DR. KEVIN JAMES SAWYER M.D.
NPI 1003013848
Radiology - Diagnostic Radiology in Lakeland, FL


Quality Rating: 67.76 out of 100 score

NPI Status: Active since June 27, 2007

Contact Information

2125 CRYSTAL GROVE DR
LAKELAND, FL
ZIP 33801
Phone: (863) 688-2334

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  • Individual
  • Male
  • Years of Experience 21
  • Radiology
  • Diagnostic Radiology
  • PECOS Enrolled
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About KEVIN SAWYER

Kevin Sawyer is a provider established in Lakeland, Florida and his medical specialization is Radiology with a focus in diagnostic radiology with more than 21 years of experience. He graduated from Georgetown University School Of Medicine in 2003. The healthcare provider is registered in the NPI registry with number 1003013848 assigned on June 2007. The practitioner's primary taxonomy code is 2085R0202X with license number ME112475 (FL). The provider is registered as an individual and his NPI record was last updated 8 years ago.

NPI
1003013848
Provider Name
DR. KEVIN JAMES SAWYER M.D.
Gender
Male
Entity Type
Individual
Location Address
2125 CRYSTAL GROVE DR LAKELAND, FL 33801
Location Phone
(863) 688-2334
Mailing Address
2125 CRYSTAL GROVE DR LAKELAND, FL 33801
Mailing Phone
(863) 688-2334
Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
2003
Is Sole Proprietor?
No
Enumeration Date
06-27-2007
Last Update Date
06-03-2016
Code Navigator

Kevin Sawyer is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 67.76, 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 following quality measures were reported for this provider: provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record.

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.56 for a new patient copayment and $18.26 for an established patient copayment.

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

Radiology Diagnostic Radiology

Taxonomy Code
2085R0202X
Type
Allopathic & Osteopathic Physicians
License No.
ME112475
License State
FL
Taxonomy Description
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Molina Healthcare

    • Bronze 4 - HMO
    • Bronze 8 - HMO
    • Gold 1 - HMO
    • Gold 1 with Adult Vision Services - HMO
    • Gold 8 - HMO
    • Silver 1 - HMO
    • Silver 1 with Adult Vision Services - HMO
    • Silver 12 with First 4 Primary Care Visits Free - HMO
    • Silver 8 - HMO
    • Silver 9 - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

PECOS Enrollment and Medicare Participation Status

Kevin Sawyer 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

  • PECOS PAC ID: 6103990916

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20120703000680

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • 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 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 33801 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $90.24
  • Minimum New Patient Price $58.4
  • Maximum New Patient Price $178.79
  • Average New Patient Copayment $22.56
  • Minimum New Patient Copayment $14.6
  • Maximum New Patient Copayment $44.69

Established Patients Visit Costs *

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

  • Average Established Patient Price $73.05
  • Minimum Established Patient Price $17.74
  • Maximum Established Patient Price $145.28
  • Average Established Patient Copayment $18.26
  • Minimum Established Patient Copayment $4.43
  • Maximum Established Patient Copayment $36.32

* 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: 67.76 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: 62.07

    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: 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 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.

Quality Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical RecordYesN/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.

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.

  • 1309

    X-ray of chest, 1 view (HCPCS:71045)

  • 353

    Ct scan head or brain (HCPCS:70450)

  • 232

    X-ray of chest, 2 views (HCPCS:71046)

  • 147

    Ct scan of abdomen and pelvis (HCPCS:74176)

  • 121

    Mammography of both breasts (HCPCS:77067)

  • 105

    Ct scan of abdomen and pelvis with contrast (HCPCS:74177)

  • 88

    X-ray of hip with pelvis, 2-3 views (HCPCS:73502)

  • 83

    Ct scan chest (HCPCS:71250)

  • 60

    X-ray of knee, 3 views (HCPCS:73562)

  • 58

    Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers (HCPCS:93971)

