JENNIFER LYNN HERSHBERGER M.D.
NPI 1003013970
Ophthalmology in Greenwood, SC


Quality Rating: 60 out of 100 score

NPI Status: Active since July 02, 2007

Contact Information

665 WEST ALEXANDER ROAD
GREENWOOD, SC
ZIP 29646
Phone: (864) 227-2020

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  • Individual
  • Female
  • Years of Experience 17
  • Ophthalmology
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About JENNIFER HERSHBERGER

Jennifer Hershberger is a provider established in Greenwood, South Carolina and her medical specialization is Ophthalmology with more than 17 years of experience. She graduated from Medical University Of South Carolina College Of Medicine in 2007. The healthcare provider is registered in the NPI registry with number 1003013970 assigned on July 2007. The practitioner's primary taxonomy code is 207W00000X with license number LL29776 (SC). The provider is registered as an individual and her NPI record was last updated 11 years ago.

NPI
1003013970
Provider Name
JENNIFER LYNN HERSHBERGER M.D.
Gender
Female
Entity Type
Individual
Location Address
665 WEST ALEXANDER ROAD GREENWOOD, SC 29646
Location Phone
(864) 227-2020
Mailing Address
PO BOX 369 GREENWOOD, SC 29648
Mailing Phone
(864) 227-2020
Medical School Name
MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduation Year
2007
Is Sole Proprietor?
No
Enumeration Date
07-02-2007
Last Update Date
01-28-2013
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Ophthalmologists like Jennifer Hershberger specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.

Jennifer Hershberger 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 60, 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: $32.11 for a new patient copayment and $17.43 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

Ophthalmology

Taxonomy Code
207W00000X
Type
Allopathic & Osteopathic Physicians
License No.
LL29776
License State
SC
Taxonomy Description
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Insurance Plans Accepted

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

  • Blue Cross and Blue Shield of Illinois

    • Blue Choice Preferred Bronze PPO℠ 201 - PPO
    • Blue Choice Preferred Bronze PPO℠ 202 - PPO
    • Blue Choice Preferred Bronze PPO℠ 601 - Rx Copays - PPO
    • Blue Choice Preferred Bronze PPO℠ 701 - Rx Copays - PPO
    • Blue Choice Preferred Bronze PPO℠ 708 - PPO
    • Blue Choice Preferred Gold PPO℠ 204 - Rx Copays - PPO
    • Blue Choice Preferred Gold PPO℠ 707 - PPO
    • Blue Choice Preferred Security PPO℠ 200 - PPO
    • Blue Choice Preferred Silver PPO℠ 203 - PPO
    • Blue Choice Preferred Silver PPO℠ 706 - PPO
    • Blue Choice Preferred Silver PPO℠ 801 - Rx Copay - PPO
    • Blue FocusCare Bronze℠ 209 - HMO
    • Blue FocusCare Gold℠ 211 - HMO
    • Blue FocusCare Silver℠ 210 - HMO
    • Blue Precision Bronze HMO℠ 205 - HMO
  • Blue Cross and Blue Shield of Montana

    • Blue Focus Bronze POS℠ 205 - POS
    • Blue Focus Bronze POS℠ 705 - POS
    • Blue Focus Bronze POS℠ 708 - POS
    • Blue Focus Gold POS℠ 207 - POS
    • Blue Focus Gold POS℠ 707 - POS
    • Blue Focus Silver POS℠ 206 - POS
    • Blue Focus Silver POS℠ 706 - POS
    • Blue Preferred Bronze PPO℠ 201 - PPO
    • Blue Preferred Bronze PPO℠ 202 - PPO
    • Blue Preferred Bronze PPO℠ 301 - PPO
    • Blue Preferred Bronze PPO℠ 705 - PPO
    • Blue Preferred Gold PPO℠ 204 - PPO
    • Blue Preferred Gold PPO℠ 704 - PPO
    • Blue Preferred Security PPO℠ 200 - PPO
    • Blue Preferred Silver PPO℠ 203 - PPO
  • Blue Cross and Blue Shield of Oklahoma

    • Blue Advantage Bronze PPO℠ 801 - PPO
    • Blue Advantage Bronze PPO℠ 202 - PPO
    • Blue Advantage Bronze PPO℠ 203 - PPO
    • Blue Advantage Gold PPO℠ 309 - PPO
    • Blue Advantage Gold PPO℠ 604 - PPO
    • Blue Advantage Gold PPO℠ 803 - PPO
    • Blue Advantage Silver PPO℠ 204 - PPO
    • Blue Advantage Silver PPO℠ 501 - PPO
    • Blue Advantage Silver PPO℠ 605 - PPO
    • Blue Advantage Silver PPO℠ 802 - PPO
    • Blue Preferred Bronze PPO℠ 206 - PPO
    • Blue Preferred Bronze PPO℠ 707 - PPO
    • Blue Preferred Gold PPO℠ 205 - PPO
    • Blue Preferred Gold PPO℠ 705 - PPO
    • Blue Preferred Security PPO℠ 200 - PPO
  • Blue Cross and Blue Shield of Texas

