DR. ERICA MICHELLE KRETCHMAN DO NPI 1003013673
Internal Medicine - Endocrinology, Diabetes & Metabolism in Richmond, IN
About DR. ERICA MICHELLE KRETCHMAN DO
Erica Kretchman is an internist established in Richmond, Indiana and her medical specialization is Internal Medicine with a focus in endocrinology, diabetes & metabolism with more than 16 years of experience. The NPI number of this provider 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.
| NPI | 1003013673 |
| Provider Name | DR. ERICA MICHELLE KRETCHMAN DO |
| Location Address | 1050 REID PKWY SUITE 300 RICHMOND, IN 47374 |
| Location Phone | (765) 935-8941 |
| Mailing Address | 1100 REID PKWY MEDICAL STAFF SERVICES RICHMOND, IN 47374 |
| Gender | Female |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 2007 |
| Is Sole Proprietor? | No |
| Enumeration Date | 06-28-2007 |
| Last Update Date | 07-08-2022 |
An internist like Erica Kretchman 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 .
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 99.9, 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.
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 Code | 207RE0101X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | Endocrinology, Diabetes & Metabolism |
| License No. | 02004002A |
| License State | IN |
| Taxonomy Description | An 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. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Anthem Blue Cross
- Blue Cross Blue Shield
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
1050 REID PKWY
SUITE 300
RICHMOND, IN
ZIP 47374
Phone: (765) 935-8941
Fax: (765) 935-8578
Mailing Address
1100 REID PKWY
MEDICAL STAFF SERVICES
RICHMOND, IN
ZIP 47374
Phone: (765) 983-3217
Fax: (765) 983-3219
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 ID | 7618133430 |
| PECOS Enrollment ID | I20120724000272 |
| 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 / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / 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 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. |
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| Promoting Interoperability (PI) | 25% | 99.7 | |
|
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. |
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| 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 | - | 99.9 | |
| 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)
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 |
|---|---|---|---|
| 0070092 | MEDICAID (05) | OH | |
| 201076370 | MEDICAID (05) | IN | |
| 000000774723 | OTHER (01) | ANTHEM BCBS |
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 | 3 | 6 | 7 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 1 | 6 | 6 | 14 | |
| 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 = 3 | 3 | ||||||||
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 |
|---|---|---|---|
| 1972683688 | MRS. 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 |
| 1760648471 | RICHMOND CANCER AND BLOOD DISEASE CENTER Organization | Internal Medicine (Hematology & Oncology) | 1050 REID PKWY SUITE 120 RICHMOND, IN 47374 (765) 983-3245 |
| 1811144793 | REID PHYSICIAN ASSOCIATES, INC Organization | Family Medicine | 1050 REID PKWY SUITE 210 RICHMOND, IN 47374 (765) 966-5217 |
| 1770730103 | REID PHYSICIAN ASSOCIATES, INC Organization | Internal Medicine | 1050 REID PKWY SUITE 110 RICHMOND, IN 47374 (765) 935-8914 |
| 1235474081 | REID PHYSICIAN ASSOCIATES INC Organization | Orthopaedic Surgery | 1050 REID PKWY SUITE 325 RICHMOND, IN 47374 (765) 935-8905 |
| 1720031917 | ORTHOPEDIC AND SPINE SURGERY LLC Organization | Orthopaedic Surgery | 1050 REID PKWY STE 100 RICHMOND, IN 47374 (765) 983-3373 |
| 1174504815 | DR. JOHN MICHAEL PEREZ M.D. Individual | Urology | 1050 REID PKWY SUITE 325 RICHMOND, IN 47374 (765) 962-8551 |
| 1295805802 | RACHEL PLATTS RDCD Individual | Dietitian, Registered | 1050 REID PKWY SUITE 305 RICHMOND, IN 47374 (765) 983-3423 |
| 1558604207 | JENNIFER M STACHLER RD Individual | Dietitian, Registered | 1050 REID PKWY SUITE 305 RICHMOND, IN 47374 (765) 983-3423 |
| 1124474358 | BRANDY HOGG-DUNCAN NP Individual | Nurse Practitioner | 1050 REID PKWY SUITE # 240 RICHMOND, IN 47374 (765) 983-3410 |
| 1164751335 | ALLANNA R. ABEL RD Individual | Dietitian, Registered | 1050 REID PKWY SUITE 300 RICHMOND, IN 47374 (765) 935-8941 |
| 1548348865 | CHRISTIE FERRIELL RD, CD Individual | Dietitian, Registered | 1050 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 | Surgery | 1050 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 | Surgery | 1050 REID PKWY SUITE 120 RICHMOND, IN 47374 (765) 962-6053 |
| 1346459534 | JOSHUA R FRENCH M.D. Individual | Surgery | 1050 REID PKWY 120 RICHMOND, IN 47374 (765) 962-6053 |
| 1558565614 | DR. ERIKA BARLOW BRANDENSTEIN M.D. Individual | Obstetrics & Gynecology | 1050 REID PKWY SUITE 220 RICHMOND, IN 47374 (765) 962-9541 |
| 1245538420 | MRS. MARLA MCDONOUGH EVANS WHNP-BC Individual | Nurse Practitioner (Women's Health) | 1050 REID PKWY SUITE 220 RICHMOND, IN 47374 (765) 962-9541 |
Frequently Asked Questions
What is Dr. Erica Kretchman DO NPI number?
The NPI number assigned to this healthcare provider is 1003013673, registered as an "individual" on June 28, 2007
Where is Dr. Erica Kretchman DO located?
The provider is located at 1050 Reid Pkwy Suite 300 Richmond, In 47374 and the phone number is (765) 935-8941
Which is Dr. Erica Kretchman DO specialty?
The provider's speciality is Internal Medicine with a focus in Endocrinology, Diabetes & Metabolism
How many years of experience does Dr. Erica Kretchman DO have?
The provider has more than 16 years of experience.
What insurance does Dr. Erica Kretchman DO accept?
The provider might be accepting Anthem Blue Cross, Blue Cross Blue Shield, Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Dr. Erica Kretchman DO registered in PECOS?
Yes, as of March 13, 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. Erica Kretchman DO Quality Ratings?
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.
How much is a visit to Dr. Erica Kretchman DO?
Medicare beneficiaries should expect a typical cost of $126.81 with an average copayment of $31.7 for new patient appointments. Established patients should expect a typical charge of $98.12 and an average copayment of 24.53. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Dr. Erica Kretchman DO?
The most common procedures or services performed by this practitioner are: Blood glucose (sugar) test performed by hand-held instrument, Hemoglobin A1C level, Injection beneath the skin or into muscle for therapy, diagnosis, or prevention, Fine needle aspiration using imaging guidance and Ultrasonic guidance imaging supervision and interpretation for insertion of needle.
How do I update my NPI information?
The NPI record of Dr. Erica Kretchman DO 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]
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