MS. CHERYL A. SPRAGG PA-C NPI 1003009176

Physician Assistant in Stuart, FL

NPI 1003009176 Individual Female Years of Experience 14 Physician Assistant PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 73.9

NPI Profile for MS. CHERYL A. SPRAGG PA-C

Cheryl Spragg is a primary care provider established in Stuart, Florida and her medical specialization is physician assistant with more than 14 years of experience. The NPI number of Cheryl Spragg is 1003009176 and was assigned on August 2007. The practitioner's primary taxonomy code is 363A00000X with license number PA9105543 (FL). The provider is registered as an individual and her NPI record was last updated 11 years ago.

A primary care provider (PCP) like Ms. Cheryl A. Spragg Pa-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

Cheryl Spragg 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.

Cheryl Spragg 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 73.9, 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: $23.66 for a new patient copayment and $19.1 for an established patient copayment.

NPI

1003009176

Provider NameMS. CHERYL A. SPRAGG PA-C
Provider Location Address2100 SE OCEAN BLVD SUITE 100 STUART, FL 34996
Provider Mailing Address1150 SW GOODMAN AVE PORT ST LUCIE, FL 34953
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2009
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date08-22-2007
Last Update Date08-23-2011


Primary Taxonomy

Taxonomy Code363A00000X
ClassificationPhysician Assistant
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.PA9105543
License StateFL
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

MS. CHERYL A. SPRAGG PA-C
2100 SE OCEAN BLVD
SUITE 100
STUART, FL
ZIP 34996
Phone: (772) 223-2115
Fax: (772) 337-9034

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Mailing Address

MS. CHERYL A. SPRAGG PA-C
1150 SW GOODMAN AVE
PORT ST LUCIE, FL
ZIP 34953
Phone: (937) 360-8152
Fax: (772) 337-9034



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 ID5698721124
PECOS Enrollment IDI20100917001054
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 34996 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
$61.36 $187 $94.64
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.34 $46.75 $23.66
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
$18.68 $151.65 $76.4
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.67 $37.91 $19.1

* 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% 68.5
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% 57.6
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 - 73.9
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.

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 Assistant50.002263OHNo

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.

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 Identifier Issuer
Y04YJOTHER (01)FLBCBS OF FLORIDA
DM382ZMEDICARE PIN (08)FL
SPPA26471MEDICARE PIN (08)OH

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.
1003009176
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20030018114
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 + 8 + 1 + 1 + 4 + 24 = 44
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 44 = 66

The NPI number 1003009176 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 13 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1114979135 EDWARD C SKIBA PA
Individual
Physician Assistant (Medical)2100 SE OCEAN BLVD
STUART, FL 34996
(772) 223-2115
1194757351 JENNIFER BARRON MSN, ARNP, FNP
Individual
Registered Nurse2100 SE OCEAN BLVD SUITE 200
STUART, FL 34996
(772) 223-2115
1649339698 CARL JOHN ABENDROTH III DC
Individual
Chiropractor2100 SE OCEAN BLVD SUITE 101
STUART, FL 34996
(772) 223-7337
1942473129ASCENT LLC
Organization
Clinic/Center (Ambulatory Surgical)2100 SE OCEAN BLVD STE 102
STUART, FL 34996
(866) 475-4100
1730418591JOHN ABENDROTH, D.C., P.A.
Organization
Chiropractor2100 SE OCEAN BLVD SUITE 101
STUART, FL 34996
(772) 223-7337
1689972200HOLISTIC GYNECOLOGY OF THE TREASURECOAST
Organization
Clinic/Center (Medical Specialty)2100 SE OCEAN BLVD STE 200-B
STUART, FL 34996
(772) 266-4258
1528318771RIOBE INSTITUTE OF HOLISTIC GYNECOLOGY, PLLC
Organization
Clinic/Center (Medical Specialty)2100 SE OCEAN BLVD SUITE 200-B
STUART, FL 34996
(772) 266-4258
1023201662MID FLORIDA ANESTHESIA ASSOCIATES, INC
Organization
Anesthesiology (Pain Medicine)2100 SE OCEAN BLVD SUITE 200
STUART, FL 34996
(772) 223-2115
1467733774COASTAL PAIN SOLUTIONS, INC.
Organization
Anesthesiology2100 SE OCEAN BLVD SUITE 100
STUART, FL 34996
(772) 223-2115
1134402712COASTAL PAIN SOLUTIONS, INC
Organization
Anesthesiology2100 SE OCEAN BLVD SUITE 100
STUART, FL 34996
(772) 223-2115
1851654743 PATRICIA M TESTA ACNP-BC
Individual
Nurse Practitioner (Acute Care)2100 SE OCEAN BLVD SUITE 100
STUART, FL 34996
(772) 223-2115
1770518524 SIDNEY D SWARTZ MD
Individual
Anesthesiology (Pain Medicine)2100 SE OCEAN BLVD SUITE100
STUART, FL 34996
(772) 223-2115
1962475657 TAMIE R. DAVIS CRNA
Individual
Nurse Anesthetist, Certified Registered2100 SE OCEAN BLVD
STUART, FL 34996
(772) 337-7676

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
Ms. Cheryl A. Spragg Pa-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.