JENNIFER LYNN STONE M.D. NPI 1003010307

Family Medicine in Roanoke Rapids, NC

NPI 1003010307 Individual Female Years of Experience 19 Family Medicine PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 91.5 Medicare Quality Reporting

NPI Profile for JENNIFER LYNN STONE M.D.

Jennifer Stone is a primary care provider established in Roanoke Rapids, North Carolina and her medical specialization is family medicine with more than 19 years of experience. The NPI number of Jennifer Stone is 1003010307 and was assigned on June 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 2007-00575 (NC). The provider is registered as an individual and her NPI record was last updated one year ago.

A primary care provider (PCP) like Jennifer Lynn Stone M.d. 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

Jennifer Stone 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.

Jennifer Stone 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 91.5, 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: breast cancer screening, chronic care and preventative care management for empaneled patients, clinical data registry reporting, colorectal cancer screening, diabetes: eye exam, e-prescribing, implementation of medication management practice improvements, measurement and improvement at the practice and panel level, preventive care and screening: body mass index (bmi) screening and follow-up plan, provide patients electronic access to their health information, public health registry reporting, query of the prescription drug monitoring program (pdmp), security risk analysis, support electronic referral loops by sending health information and use of decision support and standardized treatment protocols.

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.

NPI

1003010307

Provider Name JENNIFER LYNN STONE M.D.
Provider Location Address1385 MEDICAL CENTER DR ROANOKE RAPIDS, NC 27870
Provider Mailing Address2925 SYDNEY ST JACKSONVILLE, FL 32205
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2004
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date06-12-2007
Last Update Date02-11-2021


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.2007-00575
License StateNC
Taxonomy DescriptionFamily 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.

Business Address

JENNIFER LYNN STONE M.D.
1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC
ZIP 27870
Phone: (252) 537-9176
Fax: (252) 537-6851

Get Directions


Mailing Address

JENNIFER LYNN STONE M.D.
2925 SYDNEY ST
JACKSONVILLE, FL
ZIP 32205
Phone: (336) 420-4028
Fax: (252) 537-6851



Secondary Locations

1570 Island Ln
Orange Park, FL 32003
(904) 264-1204

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 ID6305993254
PECOS Enrollment IDI20090409000405
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 27870 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
$56.51 $172.65 $87.2
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.12 $43.16 $21.8
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
$17.43 $140.98 $100.83
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.35 $35.24 $25.2

* 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% 62.6
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% 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 - 91.5
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
Breast Cancer Screening 85% 552
Percentage of women 50 - 74 years of age who had a mammogram to screen for breast cancer
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/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)93 and the NCQA Heart/Stroke Recognition Program (HSRP)94;-   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.
Clinical Data Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to a clinical data registry.
Colorectal Cancer Screening 82% 791
Percentage of patients 50-75 years of age who had appropriate screening for colorectal cancer
Diabetes: Eye Exam 29% 214
Percentage of patients 18 - 75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal or dilated eye exam (no evidence of retinopathy) in the 12 months prior to the measurement period
e-Prescribing 98% 9007
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT.
Implementation of medication management practice improvementsYesN/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.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following:- Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or - Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 96% 1330
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 encounterNormal Parameters: Age 18 years and older BMI => 18.5 and < 25 kg/m2
Provide Patients Electronic Access to Their Health Information 85% 1410
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified electronic health record technology (CEHRT).
Public Health Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit data to public health registries.
Query of the Prescription Drug Monitoring Program (PDMP)YesN/A
For at least one Schedule II opioid electronically prescribed using CEHRT during the performance period, the MIPS eligible clinician uses data from CEHRT to conduct a query of a Prescription Drug Monitoring Program (PDMP) for prescription drug history, except where prohibited and in accordance with applicable law.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified electronic health record technology (CEHRT) in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 164.306(d)(3), implement security updates as necessary, and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Support Electronic Referral Loops By Sending Health Information 3% 1125
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider - (1) creates a summary of care record using certified electronic health record technology (CEHRT); and (2) electronically exchanges the summary of care record.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

Clinician Utilization

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 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 113Administration of pneumococcal vaccine (HCPCS:G0009)
  • 108Pneumococcal vaccine for injection into muscle (HCPCS:90670)
  • 107Administration of influenza virus vaccine (HCPCS:G0008)
  • 81Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
  • 58Injection, dexamethasone sodium phosphate, 1mg (HCPCS:J1100)
  • 49Automated urinalysis test (HCPCS:81003)
  • 49Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • 14Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
  • 12Hemoglobin A1C level (HCPCS:83036)

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
1207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineME111724FLNo

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.
1003010307
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200301030
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 0 + 3 + 0 + 24 = 33
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
40 - 33 = 77

The NPI number 1003010307 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 8 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1093832388 DIANA LYNN DILLARD FNP
Individual
Nurse Practitioner (Family)1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1104102540LABORATORY CORPORATION OF AMERICA HOLDINGS
Organization
Clinical Medical Laboratory1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(757) 621-7461
1689792830DR. MOHAMAD A SHAKIR M.D.
Individual
Family Medicine1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1235694076 JESSICA MARIE HASELMAN FNP
Individual
Nurse Practitioner1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1730138066 CHRISTIAN SORENSEN M.D.
Individual
Family Medicine1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1720198369ROANOKE VALLEY HEALTH SERVICES INC
Organization
Clinic/Center (Rural Health)1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1366402406DR. JOHN JAY MYERS M.D.
Individual
Family Medicine1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1396706214 KENNETH ROBERT MD
Individual
Family Medicine1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176

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
Jennifer Lynn Stone 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.