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 20 years of experience. She graduated from Loma Linda University School Of Medicine in 2004. The healthcare provider is registered in the NPI registry with number 1003010950 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 13 years ago.
| NPI | 1003010950 |
| Provider Name | DR. KRISTINE SUZANNE OLSON ARTHUR MD |
| Location Address | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 |
| Location Phone | (714) 549-1300 |
| Mailing Address | 2742 DOW AVE TUSTIN, CA 92780 |
| Gender | Female |
| NPI Entity Type | Individual |
| Medical School Name | LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2004 |
| Is Sole Proprietor? | No |
| Enumeration Date | 06-13-2007 |
| Last Update Date | 03-30-2011 |
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 Memorialcare Saddleback Medical Center and Memorialcare Orange Coast Medical Center.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, 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 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.
| Taxonomy Code | 207R00000X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| License No. | A95013 |
| License State | CA |
| Taxonomy Description | A 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
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 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 Medicare providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in the Medicare program need to enroll in PECOS with their NPI number to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 8628169778 |
| PECOS Enrollment ID | I20070803000609 |
| 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 Imaging | Yes |
| Eligible order or refer Durable Medical Equipment (DMEPOS) | Yes |
| Eligible order r refer Home Health Agency (HHA) | Yes |
| Eligible order r refer Power Mobility Devices | Yes |
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% | 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. |
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| 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. |
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| 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. |
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| MIPS Final Score | - | 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. | |||
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.
- 124Insertion of needle into vein for collection of blood sample (HCPCS:36415)
- 14Administration of influenza virus vaccine (HCPCS:G0008)
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. Kristine Arthur is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| MEMORIALCARE SADDLEBACK MEDICAL CENTER | 24451 HEALTH CENTER DRIVE LAGUNA HILLS, CA 92653 | (949) 837-4500 | Acute Care Hospitals | 50603 | |
| MEMORIALCARE ORANGE COAST MEDICAL CENTER | 9920 TALBERT AVENUE FOUNTAIN VALLEY, CA 92708 | (714) 378-7406 | Acute Care Hospitals | 50678 |
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 |
|---|---|---|
| EN722Z | MEDICARE PIN (08) | CA |
| 00A950130 | MEDICAID (05) | CA |
| WA95013A | MEDICARE 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. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 1 | 0 | 9 | 5 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 1 | 0 | 9 | 10 | |
| 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 |
|---|---|---|---|
| 1205826849 | DR. ARFA BABAKNIA MD Individual | Family Medicine | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 579-1300 |
| 1891785234 | DR. JULIE S FALLON MD Individual | Pediatrics | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1518957794 | DR. DAVID M DUNCKEL MD Individual | Family Medicine | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1568453637 | DR. BRANDON B KHAW MD Individual | Internal Medicine | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1619968799 | DR. ALTON P FORAN IV Individual | Internal Medicine | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1598756090 | DR. JO LIEBERMAN PAN MD Individual | Family Medicine | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1376534628 | DR. LUCY E SUWARSA MD Individual | Family Medicine | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1407847619 | DR. TIMOTHY E MCDONALD MD Individual | Family Medicine | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1619958527 | DR. MICHAEL F OZAKI MD Individual | Pediatrics | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1548242555 | MS. MICHELE COOPER NP Individual | Nurse Practitioner | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1891777462 | MR. STEVEN LERNER PA Individual | Physician Assistant | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1689621260 | BRISTOL PARK MEDICAL GROUP, INC Organization | Family Medicine | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1841303260 | GINA POSNER MD Individual | Pediatrics | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1114253515 | SUSAN JUNG PARK Individual | Family Medicine | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1194044271 | MISS CINDY H LEE RN, BSN, MSN, FNP Individual | Nurse Practitioner (Family) | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1356423396 | DR. KIM ANH TRINH M.D. Individual | Internal Medicine | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1033175658 | KIEN-AN DUONG MD Individual | Internal Medicine | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1578547782 | MR. FIDEL ANDRADE PA Individual | Physician Assistant | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1932190568 | DR. BRADFORD S CURTIS MD Individual | Pediatrics | 11420 WARNER AVE FOUNTAIN VALLEY, CA 92708 (714) 549-1300 |
| 1265907984 | MS. 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, enumerated in the NPI registry as an "individual" on June 13, 2007
Where is the provider located?
The provider is located at 11420 Warner Ave Fountain Valley, Ca 92708 and the phone number is (714) 549-1300
What is the provider specialty code?
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
How many years of experience does Dr. Kristine Arthur MD have?
The provider has more than 20 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 September 14, 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.
Is Dr. Kristine Arthur MD affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: MEMORIALCARE SADDLEBACK MEDICAL CENTER and MEMORIALCARE ORANGE COAST MEDICAL CENTER. 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 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].
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