DR. JOSHUA BLAKE WHARTON M.D. NPI 1003014762
Dermatology in Guntersville, AL
About DR. JOSHUA BLAKE WHARTON M.D.
Joshua Wharton is a provider established in Guntersville, Alabama and his medical specialization is Dermatology with more than 17 years of experience. He graduated from University Of Alabama School Of Medicine in 2006. The NPI number of this provider is 1003014762 and was assigned on July 2007. The practitioner's primary taxonomy code is 207N00000X with license number 002457 (GA). The provider is registered as an individual and his NPI record was last updated one year ago.
| NPI | 1003014762 |
| Provider Name | DR. JOSHUA BLAKE WHARTON M.D. |
| Location Address | 2307 HOMER CLAYTON DR GUNTERSVILLE, AL 35976 |
| Location Phone | (256) 571-8770 |
| Mailing Address | 2307 HOMER CLAYTON DR GUNTERSVILLE, AL 35976 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE |
| Graduation Year | 2006 |
| Is Sole Proprietor? | No |
| Enumeration Date | 07-04-2007 |
| Last Update Date | 04-28-2022 |
A dermatologist like Joshua Wharton is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.Joshua Wharton 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.
Joshua Wharton 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 Marshall Medical Centers.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, 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: biopsy follow-up, documentation of current medications in the medical record, e-prescribing, medication reconciliation, patient-specific education, preventive care and screening: tobacco use: screening and cessation intervention, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, provide patient access, secure messaging, security risk analysis and specialized registry reporting.
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.48 for a new patient copayment and $17.46 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 | 207N00000X |
| Classification | Dermatology |
| Type | Allopathic & Osteopathic Physicians |
| License No. | 002457 |
| License State | GA |
| Taxonomy Description | A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Business Address
2307 HOMER CLAYTON DR
GUNTERSVILLE, AL
ZIP 35976
Phone: (256) 571-8770
Fax: (256) 571-8775
Mailing Address
2307 HOMER CLAYTON DR
GUNTERSVILLE, AL
ZIP 35976
Phone: (256) 571-8770
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 | 9436273430 |
| PECOS Enrollment ID | I20100827000331 |
| 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 35976 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 |
| $55.54 | $170.61 | $85.95 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $13.88 | $42.65 | $21.48 |
| 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 |
| $16.93 | $139.08 | $69.84 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.23 | $34.77 | $17.46 |
* 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 | |
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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% | 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. |
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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 | |
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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 | - | 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 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 |
|---|---|---|
| Biopsy Follow-Up | 81% | 137 |
| Percentage of new patients whose biopsy results have been reviewed and communicated to the primary care/referring physician and patient by the performing physician | ||
| Documentation of Current Medications in the Medical Record | 100% | 3662 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| e-Prescribing | 91% | 706 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Medication Reconciliation | 74% | 140 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 100% | 1273 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 3% | 178 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/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. | ||
| Provide Patient Access | 98% | 1273 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 13% | 1273 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
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.
- 3443Destruction of 2-14 skin growths (HCPCS:17003)
- 993Destruction of skin growth (HCPCS:17000)
- 366Destruction of up to 14 skin growths (HCPCS:17110)
- 366Tangential biopsy of single skin lesion (HCPCS:11102)
- 258Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals (first stage, up to 5 tissue blocks) (HCPCS:17311)
- 187Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals (HCPCS:17312)
- 135Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs (HCPCS:13121)
- 104Tangential biopsy of additional skin lesion (HCPCS:11103)
- 69Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet (HCPCS:13132)
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. Joshua Wharton is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| MARSHALL MEDICAL CENTERS | 2505 U S HIGHWAY 431 NORTH BOAZ, AL 35957 | (256) 593-8310 | Acute Care Hospitals | 10005 |
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 | 4 | 7 | 6 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 1 | 8 | 7 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 0 + 1 + 8 + 7 + 1 + 2 + 24 = 48 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 48 = 2 | 2 | ||||||||
The NPI number 1003014762 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 7 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1689993156 | DERMATOLOGY OF NORTH ALABAMA, INC. Organization | Dermatology | 2307 HOMER CLAYTON DR GUNTERSVILLE, AL 35976 (205) 422-1593 |
| 1306802251 | MS. CHRISTA B HEARD CRNP Individual | Nurse Practitioner (Adult Health) | 2307 HOMER CLAYTON DR GUNTERSVILLE, AL 35976 (256) 571-8770 |
| 1649695065 | BRIGETT PAYNE APRN, FNP-C Individual | Nurse Practitioner (Family) | 2307 HOMER CLAYTON DR GUNTERSVILLE, AL 35976 (256) 571-8770 |
| 1750728580 | MRS. AMELIA MCCARRELL FRAZIER CRNP Individual | Nurse Practitioner (Adult Health) | 2307 HOMER CLAYTON DR GUNTERSVILLE, AL 35976 (256) 571-8770 |
| 1578683090 | MARSHALL MEDICAL CENTER NORTH Organization | Home Health | 2307 HOMER CLAYTON DR GUNTERSVILLE, AL 35976 (256) 571-8003 |
| 1669061461 | MS. TAYLOR DANIELLE PRINCE CRNP Individual | Nurse Practitioner (Family) | 2307 HOMER CLAYTON DR GUNTERSVILLE, AL 35976 (256) 571-8770 |
| 1831859412 | HANNAH HOVEY BROCATO Individual | Nurse Practitioner (Family) | 2307 HOMER CLAYTON DR GUNTERSVILLE, AL 35976 (256) 571-8770 |
Frequently Asked Questions
What is Dr. Joshua Wharton M.D. NPI number?
The NPI number assigned to this healthcare provider is 1003014762, registered as an "individual" on July 04, 2007
Where is Dr. Joshua Wharton M.D. located?
The provider is located at 2307 Homer Clayton Dr Guntersville, Al 35976 and the phone number is (256) 571-8770
Which is Dr. Joshua Wharton M.D. specialty?
The provider's speciality is Dermatology
How many years of experience does Dr. Joshua Wharton M.D. have?
The provider has more than 17 years of experience. He graduated from University Of Alabama School Of Medicine in 2006.
Is Dr. Joshua Wharton M.D. registered in PECOS?
Yes, as of May 11, 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. Joshua Wharton M.D. Quality Ratings?
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.
How much is a visit to Dr. Joshua Wharton M.D.?
Medicare beneficiaries should expect a typical cost of $85.95 with an average copayment of $21.48 for new patient appointments. Established patients should expect a typical charge of $69.84 and an average copayment of 17.46. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Dr. Joshua Wharton M.D.?
The most common procedures or services performed by this practitioner are: Destruction of 2-14 skin growths, Destruction of skin growth, Destruction of up to 14 skin growths, Tangential biopsy of single skin lesion, Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals (first stage, up to 5 tissue blocks), Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals, Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs, Tangential biopsy of additional skin lesion and Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet.
Is Dr. Joshua Wharton M.D. affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: MARSHALL MEDICAL CENTERS. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
The NPI record of Dr. Joshua Wharton M.D. was last updated on July 04, 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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