DAVID SHEEHAN D.O. NPI 1003013129

Radiology - Vascular & Interventional Radiology in Doylestown, PA

Individual Male Years of Experience 17 Radiology Vascular & Interventional Radiology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 100 Medicare Quality Reporting

About DAVID SHEEHAN D.O.

David Sheehan is a provider established in Doylestown, Pennsylvania and his medical specialization is Radiology with a focus in vascular & interventional radiology with more than 17 years of experience. The NPI number of David Sheehan is 1003013129 and was assigned on July 2007. The practitioner's primary taxonomy code is 2085R0204X with license number OS016077 (PA). The provider is registered as an individual and his NPI record was last updated 10 years ago.

NPI

1003013129

Provider Name DAVID SHEEHAN D.O.
Provider Location Address595 W STATE ST DOYLESTOWN RADIOLOGY ASSOCIATES DOYLESTOWN, PA 18901
Provider Mailing Address595 W STATE ST DOYLESTOWN RADIOLOGY ASSOCIATES DOYLESTOWN, PA 18901
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2006
Is Sole Proprietor?No
Enumeration Date07-02-2007
Last Update Date06-04-2012



David Sheehan 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.

David Sheehan 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 Doylestown Hospital.

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 provider also has detailed performance information the following quality measures: radiology: exposure dose indices or exposure time and number of images reported for procedures using fluoroscopy.

The typical physician office visit costs for Medicare beneficiaries in this area are: $24.07 for a new patient copayment and $19.55 for an established patient copayment.



Primary Taxonomy

Taxonomy Code2085R0204X
ClassificationRadiology
TypeAllopathic & Osteopathic Physicians
SpecializationVascular & Interventional Radiology
License No.OS016077
License StatePA
Taxonomy DescriptionA radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

Business Address

DAVID SHEEHAN D.O.
595 W STATE ST
DOYLESTOWN RADIOLOGY ASSOCIATES
DOYLESTOWN, PA
ZIP 18901
Phone: (215) 345-2849

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Mailing Address

DAVID SHEEHAN D.O.
595 W STATE ST
DOYLESTOWN RADIOLOGY ASSOCIATES
DOYLESTOWN, PA
ZIP 18901
Phone: (215) 345-2849


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 ID5395909642
PECOS Enrollment IDI20120618000215
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 18901 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
$62.8 $189.43 $96.31
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.7 $47.35 $24.07
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
$19.68 $154.62 $78.22
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.92 $38.65 $19.55

* 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.
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 - 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.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Radiology: Exposure Dose Indices or Exposure Time and Number of Images Reported for Procedures Using Fluoroscopy 98% 125
Final reports for procedures using fluoroscopy that document radiation exposure indices, or exposure time and number of fluorographic images (if radiation exposure indices are not available)

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.

  • 274X-ray of chest, 2 views, front and side (HCPCS:71020)
  • 184X-ray of chest, 1 view, front (HCPCS:71010)
  • 88Ultrasound study of arteries and arterial grafts of both legs (HCPCS:93925)
  • 62CT scan of abdomen and pelvis with contrast (HCPCS:74177)
  • 59Fluoroscopic guidance for insertion, replacement or removal of central venous access device (HCPCS:77001)
  • 52Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers (HCPCS:93971)
  • 49Ultrasound study of arteries of both arms and legs (HCPCS:93922)
  • 44X-ray of ribs of one side of body, minimum of 2 views (HCPCS:73510)
  • 42Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers (HCPCS:93970)
  • 33X-ray of abdomen, single view (HCPCS:74000)
  • 32Ultrasound of head and neck (HCPCS:76536)
  • 31CT scan of abdomen and pelvis (HCPCS:74176)
  • 31X-ray of knee, 4 or more views (HCPCS:73564)
  • 29Radiological supervision and interpretation of CT guidance for needle insertion (HCPCS:77012)
  • 26Ultrasound guidance for accessing into blood vessel (HCPCS:76937)
  • 23Ultrasonic guidance imaging supervision and interpretation for insertion of needle (HCPCS:76942)
  • 23Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)
  • 22X-ray of foot, minimum of 3 views (HCPCS:73630)
  • 18Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older (HCPCS:36561)
  • 17X-ray of hand, minimum of 3 views (HCPCS:73130)
  • 16Fine needle aspiration using imaging guidance (HCPCS:10022)
  • 16Insertion of central venous catheter for infusion, patient 5 years or older (HCPCS:36556)
  • 13X-ray of wrist, minimum of 3 views (HCPCS:73110)
  • 11Ultrasound pelvis through vagina (HCPCS:76830)

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. David Sheehan is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
DOYLESTOWN HOSPITAL595 WEST STATE ST
DOYLESTOWN, PA 18901
(215) 345-2200Acute Care Hospitals390203

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.
1003013129
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200301614
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 6 + 1 + 4 + 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 1003013129 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 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1306830815DR. EUGENE H HUNT M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1740275205DR. ELLSWORTH WEATHERBY III M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1598750028DR. MARK S SILIDKER M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1093709503DR. PAUL J ADELIZZI M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST RADIOLOGY DEPT
DOYLESTOWN, PA 18901
(215) 345-2290
1558355065DR. CRAIG D KESACK M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1205824026DR. ANDREA CANDIA M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1053309773DR. BRIAN S POLESUK MD
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1679561336DR. PRAMOD DIGAMBER M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1093703753DR. RONALD J COSTANZO M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1093703787DR. SCOTT K PRICE M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1811985500DR. GEORGE G BRACKIN M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1861480311DR. RAJESH RAI M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1437149879DR. DONALD E PARLEE M.D.
Individual
Radiology (Diagnostic Radiology)595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2290
1700858867 JOSEPH J MCHUGH MD
Individual
Emergency Medicine595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2362
1174595227 ROBERT W LINKENHEIMER DO
Individual
Emergency Medicine595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2673
1083686133 EDWARD G KUBOVSAK MD
Individual
Emergency Medicine595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2362
1932171717 STEPHEN J GAZAK MD
Individual
Emergency Medicine595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2362
1568434165 MARK CHOI MD
Individual
Emergency Medicine595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2362
1992770556 MICHAEL T MCGEE NP
Individual
Registered Nurse595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2362
1225091697DOYLESTOWN HOSPITAL
Organization
General Acute Care Hospital595 W STATE ST
DOYLESTOWN, PA 18901
(215) 345-2321

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
David Sheehan D.o. 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.