    • Blue Advantage Bronze HMO℠ 204 - HMO
    • Blue Advantage Bronze HMO℠ 301 - HMO
    • Blue Advantage Bronze HMO℠ 302 - HMO
    • Blue Advantage Bronze HMO℠ 707 - HMO
    • Blue Advantage Gold HMO℠ 206 - HMO
    • Blue Advantage Gold HMO℠ 603 - HMO
    • Blue Advantage Gold HMO℠ 706 - HMO
    • Blue Advantage Plus Bronze℠ 303 - POS
    • Blue Advantage Plus Bronze℠ 305 - POS
    • Blue Advantage Plus Bronze℠ 707 - POS
    • Blue Advantage Plus Gold℠ 203 - POS
    • Blue Advantage Plus Gold℠ 706 - POS
    • Blue Advantage Plus Gold℠ 803 - POS
    • Blue Advantage Plus Silver℠ 202 - POS
    • Blue Advantage Plus Silver℠ 605 - POS
  • BlueCross BlueShield of South Carolina

    • Blue VirtuConnect Bronze 1 - EPO
    • Blue VirtuConnect Gold 1 - EPO
    • Blue VirtuConnect Silver 1 - EPO
    • BlueEssentials Bronze 4 - EPO
    • BlueEssentials Bronze 6 - EPO
    • BlueEssentials Catastrophic 1 - EPO
    • BlueEssentials Gold 1 - EPO
    • BlueEssentials Gold 4 - EPO
    • BlueEssentials Gold 5 - EPO
    • BlueEssentials HD Bronze 3 - EPO
    • BlueEssentials HD Bronze 5 - EPO
    • BlueEssentials HD Gold 3 - EPO
    • BlueEssentials Silver 14 - EPO
    • BlueEssentials Silver 38 - EPO
    • BlueEssentials Silver 39 - EPO

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

PECOS Enrollment and Medicare Participation Status

Jennifer Hershberger 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: 3173793346

    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: I20110825000169

    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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Prosthetic and Orthotic Devices

  • Prosthetic/Orthotic devices (D1F)

    Frames, purchases (HCPCS:V2020)

    2 DME suppliers used 13 Medicare Claims 13 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens (HCPCS:V2303)

    1 DME suppliers used 11 Medicare Claims 18 Services Paid

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 29646 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $128.46
  • Minimum New Patient Price $55.43
  • Maximum New Patient Price $169.76
  • Average New Patient Copayment $32.11
  • Minimum New Patient Copayment $13.85
  • Maximum New Patient Copayment $42.44

Established Patients Visit Costs *

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

  • Average Established Patient Price $69.73
  • Minimum Established Patient Price $17.06
  • Maximum Established Patient Price $138.69
  • Average Established Patient Copayment $17.43
  • Minimum Established Patient Copayment $4.26
  • Maximum Established Patient Copayment $34.67

* 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: 60 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: N/A

    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: N/A

    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.

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.

  • 861

    Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)

  • 456

    Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)

  • 293

    Diagnostic imaging of retina (HCPCS:92134)

  • 165

    Photography of the retina (HCPCS:92250)

  • 139

    Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)

  • 135

    Diagnostic imaging of optic nerve of eye (HCPCS:92133)

  • 96

    Measurement of field of vision during daylight conditions (HCPCS:92083)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Jennifer Hershberger is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SELF REGIONAL HEALTHCARE1325 SPRING STREET
GREENWOOD, SC 29646
(864) 227-4111Acute Care Hospitals

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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.
1003013970
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003016914
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 + 9 + 1 + 4 + 24 = 50
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1003013970 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1730186099 MARVIN G. BURDETTE JR. M.D.
Individual
Ophthalmology665 WEST ALEXANDER ROAD
GREENWOOD, SC 29646
(864) 227-2020
1720085087 WILLIAM F. DARBY JR. M.D.
Individual
Ophthalmology665 WEST ALEXANDER ROAD
GREENWOOD, SC 29646
(864) 227-2020
1548267800 STEPHANIE C. TURNER M.D.
Individual
Ophthalmology665 WEST ALEXANDER ROAD
GREENWOOD, SC 29646
(864) 227-2020
1184621443 TIMOTHY L. AUSTIN M.D.
Individual
Ophthalmology665 WEST ALEXANDER ROAD
GREENWOOD, SC 29646
(864) 227-2020
1265418388GREENWOOD EYE CLINIC, P.A.
Organization
Ophthalmology665 WEST ALEXANDER ROAD
GREENWOOD, SC 29646
(864) 227-2020
1649398579 BRIAN PATRICK VAHJEN M.D.
Individual
Ophthalmology665 WEST ALEXANDER ROAD
GREENWOOD, SC 29646
(803) 434-7920

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003013970, enumerated in the NPI registry as an "individual" on July 02, 2007

The provider is located at 665 West Alexander Road Greenwood, Sc 29646 and the phone number is (864) 227-2020

The provider's speciality is Ophthalmology with taxonomy code 207W00000X

The provider has more than 17 years of experience. She graduated from Medical University Of South Carolina College Of Medicine in 2007.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Blue Cross. 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 $128.46 with an average copayment of $32.11 for new patient appointments. Established patients should expect a typical charge of $69.73 and an average copayment of 17.43. 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: Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits, Eye and medical examination for diagnosis and treatment, established patient, Diagnostic imaging of retina, Photography of the retina, Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits, Diagnostic imaging of optic nerve of eye and Measurement of field of vision during daylight conditions.

The practitioner is affiliated to the following hospital(s): SELF REGIONAL HEALTHCARE. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on July 02, 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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