DR. ANTONINO INSANA M.D. NPI 1003010844

Emergency Medicine in St Petersburg, FL

NPI 1003010844 Individual Male Years of Experience 16 Emergency Medicine PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 90.1 Medicare Quality Reporting

NPI Profile for DR. ANTONINO INSANA M.D.

Antonino Insana is a provider established in St Petersburg, Florida and his medical specialization is emergency medicine with more than 16 years of experience. He graduated from Northeastern Ohio University College Of Medicine in 2007. The NPI number of Antonino Insana is 1003010844 and was assigned on June 2007. The practitioner's primary taxonomy code is 207P00000X with license number ME106755 (FL). The provider is registered as an individual and his NPI record was last updated 11 years ago.

Antonino Insana 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.

Antonino Insana 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 Inspira Medical Center Elmer and Inspira Medical Center Vineland.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90.1, 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 following quality measures were reported for this provider: implementation of an asp, implementation of formal quality improvement methods, practice changes, or other practice improvement processes, measurement and improvement at the practice and panel level and participation in an ahrq-listed patient safety organization..

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.56 for a new patient copayment and $25.94 for an established patient copayment.

NPI

1003010844

Provider NameDR. ANTONINO INSANA M.D.
Provider Location Address6000 49TH ST N ST PETERSBURG, FL 33709
Provider Mailing Address6000 49TH ST N ST PETERSBURG, FL 33709
GenderMale
NPI Entity TypeIndividual
Medical School NameNORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Graduation Year2007
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-14-2007
Last Update Date04-08-2011


Primary Taxonomy

Taxonomy Code207P00000X
ClassificationEmergency Medicine
TypeAllopathic & Osteopathic Physicians
License No.ME106755
License StateFL
Taxonomy DescriptionAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Business Address

DR. ANTONINO INSANA M.D.
6000 49TH ST N
ST PETERSBURG, FL
ZIP 33709
Phone: (727) 521-5510

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Mailing Address

DR. ANTONINO INSANA M.D.
6000 49TH ST N
ST PETERSBURG, FL
ZIP 33709
Phone: (727) 521-5510



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 ID143365569
PECOS Enrollment IDI20190529000053
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 33709 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
$58.4 $178.79 $90.24
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.6 $44.69 $22.56
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
$17.74 $145.28 $103.76
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.43 $36.32 $25.94

* 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% 87.4
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% 75.6
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 - 90.1
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 Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Implementation of an ASPYesN/A
Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance
Implementation of formal quality improvement methods, practice changes, or other practice improvement processesYesN/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
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.
Participation in an AHRQ-listed patient safety organization.YesN/A
Participation in an AHRQ-listed patient safety organization.

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. Antonino Insana is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
INSPIRA MEDICAL CENTER ELMER501 WEST FRONT STREET
ELMER, NJ 8318
(856) 363-1000Acute Care Hospitals310069
INSPIRA MEDICAL CENTER VINELAND1505 W SHERMAN AVE
VINELAND, NJ 8360
(856) 641-8000Acute Care Hospitals310032

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.
1003010844
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200301088
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 + 8 + 8 + 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 = 44

The NPI number 1003010844 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
1619934049DR. CATHERINE ANN PHILLIPS M.D.
Individual
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5510
1457300485FLORIDA EMI MEDICAL SERVICES PA
Organization
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5510
1619926425GLADDEN EMERGENCY PHYSICIANS
Organization
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5510
1841249695EMCARE PHYSICIAN PROVIDERS, INC.
Organization
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5510
1538112651 FRANK A. PIDALA M.D.
Individual
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5044
1922051283 BEVERLY WILCHER D.O.
Individual
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5044
1013960046DR. CHRIS N. KYRUS M.D.
Individual
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5044
1598718447 SETH LABINGER M.D.
Individual
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5044
1427001304 ESTHER T. OPINION M.D.
Individual
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5044
1548214422 ALFRED FRANKEL
Individual
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5044
1194771949 BRADLEY F. PECKLER
Individual
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5044
1952348062 RAAFAT M HANNA M.D.
Individual
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5044
1548282759DR. HECTOR COLLAZO-RAMIS MD
Individual
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5510
1679582514CATHERINE A. PHILLIPS, M.D., PA
Organization
Emergency Medicine6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5510
1104959667 DENISE G BESSETTE RN
Individual
Registered Nurse6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-4411
1821201781 DANIELLE LYNN LAFERRIERE P.T.
Individual
Physical Therapist6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5031
1801009774 KATHLEEN KARA BROWN P.T.
Individual
Physical Therapist6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5031
1518172808MR. PIERRE MICHAEL STEVENSON P.T.
Individual
Physical Therapist6000 49TH ST N
ST PETERSBURG, FL 33709
(727) 521-5507
1205042538 RICHARD ANTHONY REDENBO RPT
Individual
Physical Therapist6000 49TH ST N
SAINT PETERSBURG, FL 33709
(727) 521-5031
1992913693DR. EMILY JOANNE HELM M.D.
Individual
Emergency Medicine6000 49TH ST N DEPARTMENT OF EMERGENCY MEDICINE
ST PETERSBURG, FL 33709
(727) 521-5510

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. Antonino Insana 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.