MARY COLEEN GELMANN CRNA
NPI 1003009952
Nurse Anesthetist, Certified Registered in Greensboro, NC


Quality Rating: 100 out of 100 score

NPI Status: Active since August 23, 2007

Contact Information

21A OAK BRANCH DR
GREENSBORO, NC
ZIP 27407
Phone: (336) 478-2664

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  • Individual
  • Female
  • Years of Experience 35
  • Nurse Anesthetist, Certified Registered
  • Accepts Medicare Approved Payment

About MARY GELMANN

Mary Gelmann is a provider established in Greensboro, North Carolina and her medical specialization is Nurse Anesthetist, Certified Registered with more than 35 years of experience. She graduated from Albany Medical College Of Union University in 1990. The healthcare provider is registered in the NPI registry with number 1003009952 assigned on August 2007. The practitioner's primary taxonomy code is 367500000X with license number 7039 (NC). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI
1003009952
Provider Name
MARY COLEEN GELMANN CRNA
Other Name
COLEEN GELMANN CRNA
Other Name Type
Professional Name (2)
Gender
Female
Entity Type
Individual
Location Address
21A OAK BRANCH DR GREENSBORO, NC 27407
Location Phone
(336) 478-2664
Mailing Address
21A OAK BRANCH DR GREENSBORO, NC 27407
Mailing Phone
(336) 478-2664
Medical School Name
ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
Graduation Year
1990
Is Sole Proprietor?
No
Enumeration Date
08-23-2007
Last Update Date
05-09-2023
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Mary Gelmann is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, 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: $21.8 for a new patient copayment and $25.2 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Anesthetist, Certified Registered

Taxonomy Code
367500000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
7039
License State
NC
Taxonomy Description
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1367500000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Anesthetist, Certified Registered

041887 (MD)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Medicare

  • Medicaid


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
041887OTHER (01)CRNA NUMBER

PECOS Enrollment and Medicare Participation Status

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • PECOS PAC ID: 446336978

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20080909000400, I20230504000623

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • 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.

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 27407 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $87.2
  • Minimum New Patient Price $56.51
  • Maximum New Patient Price $172.65
  • Average New Patient Copayment $21.8
  • Minimum New Patient Copayment $14.12
  • Maximum New Patient Copayment $43.16

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $100.83
  • Minimum Established Patient Price $17.43
  • Maximum Established Patient Price $140.98
  • Average Established Patient Copayment $25.2
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $35.24

* The physician office visit costs information is generated by 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 CMS 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.

  • Final Score: 100 out of 100

    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 Score: 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 Score: 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 Score: 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 activities measure category compromises 15% providers final MPIS scores.

    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 Score: 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.

  • Cost Score: 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.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 37

    Anesthesia for procedure on large bowel using an endoscope (HCPCS:00811)

  • 25

    Anesthesia for procedure on esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:00731)

  • 19

    Anesthesia for diagnostic examination of large bowel using an endoscope (HCPCS:00812)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Mary Gelmann is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
HIGH POINT REGIONAL HEALTH SYSTEM601 N ELM ST
HIGH POINT, NC 27261
(336) 878-6000Acute Care Hospitals

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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.
1003009952
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20030018910
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 + 9 + 1 + 0 + 24 = 48
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 48 = 22

The NPI number 1003009952 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003009952, enumerated in the NPI registry as an "individual" on August 23, 2007

The provider is located at 21a Oak Branch Dr Greensboro, Nc 27407 and the phone number is (336) 478-2664

The provider's speciality is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X

The provider has more than 35 years of experience. She graduated from Albany Medical College Of Union University in 1990.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.

Medicare beneficiaries should expect a typical cost of $87.2 with an average copayment of $21.8 for new patient appointments. Established patients should expect a typical charge of $100.83 and an average copayment of 25.2. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Anesthesia for procedure on large bowel using an endoscope, Anesthesia for procedure on esophagus, stomach, and/or upper small bowel using an endoscope and Anesthesia for diagnostic examination of large bowel using an endoscope.

The practitioner is affiliated to the following hospital(s): HIGH POINT REGIONAL HEALTH SYSTEM. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on August 23, 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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