DR. KEVIN JAMES SAWYER M.D. NPI 1003013848

Radiology - Diagnostic Radiology in Lakeland, FL

Individual Male Years of Experience 20 Radiology Diagnostic Radiology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 89.3 Medicare Quality Reporting

About DR. KEVIN JAMES SAWYER M.D.

Kevin Sawyer is a provider established in Lakeland, Florida and his medical specialization is Radiology with a focus in diagnostic radiology with more than 20 years of experience. He graduated from Georgetown University School Of Medicine in 2003. The NPI number of Kevin Sawyer is 1003013848 and was 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 6 years ago.

NPI

1003013848

Provider NameDR. KEVIN JAMES SAWYER M.D.
Provider Location Address2125 CRYSTAL GROVE DR LAKELAND, FL 33801
Provider Mailing Address2125 CRYSTAL GROVE DR LAKELAND, FL 33801
GenderMale
NPI Entity TypeIndividual
Medical School NameGEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduation Year2003
Is Sole Proprietor?No
Enumeration Date06-27-2007
Last Update Date06-03-2016



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.

Kevin Sawyer 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 Adventhealth Heart Of Florida, Winter Haven Hospital, Adventhealth Lake Wales, Manatee Memorial Hospital and South Florida Baptist 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 89.3, 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.



Primary Taxonomy

Taxonomy Code2085R0202X
ClassificationRadiology
TypeAllopathic & Osteopathic Physicians
SpecializationDiagnostic Radiology
License No.ME112475
License StateFL
Taxonomy DescriptionA radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Business Address

DR. KEVIN JAMES SAWYER M.D.
2125 CRYSTAL GROVE DR
LAKELAND, FL
ZIP 33801
Phone: (863) 688-2334

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Mailing Address

DR. KEVIN JAMES SAWYER M.D.
2125 CRYSTAL GROVE DR
LAKELAND, FL
ZIP 33801
Phone: (863) 688-2334


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 ID6103990916
PECOS Enrollment IDI20120703000680
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 33801 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$58.4 $178.79 $90.24
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.6 $44.69 $22.56
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
$17.74 $145.28 $73.05
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.43 $36.32 $18.26

* 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% 88.6
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% 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 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% 64.7
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 - 89.3
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 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 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.

  • 953X-ray of chest, 1 view, front (HCPCS:71010)
  • 228X-ray of chest, 2 views, front and side (HCPCS:71020)
  • 181Nuclear medicine study with CT imaging skull base to mid-thigh (HCPCS:78815)
  • 102CT scan of abdomen and pelvis (HCPCS:74176)
  • 90CT scan of abdomen and pelvis with contrast (HCPCS:74177)
  • 83X-ray of abdomen, single view (HCPCS:74000)
  • 64Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers (HCPCS:93970)
  • 63Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)
  • 44X-ray of ribs of one side of body, minimum of 2 views (HCPCS:73510)
  • 44Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers (HCPCS:93971)
  • 34X-ray of foot, minimum of 3 views (HCPCS:73630)
  • 33X-ray of knee, 3 views (HCPCS:73562)
  • 28Ultrasound guidance for accessing into blood vessel (HCPCS:76937)
  • 28Fluoroscopic guidance for insertion, replacement or removal of central venous access device (HCPCS:77001)
  • 27Bone and/or joint imaging, whole body (HCPCS:78306)
  • 22Nuclear medicine study of lung ventilation and blood circulation in the lungs (HCPCS:78582)
  • 22X-ray of wrist, minimum of 3 views (HCPCS:73110)
  • 15X-ray of hand, minimum of 3 views (HCPCS:73130)
  • 14X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • 11Ultrasound of head and neck (HCPCS:76536)

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. Kevin Sawyer is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
ADVENTHEALTH HEART OF FLORIDA40100 HWY 27
DAVENPORT, FL 33837
(863) 422-4971Acute Care Hospitals100137
WINTER HAVEN HOSPITAL200 AVE F NE
WINTER HAVEN, FL 33881
(863) 293-1121Acute Care Hospitals100052
ADVENTHEALTH LAKE WALES410 S 11TH ST
LAKE WALES, FL 33853
(863) 676-1433Acute Care Hospitals100099
MANATEE MEMORIAL HOSPITAL206 2ND ST E
BRADENTON, FL 34208
(941) 746-5111Acute Care Hospitals100035
SOUTH FLORIDA BAPTIST HOSPITAL301 N ALEXANDER ST
PLANT CITY, FL 33563
(813) 757-1200Acute Care Hospitals100132

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
1427049931RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND
Organization
Radiology (Diagnostic Radiology)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
1336448562 NEEL D KARAMSADKAR M.D.
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
1801185897 MATTHEW P BUZZEO M.D.
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
1447439575 LAWRENCE R WHITNEY III M.D.
Individual
Radiology (Diagnostic Radiology)2125 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
1023248648 MICHAEL K GORDON 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
1225430028 DAVID MINA M.D.
Individual
Radiology (Diagnostic Radiology)2125 CRYSTAL GROVE DR
LAKELAND, FL 33801
(863) 688-2334

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. Kevin James Sawyer M.d. 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.