NATHANAEL BAILEY NPI 1003013814

Pathology - Anatomic Pathology & Clinical Pathology in Ann Arbor, MI

Individual Male Years of Experience 18 Pathology Anatomic Pathology & Clinical Pathology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 89.7

About NATHANAEL BAILEY

Nathanael Bailey is a provider established in Ann Arbor, Michigan and his medical specialization is Pathology with a focus in anatomic pathology & clinical pathology with more than 18 years of experience. He graduated from West Virginia University School Of Medicine in 2005. The NPI number of Nathanael Bailey is 1003013814 and was assigned on June 2007. The practitioner's primary taxonomy code is 207ZP0102X with license number 4301095848 (MI). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI

1003013814

Provider Name NATHANAEL BAILEY
Provider Location Address1500 E MEDICAL CENTER DR 2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY ANN ARBOR, MI 48109
Provider Mailing Address3621 S STATE ST 700 KMS PLACE ANN ARBOR, MI 48108
GenderMale
NPI Entity TypeIndividual
Medical School NameWEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year2005
Is Sole Proprietor?No
Enumeration Date06-27-2007
Last Update Date06-15-2021



Nathanael Bailey 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.

Nathanael Bailey 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 Magee Womens Hospital Of Upmc Health System, Upmc Presbyterian Shadyside, Upmc East, Upmc Jameson and Upmc St Margaret.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 89.7, 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: $34.94 for a new patient copayment and $18.9 for an established patient copayment.



Primary Taxonomy

Taxonomy Code207ZP0102X
ClassificationPathology
TypeAllopathic & Osteopathic Physicians
SpecializationAnatomic Pathology & Clinical Pathology
License No.4301095848
License StateMI
Taxonomy DescriptionA pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

Business Address

NATHANAEL BAILEY
1500 E MEDICAL CENTER DR
2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY
ANN ARBOR, MI
ZIP 48109
Phone: (800) 862-7284

Get Directions


Mailing Address

NATHANAEL BAILEY
3621 S STATE ST
700 KMS PLACE
ANN ARBOR, MI
ZIP 48108
Phone:


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 ID7012194491
PECOS Enrollment IDI20160902000941
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 48109 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
$60.64 $184.65 $139.76
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.16 $46.16 $34.94
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
$18.56 $150 $75.6
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.64 $37.5 $18.9

* 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% 87.8
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% 88
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% 71.5
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 - 89.7
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.

  • 323Special stained specimen slides to examine tissue (HCPCS:88341)
  • 119Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)
  • 81Tissue or cell analysis by immunologic technique (HCPCS:88342)

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. Nathanael Bailey is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM300 HALKET STREET
PITTSBURGH, PA 15213
(412) 641-4010Acute Care Hospitals390114
UPMC PRESBYTERIAN SHADYSIDE200 LOTHROP STREET
PITTSBURGH, PA 15213
(412) 647-8788Acute Care Hospitals390164
UPMC EAST2775 MOSSIDE BOULEVARD
MONROEVILLE, PA 15146
(412) 357-3000Acute Care Hospitals390328
UPMC JAMESON1211 WILMINGTON AVENUE
NEW CASTLE, PA 16105
(724) 656-4100Acute Care Hospitals390016
UPMC ST MARGARET815 FREEPORT ROAD
PITTSBURGH, PA 15215
(412) 784-4000Acute Care Hospitals390102

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.
1003013814
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200301682
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 + 8 + 2 + 24 = 46
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 46 = 44

