KATHERINE L WALSH PA-C/MPH NPI 1003015280

Physician Assistant in Jacksonville, FL

NPI 1003015280 Individual Female Years of Experience 16 Physician Assistant PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 91.5 Medicare Quality Reporting

NPI Profile for KATHERINE L WALSH PA-C/MPH

Katherine Walsh is a primary care provider established in Jacksonville, Florida and her medical specialization is physician assistant with more than 16 years of experience. The NPI number of Katherine Walsh is 1003015280 and was 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 2 years ago.

A primary care provider (PCP) like Katherine L Walsh Pa-c/mph 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

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.

Katherine Walsh 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 she has hospital affiliations with Mayo Clinic Florida.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 91.5, 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.

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.

NPI

1003015280

Provider Name KATHERINE L WALSH PA-C/MPH
Provider Location Address4500 SAN PABLO RD S JACKSONVILLE, FL 32224
Provider Mailing Address4500 SAN PABLO RD S JACKSONVILLE, FL 32224
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2007
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-17-2007
Last Update Date09-01-2020


Primary Taxonomy

Taxonomy Code363A00000X
ClassificationPhysician Assistant
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.PA9104989
License StateFL
Taxonomy DescriptionA 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.

Business Address

KATHERINE L WALSH PA-C/MPH
4500 SAN PABLO RD S
JACKSONVILLE, FL
ZIP 32224
Phone: (904) 953-2000

Get Directions


Mailing Address

KATHERINE L WALSH PA-C/MPH
4500 SAN PABLO RD S
JACKSONVILLE, FL
ZIP 32224
Phone: (904) 953-2000



Secondary Locations

425 N Lee St Suite 202
Jacksonville, FL 32204
(904) 366-3738

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 ID5698867927
PECOS Enrollment IDI20100209000564
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 32224 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% 100
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% 62.6
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% 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.
MIPS Final Score - 91.5
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
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.

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. Katherine Walsh is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
MAYO CLINIC FLORIDA4500 SAN PABLO RD
JACKSONVILLE, FL 32224
(904) 953-2000Acute Care Hospitals100151

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalPA9104989FLNo

Taxonomy Description: Not Available

NPI Validation Check Digit Calculation


The following table explains step by step the 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
1851380430DR. JOSEPH WEST PAUL JR. 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

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
Katherine L Walsh Pa-c/mph 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.