KATHERINE L WALSH PA-C/MPH
NPI 1003015280
Physician Assistant in Jacksonville, FL


Quality Rating: 96.74 out of 100 score

NPI Status: Active since July 17, 2007

Contact Information

4500 SAN PABLO RD S
JACKSONVILLE, FL
ZIP 32224
Phone: (904) 953-2000

Get Directions Reviews

  • Individual
  • Female
  • Physician Assistant
  • PECOS Enrolled
  • Medicare Quality Reporting

About KATHERINE WALSH

Katherine Walsh is a primary care provider established in Jacksonville, Florida and her medical specialization is Physician Assistant. The healthcare provider is registered in the NPI registry with number 1003015280 assigned on July 2007. The practitioner's primary taxonomy code is 363A00000X with license number PA9104989 (FL). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1003015280
Provider Name
KATHERINE L WALSH PA-C/MPH
Gender
Female
Entity Type
Individual
Location Address
4500 SAN PABLO RD S JACKSONVILLE, FL 32224
Location Phone
(904) 953-2000
Mailing Address
4500 SAN PABLO RD S JACKSONVILLE, FL 32224
Mailing Phone
(904) 953-2000
Is Sole Proprietor?
No
Enumeration Date
07-17-2007
Last Update Date
09-01-2020
Code Navigator

A primary care provider (PCP) like Katherine Walsh sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 96.74, 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: chronic care and preventative care management for empaneled patients, e-prescribing, health information exchange, implementation of medication management practice improvements, measurement and improvement at the practice and panel level, medication reconciliation, patient-specific education, provide patient access, secure messaging, security risk analysis, specialized registry reporting and use of decision support and standardized treatment protocols.

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

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
PA9104989
License State
FL
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363AM0700XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant
Medical

PA9104989 (FL)

PECOS Enrollment and Medicare Participation Status

Katherine Walsh 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

  • 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.

Durable Medical Equipment

  • Other DME (D1E)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    4 DME suppliers used 11 Medicare Claims 11 Services Paid

  • Other DME (D1E)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    5 DME suppliers used 11 Medicare Claims 11 Services Paid

  • Other DME (D1E)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    6 DME suppliers used 13 Medicare Claims 13 Services Paid

  • Other DME (D1E)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    9 DME suppliers used 19 Medicare Claims 105 Services Paid

  • Oxygen and supplies (D1C)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    3 DME suppliers used 26 Medicare Claims 32 Services Paid

  • Other DME (D1E)

    Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) (HCPCS:E0466)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Other DME (D1E)

    Nebulizer, with compressor (HCPCS:E0570)

    4 DME suppliers used 28 Medicare Claims 28 Services Paid

  • Other DME (D1E)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    5 DME suppliers used 38 Medicare Claims 39 Services Paid

  • Oxygen and supplies (D1C)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    7 DME suppliers used 57 Medicare Claims 62 Services Paid

  • Oxygen and supplies (D1C)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Drugs Administered through DME (D1G)

    Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms (HCPCS:J7605)

    1 DME suppliers used 11 Medicare Claims 660 Services Paid

  • Drugs Administered through DME (D1G)

    Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)

    11 DME suppliers used 29 Medicare Claims 5629 Services Paid

  • Drugs Administered through DME (D1G)

    Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)

    1 DME suppliers used 11 Medicare Claims 660 Services Paid

Drugs and Nutritional Products

  • Other drugs (O1E)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    12 DME suppliers used 36 Medicare Claims 36 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 32224 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: 96.74 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: 94.08

    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: 100

    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
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
e-Prescribing 93% 697
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange 27% 143
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Medication Reconciliation 99% 148
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 36% 909
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.
Provide Patient Access 82% 909
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 16% 909
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 AnalysisYesN/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 ReportingYesN/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.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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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.
1003015280
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20030110216
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 1 + 0 + 2 + 1 + 6 + 24 = 40
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1003015280 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 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1023015062MS. KATHERINE ANN LEMASTER LCSW, RN
Individual
Social Worker (Clinical)4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 296-3700
1962403964MS. NANCY DALTON CRNA
Individual
Nurse Anesthetist, Certified Registered4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 296-4667
1285621573DR. ROBERT ALLEN GILLHAM JR. M.D.
Individual
Allergy & Immunology4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1831186089DR. GEOFFREY STEVEN GATES M.D.
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1750378907DR. THOMAS PATRICK FOX M.D.
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1083601231DR. GRETCHEN KAY LIPKE M.D.
Individual
Emergency Medicine4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1790772747DR. PHILIP PAUL METZGER M.D.
Individual
Colon & Rectal Surgery4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1316935190DR. SANFORD JOSPEH FINCK M.D.
Individual
Internal Medicine (Critical Care Medicine)4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1871582726DR. JAN MARIE LARSON M.D.
Individual
Family Medicine4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1437148392DR. JERRY WAYNE SAYRE M.D.
Individual
Family Medicine4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1912996877DR. WALTER CLYBURN TAYLOR III M.D.
Individual
Family Medicine4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1689663569DR. JAMES SAMUEL SCOLAPIO M.D.
Individual
Internal Medicine (Gastroenterology)4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1598754210DR. RONALD ALBERT HINDER M.D.
Individual
Surgery4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1043209778DR. WILLIAM JAMES MAPLES M.D.
Individual
Internal Medicine (Hematology & Oncology)4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1578552204DR. SHARON YVETT EZELL GERLACH M.D.
Individual
Internal Medicine4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1619966348DR. FRANCOIS LETTE M.D.
Individual
Internal Medicine4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1154310886DR. KAY MULLINAX MITCHELL M.D.
Individual
Internal Medicine4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1518956192DR. KENNETH GORDON NIX JR. M.D.
Individual
Internal Medicine4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1548259138DR. KATHLEEN ALLEN ROWLETT M.D.
Individual
Internal Medicine4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000
1427047018DR. JAMES HANNIS STEWART M.D.
Individual
Internal Medicine4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
(904) 953-2000

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003015280, enumerated in the NPI registry as an "individual" on July 17, 2007

The provider is located at 4500 San Pablo Rd S Jacksonville, Fl 32224 and the phone number is (904) 953-2000

The provider's speciality is Physician Assistant with taxonomy code 363A00000X

Yes, as of June 14, 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.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

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.

This NPI record was last updated on July 17, 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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