medicine600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1730179136 GIACOMO RUOSI MD
Individual
Emergency Medicine600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1215907217 MATTHEW BRENT WARD M.D.
Individual
Radiology (Diagnostic Radiology)600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1891750121 KARL TOAN BUI DPM
Individual
Podiatrist (Foot & Ankle Surgery)600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1770548646 MAREK TADEUSZ SKOWRON M.D.
Individual
Internal Medicine600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1720044498 CENTI SANDY YOUNAN MD
Individual
Hospitalist600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1659337467 EUTIQUIO DESILVA IMPERIAL MD
Individual
Anesthesiology600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1629034434 RAMAN W KANON MD
Individual
Anesthesiology600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1407812209 BRIGIDA ESTABILLO ANDAYA MD
Individual
Anesthesiology600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1023074820 DAVID ALLEN BETZ MD
Individual
Anesthesiology600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1679539084 CHARLES FRED WILCOX MD
Individual
Obstetrics & Gynecology600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1568428738 CHAI JIE CHANG MD
Individual
Anesthesiology600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1619933850 MING ZHOU MD
Individual
Internal Medicine (Medical Oncology)600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1851357958 JAMES I THOMPSON DO
Individual
Anesthesiology600 COFFEE RD
MODESTO, CA 95355
(209) 521-6097
1114983210 THOMAS G SALOPEK MD
Individual
Dermatology600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1841256948 NIRALI PATEL M.D.
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1104883644 DAVID H ADKINS MD
Individual
Internal Medicine (Hematology & Oncology)600 COFFEE RD
MODESTO, CA 95355
(209) 521-6097
1013974567 KENNETH IMANAKA MD
Individual
Anesthesiology600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211
1831156389 CELINA HETNAL MD
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)600 COFFEE RD
MODESTO, CA 95355
(209) 524-1211

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
The code describing 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.