  • 51

    Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers (HCPCS:93970)

  • 36

    Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)

  • 35

    X-ray of shoulder, minimum of 2 views (HCPCS:73030)

  • 33

    Nuclear medicine study with ct imaging skull base to mid-thigh (HCPCS:78815)

  • 23

    X-ray of wrist, minimum of 3 views (HCPCS:73110)

  • 20

    Bone density measurement using dedicated x-ray machine (HCPCS:77080)

  • 18

    Ct scan of face (HCPCS:70486)

  • 16

    X-ray of hand, minimum of 3 views (HCPCS:73130)

  • 16

    Bone and/or joint imaging, whole body (HCPCS:78306)

  • 13

    X-ray of foot, minimum of 3 views (HCPCS:73630)

Reviews for DR. KEVIN JAMES SAWYER M.D.

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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.
1003013848
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200301688
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 + 8 + 24 = 52
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 52 = 88

The NPI number 1003013848 is valid because the calculated check digit 8 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
1548526155VASCULAR SPECIALISTS OF LAKELAND, LLC
Organization
Surgery (Vascular Surgery)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1457342727DR. CHARLEY T. MYRICK III D. O.
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1568435915DR. MARY T GRIFFEN MD
Individual
Radiology (Neuroradiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1326208034DR. JONG HO PARK M.D., M.P.H
Individual
Radiology (Vascular & Interventional Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1568626026 NARAYAN VISWANADHAN MD
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1063639342 ALEXANDER J FERNANDEZ M.D.
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1154531887 SARA SAFDER M.D.
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1871721167 JOSEPH DANIEL MULLEN MD
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1225589179 RODNEY SHAWN CARTER ARNP, FNP-C, MSN
Individual
Nurse Practitioner (Family)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1942751813 TERESA M COLLETTI ARNP
Individual
Nurse Practitioner2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1427207968DR. VENKAT P TUMMALA MD
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1811216732DR. RITU APARAJITA MD
Individual
Surgery (Vascular Surgery)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1740850445 JONATHYN ANDREW MARX PA-C
Individual
Physician Assistant2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1265918098 JEFFREY E HALL ARNP
Individual
Nurse Practitioner (Family)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(800) 229-2273
1417121120 JEFFREY JOSEPH GRONKIEWICZ M.D.
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1669103198RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND
Organization
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1336448562 NEEL D KARAMSADKAR M.D.
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1801185897 MATTHEW P BUZZEO M.D.
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1285923292DR. MATTHEW ALLAN ASSING M.D.
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334
1679956817 DAVIN WATSON M.D.
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003013848, enumerated in the NPI registry as an "individual" on June 27, 2007

The provider is located at 2125 Crystal Grove Dr Lakeland, Fl 33801 and the phone number is (863) 688-2334

The provider's speciality is Radiology with taxonomy code 2085R0202X with a focus in Diagnostic Radiology

The provider has more than 21 years of experience. He graduated from Georgetown University School Of Medicine in 2003.

The provider might be accepting Accepts: Molina Healthcare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 10, 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 $90.24 with an average copayment of $22.56 for new patient appointments. Established patients should expect a typical charge of $73.05 and an average copayment of 18.26. 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: X-ray of chest, 1 view, Ct scan head or brain, X-ray of chest, 2 views, Ct scan of abdomen and pelvis, Mammography of both breasts, Ct scan of abdomen and pelvis with contrast, X-ray of hip with pelvis, 2-3 views, Ct scan chest, X-ray of knee, 3 views, Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers, Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers, Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck, X-ray of shoulder, minimum of 2 views, Nuclear medicine study with ct imaging skull base to mid-thigh, X-ray of wrist, minimum of 3 views, Bone density measurement using dedicated x-ray machine, Ct scan of face, X-ray of hand, minimum of 3 views, Bone and/or joint imaging, whole body and X-ray of foot, minimum of 3 views.

This NPI record was last updated on June 27, 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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