DR. PETER DANIEL FREDERICKS M.D. NPI 1003010919

Orthopaedic Surgery in Colorado Springs, CO

NPI 1003010919 Individual Male Years of Experience 16 Orthopaedic Surgery PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 88.4

NPI Profile for DR. PETER DANIEL FREDERICKS M.D.

Peter Fredericks is a provider established in Colorado Springs, Colorado and his medical specialization is orthopaedic surgery with more than 16 years of experience. He graduated from University Of Arizona College Of Medicine in 2007. The NPI number of Peter Fredericks is 1003010919 and was assigned on June 2007. The practitioner's primary taxonomy code is 207X00000X with license number FF3091573 (CO). The provider is registered as an individual and his NPI record was last updated 6 years ago.

Peter Fredericks 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.

Peter Fredericks 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 Uch-memorial Health System.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 88.4, 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: $23.01 for a new patient copayment and $18.75 for an established patient copayment.

NPI

1003010919

Provider NameDR. PETER DANIEL FREDERICKS M.D.
Provider Location Address175 S UNION BLVD STE 300 COLORADO SPRINGS, CO 80910
Provider Mailing Address175 S UNION BLVD STE 300 COLORADO SPRINGS, CO 80910
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF ARIZONA COLLEGE OF MEDICINE
Graduation Year2007
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-13-2007
Last Update Date05-06-2016


Primary Taxonomy

Taxonomy Code207X00000X
ClassificationOrthopaedic Surgery
TypeAllopathic & Osteopathic Physicians
License No.FF3091573
License StateCO
Taxonomy DescriptionAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Business Address

DR. PETER DANIEL FREDERICKS M.D.
175 S UNION BLVD STE 300
COLORADO SPRINGS, CO
ZIP 80910
Phone: (719) 365-1950
Fax: (719) 365-1951

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Mailing Address

DR. PETER DANIEL FREDERICKS M.D.
175 S UNION BLVD STE 300
COLORADO SPRINGS, CO
ZIP 80910
Phone: (719) 365-1950
Fax: (719) 365-1951



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 ID4183871882
PECOS Enrollment IDI20131009002052
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 80910 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
$60.06 $181 $92.04
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.01 $45.25 $23.01
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
$18.98 $148.2 $75
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.74 $37.05 $18.75

* 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% 95.3
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% 77
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% 63.3
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 - 88.4
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.

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.

  • 17X-ray of ribs of one side of body, minimum of 2 views (HCPCS:73510)

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. Peter Fredericks is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
UCH-MEMORIAL HEALTH SYSTEM1400 E BOULDER ST
COLORADO SPRINGS, CO 80909
(719) 365-5000Acute Care Hospitals60022

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
54988764MEDICAID (05)CO
470219YLB8MEDICARE PIN (08)CO

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.
1003010919
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200301092
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 + 9 + 2 + 24 = 41
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 41 = 99

The NPI number 1003010919 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 12 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1619942604MRS. JANET SUE ANDERSON N.P.
Individual
Nurse Practitioner (Adult Health)175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 365-6363
1609927854MRS. VALERIE J SHERECK A.N.P.
Individual
Nurse Practitioner175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 365-6363
1689713398DR. JOHN L. BENGFORT M.D.
Individual
Internal Medicine (Nephrology)175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 365-6363
1629054101 DENNIS A PHELPS MD
Individual
Orthopaedic Surgery175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 365-1950
1396715876 MINDY SIEGEL MD
Individual
Orthopaedic Surgery175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 365-1950
1639149214MR. JAMES WILLIS SOUTH PA-C
Individual
Physician Assistant (Surgical)175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 365-1950
1073856001 MEGHAN TERESA RUSH M.D.
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 365-6881
1356787436 CAMERON HURST SIDDENS M.D.
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 365-7630
1093792020 KEVIN D PERCY PAC
Individual
Physician Assistant (Surgical)175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 365-1950
1972966992 JEANNETTE RENEE LILLER NP
Individual
Nurse Practitioner (Family)175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 365-7630
1457970238POUDRE VALLEY MEDICAL GROUP, LLC
Organization
Internal Medicine (Endocrinology, Diabetes & Metabolism)175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 365-6881
1194776013 LISA M KEITH ARNP
Individual
Nurse Practitioner175 S UNION BLVD STE 300
COLORADO SPRINGS, CO 80910
(719) 364-5005

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. Peter Daniel Fredericks 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.