DR. ANTONINO INSANA M.D.
NPI 1003010844
Emergency Medicine in St Petersburg, FL


Quality Rating: 60 out of 100 score

NPI Status: Active since June 14, 2007

Contact Information

6000 49TH ST N
ST PETERSBURG, FL
ZIP 33709
Phone: (727) 521-5510

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  • Individual
  • Male
  • Years of Experience 17
  • Emergency Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About ANTONINO INSANA

Antonino Insana is a provider established in St Petersburg, Florida and his medical specialization is Emergency Medicine with more than 17 years of experience. He graduated from Northeastern Ohio University College Of Medicine in 2007. The healthcare provider is registered in the NPI registry with number 1003010844 assigned on June 2007. The practitioner's primary taxonomy code is 207P00000X with license number 25MA10554700 (NJ). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI1003010844
Provider NameDR. ANTONINO INSANA M.D.
Location Address6000 49TH ST N ST PETERSBURG, FL 33709
Location Phone(727) 521-5510
Mailing Address6000 49TH ST N ST PETERSBURG, FL 33709
GenderMale
Entity TypeIndividual
Medical School NameNORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Graduation Year2007
Is Sole Proprietor?No
Enumeration Date06-14-2007
Last Update Date06-09-2023
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Antonino Insana 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 60, 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.

Location Map

Mailing Address

6000 49TH ST N
ST PETERSBURG, FL
ZIP 33709
Phone: (727) 521-5510

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

Emergency Medicine

Taxonomy Code207P00000X
TypeAllopathic & Osteopathic Physicians
License No.25MA10554700
License StateNJ
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.

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)
1207P00000XAllopathic & Osteopathic Physicians

Emergency Medicine

ME106755 (FL)

Insurance Plans Accepted

The NPI profile data suggests this provider may be accepting health plans from these insurance companies or healthcare programs:

  • Medicaid
  • Medicare

*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
0688703MEDICAID (05)NJ 

PECOS Enrollment and Medicare Participation Status

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.

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.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 143365569

    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: I20190529000053

    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.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

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 33709 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $90.24
  • Minimum New Patient Price $58.4
  • Maximum New Patient Price $178.79
  • Average New Patient Copayment $22.56
  • Minimum New Patient Copayment $14.6
  • Maximum New Patient Copayment $44.69

Established Patients Visit Costs *

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

  • Average Established Patient Price $103.76
  • Minimum Established Patient Price $17.74
  • Maximum Established Patient Price $145.28
  • Average Established Patient Copayment $25.94
  • Minimum Established Patient Copayment $4.43
  • Maximum Established Patient Copayment $36.32

* 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: 60 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: N/A

    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: N/A

    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.

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

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. Antonino Insana is affiliated with the following medical facilities:

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

Frequently Asked Questions

What is Dr. Antonino Insana M.D. NPI number?

The NPI number assigned to this healthcare provider is 1003010844, enumerated in the NPI registry as an "individual" on June 14, 2007

Where is the provider located?

The provider is located at 6000 49th St N St Petersburg, Fl 33709 and the phone number is (727) 521-5510

What is the provider specialty code?

The provider's speciality is Emergency Medicine with taxonomy code 207P00000X

How many years of experience does Dr. Antonino Insana M.D. have?

The provider has more than 17 years of experience. He graduated from Northeastern Ohio University College Of Medicine in 2007.

What insurance does Dr. Antonino Insana M.D. accept?

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

Is Dr. Antonino Insana M.D. registered in PECOS?

Yes, as of February 16, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

How much is a visit to Dr. Antonino Insana M.D.?

Medicare beneficiaries should expect a typical cost of $90.24 with an average copayment of $22.56 for new patient appointments. Established patients should expect a typical charge of $103.76 and an average copayment of 25.94. Please review your insurance plan or contact the provider directly to determine your specific costs.

Is Dr. Antonino Insana M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospital(s): INSPIRA MEDICAL CENTER VINELAND and INSPIRA MEDICAL CENTER ELMER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

This NPI record was last updated on June 14, 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.