The NPI number 1003013814 is valid because the calculated check digit 4 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
1669475836DR. TAMI L. REMINGTON PHARM.D.
Individual
Pharmacist (Pharmacotherapy)1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
(734) 936-5023
1275536401DR. JAMES G STEVENSON PHARMD
Individual
Pharmacist1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
(734) 647-7794
1508864315DR. SALLY K GUTHRIE PHARM.D.
Individual
Pharmacist (Psychiatric)1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
(734) 647-2350
1356343370 ANDREA RAE BOTTERILL PA
Individual
Physician Assistant1500 E MEDICAL CENTER DR 2ND FLOOR TAUBMAN CENTER RECP C
ANN ARBOR, MI 48109
(734) 936-5780
1871586719DR. KARLA AURORA BLACKWOOD MD
Individual
Psychiatry & Neurology (Psychiatry)1500 E MEDICAL CENTER DR B1 FLOOR UNIVERSITY HOSPITAL RECP EMERGENCY
ANN ARBOR, MI 48109
(734) 996-4747
1871586479 DEBORAH LOUISE VIHER NP
Individual
Nurse Practitioner1500 E MEDICAL CENTER DR 3RD FLOOR TAUBMAN CENTER RECP D
ANN ARBOR, MI 48109
(734) 647-5944
1740276633DR. HOLLY ELAINE ROSS M.D.
Individual
General Practice1500 E MEDICAL CENTER DR L2003 WOMEN'S, BOX 0239
ANN ARBOR, MI 48109
(734) 615-2690
1265420228MS. DEBRA BANCROFT RIZZO F.N.P.-C
Individual
Nurse Practitioner1500 E MEDICAL CENTER DR 3RD TAUBMAN CENTER RECP A
ANN ARBOR, MI 48109
(734) 647-5900
1992794481 WILLIAM CHARLES STACEY M.D., PHD
Individual
Psychiatry & Neurology (Neurology)1500 E MEDICAL CENTER DR 1ST FLOOR TAUBMAN CENTER RECP C
ANN ARBOR, MI 48109
(734) 936-9010
1104809623DR. ELIZABETH KATHERINE SPELIOTES MD PHD
Individual
Internal Medicine (Gastroenterology)1500 E MEDICAL CENTER DR 3RD FLOOR TAUBMAN CENTER RECP D
ANN ARBOR, MI 48109
(734) 647-5944
1114903549DR. ROBERT ADAM LIOTTA M.D.
Individual
Radiology (Diagnostic Radiology)1500 E MEDICAL CENTER DR B1 FLOOR UNIVERSITY HOSPITAL RECP C
ANN ARBOR, MI 48109
(734) 936-4566
1114998580 LISA A HARRIS SPINNER CRNA
Individual
Nurse Anesthetist, Certified Registered1500 E MEDICAL CENTER DR 1ST FLOOR TAUBMAN CENTER RECP E
ANN ARBOR, MI 48109
(734) 763-6295
1609849447 HUI HUA S YUE CRNA
Individual
Nurse Anesthetist, Certified Registered1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
(734) 936-4280
1801863741 SHANNON LEE MITCHELL CRNA
Individual
Nurse Anesthetist, Certified Registered1500 E MEDICAL CENTER DR 1H247 UNIVERSITY HOSPITAL
ANN ARBOR, MI 48109
(734) 936-4280
1841267788 CHRISTINA BUSH CRNA
Individual
Nurse Anesthetist, Certified Registered1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
(734) 936-4280
1922076215 MARLENA STANKIEWICZ CRNA
Individual
Nurse Anesthetist, Certified Registered1500 E MEDICAL CENTER DR 1H247 UNIVERSITY HOSPITAL
ANN ARBOR, MI 48109
(734) 936-4280
1497724835 DENISE R BAUER N.P.
Individual
Nurse Practitioner1500 E MEDICAL CENTER DR 7TH FLOOR MOTT RM F7830
ANN ARBOR, MI 48109
(734) 763-7354
1972564458MRS. CARRIE LEE LINT RN ACNP
Individual
Nurse Practitioner1500 E MEDICAL CENTER DR 2ND FLOOR TAUBMAN CENTER RECP G
ANN ARBOR, MI 48109
(734) 936-7010
1851353932MRS. TAMARA MANGAN GHORMLEY NP
Individual
Nurse Practitioner (Family)1500 E MEDICAL CENTER DR B1 FLOOR CANCER CTR RECP C
ANN ARBOR, MI 48109
(734) 936-6000
1568428951 ELENA MARTINEZ STOFFEL MD MPH
Individual
Internal Medicine (Gastroenterology)1500 E MEDICAL CENTER DR 3RD FLOOR TAUBMAN CENTER RECP D
ANN ARBOR, MI 48109
(734) 647-5944

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
Nathanael Bailey 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.