DR. ERICA MICHELLE KRETCHMAN DO NPI 1003013673

Internal Medicine (Endocrinology, Diabetes & Metabolism) in Richmond, IN

NPI 1003013673 Individual Female Years of Experience 16 Internal Medicine Endocrinology, Diabetes & Metabolism PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 98.2

NPI Profile for DR. ERICA MICHELLE KRETCHMAN DO

Erica Kretchman is an internal medicine provider established in Richmond, Indiana and her medical specialization is internal medicine (endocrinology, diabetes & metabolism) with more than 16 years of experience. The NPI number of Erica Kretchman is 1003013673 and was assigned on June 2007. The practitioner's primary taxonomy code is 207RE0101X with license number 02004002A (IN). The provider is registered as an individual and her NPI record was last updated one year ago.

An internist like Dr. Erica Michelle Kretchman Do 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.

Erica Kretchman 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.

Erica Kretchman 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 Reid Health, Wayne Hospital, Ascension St Vincent Randolph, Grandview Hospital & Medical Center and Henry County Memorial 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 98.2, 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: $31.7 for a new patient copayment and $24.53 for an established patient copayment.

NPI

1003013673

Provider NameDR. ERICA MICHELLE KRETCHMAN DO
Provider Location Address1050 REID PKWY SUITE 300 RICHMOND, IN 47374
Provider Mailing Address1100 REID PKWY MEDICAL STAFF SERVICES RICHMOND, IN 47374
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2007
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-28-2007
Last Update Date05-14-2021


Primary Taxonomy

Taxonomy Code207RE0101X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationEndocrinology, Diabetes & Metabolism
License No.02004002A
License StateIN
Taxonomy DescriptionAn internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Business Address

DR. ERICA MICHELLE KRETCHMAN DO
1050 REID PKWY
SUITE 300
RICHMOND, IN
ZIP 47374
Phone: (765) 935-8941
Fax: (765) 935-8578

Get Directions


Mailing Address

DR. ERICA MICHELLE KRETCHMAN DO
1100 REID PKWY
MEDICAL STAFF SERVICES
RICHMOND, IN
ZIP 47374
Phone: (765) 983-3217
Fax: (765) 983-3219



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 ID7618133430
PECOS Enrollment IDI20120724000272
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 47374 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
$54.76 $167.54 $126.81
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.69 $41.88 $31.7
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
$16.96 $137.16 $98.12
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.24 $34.29 $24.53

* 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% 82
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 - 98.2
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.

  • 567Blood glucose (sugar) test performed by hand-held instrument (HCPCS:82962)
  • 448Hemoglobin A1C level (HCPCS:83036)
  • 50Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
  • 16Fine needle aspiration using imaging guidance (HCPCS:10022)
  • 14Ultrasonic guidance imaging supervision and interpretation for insertion of needle (HCPCS:76942)

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. Erica Kretchman is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
REID HEALTH1100 REID PKWY
RICHMOND, IN 47374
(765) 983-3000Acute Care Hospitals150048
WAYNE HOSPITAL835 SWEITZER STREET
GREENVILLE, OH 45331
(937) 569-6722Acute Care Hospitals360044
ASCENSION ST VINCENT RANDOLPH473 E GREENVILLE AVE
WINCHESTER, IN 47394
(765) 584-0004Critical Access Hospitals151301
GRANDVIEW HOSPITAL & MEDICAL CENTER405 GRAND AVENUE
DAYTON, OH 45405
(937) 723-3410Acute Care Hospitals360133
HENRY COUNTY MEMORIAL HOSPITAL1000 N 16TH ST
NEW CASTLE, IN 47362
(765) 521-0890Acute Care Hospitals150030

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 Identifier Issuer
201076370MEDICAID (05)IN
0070092MEDICAID (05)OH
000000774723OTHER (01)ANTHEM BCBS

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.
1003013673
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003016614
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 + 4 + 24 = 47
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 47 = 33

