DR. RICHARD C SPINALE DO
NPI 1003013657
Surgery in Garden City, MI


Quality Rating: 60 out of 100 score

NPI Status: Active since June 28, 2007

Contact Information

6255 INKSTER RD
SUITE 207
GARDEN CITY, MI
ZIP 48135
Phone: (734) 427-6570
Fax: (734) 427-6140

Get Directions Reviews

  • Individual
  • Male
  • Surgery
  • PECOS Enrolled

About RICHARD SPINALE

Richard Spinale is a provider established in Garden City, Michigan and his medical specialization is Surgery. The healthcare provider is registered in the NPI registry with number 1003013657 assigned on June 2007. The practitioner's primary taxonomy code is 208600000X with license number 009110 (MI). The provider is registered as an individual and his NPI record was last updated 17 years ago.

NPI
1003013657
Provider Name
DR. RICHARD C SPINALE DO
Gender
Male
Entity Type
Individual
Location Address
6255 INKSTER RD SUITE 207 GARDEN CITY, MI 48135
Location Phone
(734) 427-6570
Location Fax
(734) 427-6140
Mailing Address
6255 INKSTER RD SUITE 207 GARDEN CITY, MI 48135
Mailing Phone
(734) 427-6570
Mailing Fax
(734) 427-6140
Is Sole Proprietor?
Yes
Enumeration Date
06-28-2007
Last Update Date
07-08-2007
Code Navigator

A surgeon like Richard Spinale treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.

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.

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

Surgery

Taxonomy Code
208600000X
Type
Allopathic & Osteopathic Physicians
License No.
009110
License State
MI
Taxonomy Description
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

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
E38094MEDICARE UPIN (02)MI 
2842362MEDICAID (05)MI 
5820254MEDICARE ID-TYPE UNSPECIFIED (04)MI 

PECOS Enrollment and Medicare Participation Status

Richard Spinale 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

  • 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 48135 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $93.48
  • Minimum New Patient Price $60.64
  • Maximum New Patient Price $184.65
  • Average New Patient Copayment $23.37
  • Minimum New Patient Copayment $15.16
  • Maximum New Patient Copayment $46.16

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $75.6
  • Minimum Established Patient Price $18.56
  • Maximum Established Patient Price $150
  • Average Established Patient Copayment $18.9
  • Minimum Established Patient Copayment $4.64
  • Maximum Established Patient Copayment $37.5

* 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.

Clinician Services

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 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 22

    Removal of polyps or growths of large bowel using an endoscope (HCPCS:45385)

  • 12

    Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS:G0105)

Reviews for DR. RICHARD C SPINALE DO

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

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.
1003013657
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003016610
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 + 6 + 1 + 0 + 24 = 43
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 43 = 77

The NPI number 1003013657 is valid because the calculated check digit 7 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
1497755177DR. STEPHEN B GOLDFARB D.O.
Individual
Internal Medicine (Hematology & Oncology)6255 INKSTER RD SUITE 105
GARDEN CITY, MI 48135
(734) 522-0404
1902889884RICHARD C SPINALE DO PC
Organization
Surgery6255 INKSTER RD SUITE 207
GARDEN CITY, MI 48135
(734) 427-6570
1215902382 RONALD LUTSIC D.O.
Individual
Radiology (Radiation Oncology)6255 INKSTER RD
GARDEN CITY, MI 48135
(734) 522-8540
1932143013DR. WILLIAM DAVIDSON D.O.
Individual
Urology6255 INKSTER RD
GARDEN CITY, MI 48135
(734) 425-7230
1922219260 CYNTHIA MORIN P.A.
Individual
Physician Assistant6255 INKSTER RD
GARDEN CITY, MI 48135
(734) 522-8540
1992992671JOHN H MORRISON JR DO PC
Organization
Internal Medicine (Pulmonary Disease)6255 INKSTER RD STE 204
GARDEN CITY, MI 48135
(734) 525-0350
1740469451LEONARD T GLINSKI DO PC
Organization
Otolaryngology (Otolaryngology/Facial Plastic Surgery)6255 INKSTER RD SUITE 202
GARDEN CITY, MI 48135
(734) 261-8040
1043491343MICHAEL S. SHERMAN, DO, PC
Organization
Ophthalmology6255 INKSTER RD SUITE 303
GARDEN CITY, MI 48135
(734) 421-0790
1780856393REUBEN D ELIUK, DO, PLC
Organization
Internal Medicine6255 INKSTER RD SUITE 101
GARDEN CITY, MI 48135
(734) 421-4850
1336312867 PREETI S KELKAR M.D.
Individual
Radiology (Radiation Oncology)6255 INKSTER RD STE B-7
GARDEN CITY, MI 48135
(734) 522-8540
1275706640STEPHEN B GOLDFARB DO PC
Organization
Internal Medicine (Hematology & Oncology)6255 INKSTER RD STE 105
GARDEN CITY, MI 48135
(734) 522-0404
1245403492LOUIS JACOBS, D.O., P.C.
Organization
Neurological Surgery6255 INKSTER RD SUITE 206
GARDEN CITY, MI 48135
(734) 421-0044
1770815615ANKLE AND FOOTCARE SPECIALISTS PLC
Organization
Podiatrist6255 INKSTER RD SUITE 307
GARDEN CITY, MI 48135
(734) 751-2533
1427143387 ROBERT GROSS DO
Individual
Surgery6255 INKSTER RD SUITE 204
GARDEN CITY, MI 48135
(734) 458-4492
1740375518GREAT LAKES ORTHOPAEDICS
Organization
Orthopaedic Surgery6255 INKSTER RD STE 103
GARDEN CITY, MI 48135
(734) 422-8400
1396716544 JOSEPH L WALKIEWICZ D.O.
Individual
Orthopaedic Surgery6255 INKSTER RD SUITE 103
GARDEN CITY, MI 48135
(734) 422-8400
1477538056PRIME HEALTHCARE SERVICES - GARDEN CITY, LLC
Organization
Pharmacy (Community/Retail Pharmacy)6255 INKSTER RD STE 106
GARDEN CITY, MI 48135
(734) 458-4224
1174522163DR. LOUIS ISRAEL JACOBS D.O.
Individual
Neurological Surgery6255 INKSTER RD SUITE #206
GARDEN CITY, MI 48135
(734) 421-0044
1902260417JAGANNATHAN NEUROSURGICAL INSTITUTE PLLC
Organization
Neurological Surgery6255 INKSTER RD SUITE 206
GARDEN CITY, MI 48135
(734) 458-3614
1861705402 TIMOTHY JAMES DOIG D.O.
Individual
Orthopaedic Surgery6255 INKSTER RD SUITE 103
GARDEN CITY, MI 48135
(734) 422-8400

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003013657, enumerated in the NPI registry as an "individual" on June 28, 2007

The provider is located at 6255 Inkster Rd Suite 207 Garden City, Mi 48135 and the phone number is (734) 427-6570

The provider's speciality is Surgery with taxonomy code 208600000X

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.

Yes, as of April 12, 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.

Medicare beneficiaries should expect a typical cost of $93.48 with an average copayment of $23.37 for new patient appointments. Established patients should expect a typical charge of $75.6 and an average copayment of 18.9. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Removal of polyps or growths of large bowel using an endoscope and Colorectal cancer screening; colonoscopy on individual at high risk.

This NPI record was last updated on June 28, 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.