DR. KRISTINE SUZANNE OLSON ARTHUR MD NPI 1003010950
Internal Medicine in Fountain Valley, CA

About DR. KRISTINE SUZANNE OLSON ARTHUR MD

Kristine Arthur is an internist established in Fountain Valley, California and her medical specialization is Internal Medicine with more than 19 years of experience. She graduated from Loma Linda University School Of Medicine in 2004. The NPI number of this provider is 1003010950 and was assigned on June 2007. The practitioner's primary taxonomy code is 207R00000X with license number A95013 (CA). The provider is registered as an individual and her NPI record was last updated 12 years ago.

NPI
1003010950
Provider NameDR. KRISTINE SUZANNE OLSON ARTHUR MD
Location Address11420 WARNER AVE FOUNTAIN VALLEY, CA 92708
Location Phone(714) 549-1300
Mailing Address2742 DOW AVE TUSTIN, CA 92780
GenderFemale
NPI Entity TypeIndividual
Medical School NameLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year2004
Is Sole Proprietor?No
Enumeration Date06-13-2007
Last Update Date03-30-2011

An internist like Kristine Arthur is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.Kristine Arthur 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.

Kristine Arthur 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 she has hospital affiliations with .

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 96.8, 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: $36.95 for a new patient copayment and $28.72 for an established patient copayment.



Primary Taxonomy

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.

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.A95013
License StateCA
Taxonomy DescriptionA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:

  • Medicaid
  • Medicare

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

Business Address

11420 WARNER AVE
FOUNTAIN VALLEY, CA
ZIP 92708
Phone: (714) 549-1300
Fax: (714) 433-3100

Get Directions


Mailing Address

2742 DOW AVE
TUSTIN, CA
ZIP 92780
Phone: (714) 665-1600


Location Map

PECOS Enrollment and Medicare Participation Status

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 ID8628169778
PECOS Enrollment IDI20070803000609
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 92708 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$65.18 $194.87 $147.83
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$16.29 $48.71 $36.95
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
$20.89 $159.82 $114.88
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.22 $39.95 $28.72

* 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% 96.3
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% 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% 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 - 96.8
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.

  • 22Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 18Administration of influenza virus vaccine (HCPCS:G0008)

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
EN722ZMEDICARE PIN (08)CA
00A950130MEDICAID (05)CA
WA95013AMEDICARE PIN (08)CA

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.
1003010950
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003010910
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 + 1 + 0 + 24 = 40
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1003010950 is valid because the calculated check digit 0 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
1205826849DR. ARFA BABAKNIA MD
Individual
Family Medicine11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 579-1300
1891785234DR. JULIE S FALLON MD
Individual
Pediatrics11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1518957794DR. DAVID M DUNCKEL MD
Individual
Family Medicine11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1568453637DR. BRANDON B KHAW MD
Individual
Internal Medicine11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1619968799DR. ALTON P FORAN IV
Individual
Internal Medicine11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1598756090DR. JO LIEBERMAN PAN MD
Individual
Family Medicine11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1376534628DR. LUCY E SUWARSA MD
Individual
Family Medicine11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1407847619DR. TIMOTHY E MCDONALD MD
Individual
Family Medicine11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1619958527DR. MICHAEL F OZAKI MD
Individual
Pediatrics11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1548242555MS. MICHELE COOPER NP
Individual
Nurse Practitioner11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1891777462MR. STEVEN LERNER PA
Individual
Physician Assistant11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1689621260BRISTOL PARK MEDICAL GROUP, INC
Organization
Family Medicine11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1841303260 GINA POSNER MD
Individual
Pediatrics11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1114253515 SUSAN JUNG PARK
Individual
Family Medicine11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1194044271MISS CINDY H LEE RN, BSN, MSN, FNP
Individual
Nurse Practitioner (Family)11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1356423396DR. KIM ANH TRINH M.D.
Individual
Internal Medicine11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1033175658 KIEN-AN DUONG MD
Individual
Internal Medicine11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1578547782MR. FIDEL ANDRADE PA
Individual
Physician Assistant11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1932190568DR. BRADFORD S CURTIS MD
Individual
Pediatrics11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300
1265907984MS. CARLIE DAYLE GALLOWAY LCSW
Individual
Social Worker (Clinical)11420 WARNER AVE
FOUNTAIN VALLEY, CA 92708
(714) 549-1300

Frequently Asked Questions

What is Dr. Kristine Arthur MD NPI number?

The NPI number assigned to this healthcare provider is 1003010950, registered as an "individual" on June 13, 2007

Where is Dr. Kristine Arthur MD located?

The provider is located at 11420 Warner Ave Fountain Valley, Ca 92708 and the phone number is (714) 549-1300

Which is Dr. Kristine Arthur MD specialty?

The provider's speciality is Internal Medicine

How many years of experience does Dr. Kristine Arthur MD have?

The provider has more than 19 years of experience. She graduated from Loma Linda University School Of Medicine in 2004.

What insurance does Dr. Kristine Arthur MD 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. Kristine Arthur MD registered in PECOS?

Yes, as of January 10, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare 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.

What are Dr. Kristine Arthur MD Quality Ratings?

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

How much is a visit to Dr. Kristine Arthur MD?

Medicare beneficiaries should expect a typical cost of $147.83 with an average copayment of $36.95 for new patient appointments. Established patients should expect a typical charge of $114.88 and an average copayment of 28.72. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dr. Kristine Arthur MD?

The most common procedures or services performed by this practitioner are: Insertion of needle into vein for collection of blood sample and Administration of influenza virus vaccine.

How do I update my NPI information?

The NPI record of Dr. Kristine Arthur MD was last updated on June 13, 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 at: [email protected]