The NPI number 1003013673 is valid because the calculated check digit 3 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
1972683688MRS. EILEEN E CRAVENS MD
Individual
Internal Medicine (Gastroenterology)1050 REID PKWY SUITE 130
RICHMOND, IN 47374
(765) 983-3208
1902977317 BRENDA L COX R.N.C.N.P.
Individual
Nurse Practitioner (Women's Health)1050 REID PKWY SUITE 220
RICHMOND, IN 47374
(765) 962-9541
1760648471RICHMOND CANCER AND BLOOD DISEASE CENTER
Organization
Internal Medicine (Hematology & Oncology)1050 REID PKWY SUITE 120
RICHMOND, IN 47374
(765) 983-3245
1811144793REID PHYSICIAN ASSOCIATES, INC
Organization
Family Medicine1050 REID PKWY SUITE 210
RICHMOND, IN 47374
(765) 966-5217
1770730103REID PHYSICIAN ASSOCIATES, INC
Organization
Internal Medicine1050 REID PKWY SUITE 110
RICHMOND, IN 47374
(765) 935-8914
1235474081REID PHYSICIAN ASSOCIATES INC
Organization
Orthopaedic Surgery1050 REID PKWY SUITE 325
RICHMOND, IN 47374
(765) 935-8905
1720031917ORTHOPEDIC AND SPINE SURGERY LLC
Organization
Orthopaedic Surgery1050 REID PKWY STE 100
RICHMOND, IN 47374
(765) 983-3373
1174504815DR. JOHN MICHAEL PEREZ M.D.
Individual
Urology1050 REID PKWY SUITE 325
RICHMOND, IN 47374
(765) 962-8551
1316324502CENTRAL INDIANA ORTHOPEDICS, PC
Organization
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)1050 REID PKWY SUITE 100
RICHMOND, IN 47374
(765) 983-3373
1295805802 RACHEL PLATTS RDCD
Individual
Dietitian, Registered1050 REID PKWY SUITE 305
RICHMOND, IN 47374
(765) 983-3423
1558604207 JENNIFER M STACHLER RD
Individual
Dietitian, Registered1050 REID PKWY SUITE 305
RICHMOND, IN 47374
(765) 983-3423
1124474358 BRANDY HOGG-DUNCAN NP
Individual
Nurse Practitioner1050 REID PKWY SUITE # 240
RICHMOND, IN 47374
(765) 983-3410
1164751335 ALLANNA R. ABEL RD
Individual
Dietitian, Registered1050 REID PKWY SUITE 300
RICHMOND, IN 47374
(765) 935-8941
1548348865 CHRISTIE FERRIELL RD, CD
Individual
Dietitian, Registered1050 REID PKWY SUITE 300
RICHMOND, IN 47374
(765) 935-8941
1467815571 JENNIFER GRIGSBY NP
Individual
Nurse Practitioner (Family)1050 REID PKWY SUITE 100
RICHMOND, IN 47374
(765) 983-3373
1912902289 THOMAS M GRAYSON M.D.
Individual
Surgery1050 REID PKWY SUITE 120
RICHMOND, IN 47374
(765) 962-6053
1912975525 HORIA DRAGHICIU MD
Individual
Internal Medicine (Critical Care Medicine)1050 REID PKWY SUITE 200
RICHMOND, IN 47374
(765) 935-8943
1588783633 CHRISTOPHER MOORE
Individual
Surgery1050 REID PKWY SUITE 120
RICHMOND, IN 47374
(765) 962-6053
1346459534 JOSHUA R FRENCH M.D.
Individual
Surgery1050 REID PKWY 120
RICHMOND, IN 47374
(765) 962-6053
1558565614DR. ERIKA BARLOW BRANDENSTEIN M.D.
Individual
Obstetrics & Gynecology1050 REID PKWY SUITE 220
RICHMOND, IN 47374
(765) 962-9541

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. Erica Michelle Kretchman Do 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.