MAUREEN U TAN- PEDRES M.D.
NPI 1003015736
Internal Medicine in Grand Rapids, MI


Quality Rating: 100 out of 100 score

NPI Status: Active since July 12, 2007

Contact Information

100 MICHIGAN ST NE
SUITE A721
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 391-3139
Fax: (616) 391-3044

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  • Individual
  • Female
  • Years of Experience 20
  • Internal Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About MAUREEN TAN- PEDRES

Maureen Tan- Pedres is an internist established in Grand Rapids, Michigan and her medical specialization is Internal Medicine with more than 20 years of experience. The healthcare provider is registered in the NPI registry with number 1003015736 assigned on July 2007. The practitioner's primary taxonomy code is 207R00000X with license number 4301090617 (MI). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI
1003015736
Provider Name
MAUREEN U TAN- PEDRES M.D.
Gender
Female
Entity Type
Individual
Location Address
100 MICHIGAN ST NE SUITE A721 GRAND RAPIDS, MI 49503
Location Phone
(616) 391-3139
Location Fax
(616) 391-3044
Mailing Address
100 MICHIGAN ST NE MC 845 GRAND RAPIDS, MI 49503
Medical School Name
OTHER
Graduation Year
2004
Is Sole Proprietor?
No
Enumeration Date
07-12-2007
Last Update Date
02-25-2021
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An internist like Maureen Tan- Pedres is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Maureen Tan- Pedres 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 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 typical physician office visit costs for Medicare beneficiaries in this area are: $32.68 for a new patient copayment and $25.16 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

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
4301090617
License State
MI
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Insurance Plans Accepted

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

  • Molina Healthcare

    • Gold 1 - HMO
    • Gold 1 with Adult Vision Services - HMO
    • Gold 8 - HMO
    • Silver 1 - HMO
    • Silver 1 with Adult Vision Services - HMO
    • Silver 12 with First 4 Primary Care Visits Free - HMO
    • Silver 8 - HMO

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

PECOS Enrollment and Medicare Participation Status

Maureen Tan- Pedres 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: 9133244734

    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: I20100920001027

    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.

Durable Medical Equipment

  • Hospital beds (D1B)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

    1 DME suppliers used 11 Medicare Claims 11 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)

    3 DME suppliers used 15 Medicare Claims 15 Services Paid

  • Oxygen and supplies (D1C)

    Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:K0738)

    2 DME suppliers used 17 Medicare Claims 17 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 49503 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $130.74
  • Minimum New Patient Price $56.39
  • Maximum New Patient Price $172.8
  • Average New Patient Copayment $32.68
  • Minimum New Patient Copayment $14.09
  • Maximum New Patient Copayment $43.2

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $100.65
  • Minimum Established Patient Price $17.24
  • Maximum Established Patient Price $140.86
  • Average Established Patient Copayment $25.16
  • Minimum Established Patient Copayment $4.31
  • Maximum Established Patient Copayment $35.21

* 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: 100 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: 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 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.

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. Maureen Tan- Pedres is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SPECTRUM HEALTH100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1774Acute Care Hospitals

Reviews for MAUREEN U TAN- PEDRES M.D.

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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.
1003015736
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003011076
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 + 7 + 6 + 24 = 44
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 44 = 66

The NPI number 1003015736 is valid because the calculated check digit 6 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
1275528689 JASON P SEAMON DO
Individual
Emergency Medicine (Emergency Medical Services)100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1680
1730174137 STUART A MALAFA MD
Individual
Emergency Medicine100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1680
1720078793 BRIAN M BOSSCHER MD
Individual
Emergency Medicine (Emergency Medical Services)100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1680
1205819059 RYAN A PETERS DO
Individual
Emergency Medicine (Emergency Medical Services)100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1680
1194700963 AARON W ZIEGLER MD
Individual
Emergency Medicine (Emergency Medical Services)100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1680
1194702217 MICHAEL P UHLIG PA-C
Individual
Physician Assistant100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1680
1417935750 MARK D ALTMAN PA-C
Individual
Physician Assistant (Medical)100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1680
1851361190 ALY S ABDEL-MAGEED MD
Individual
Pediatrics (Pediatric Hematology-Oncology)100 MICHIGAN ST NE MC 109 ATTN JULIE L
GRAND RAPIDS, MI 49503
(616) 643-9347
1740252766 MITCHELL H DEJONGE MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)100 MICHIGAN ST NE MC 845 ATTN
GRAND RAPIDS, MI 49503
(616) 391-1714
1164494878 BENEDICT A DOCTOR MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)100 MICHIGAN ST NE MC 035
GRAND RAPIDS, MI 49503
(616) 391-1714
1639143126 DANIEL SCOTT KNEE M.D.
Individual
Pediatrics (Neonatal-Perinatal Medicine)100 MICHIGAN ST NE MC 035
GRAND RAPIDS, MI 49503
(616) 391-1714
1376517441 KENNETH WAYNE POST M.D.
Individual
Surgery100 MICHIGAN ST NE MC 845
GRAND RAPIDS, MI 49503
(616) 454-9960
1174597835 ALAN S JONES MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)100 MICHIGAN ST NE MC 109 ATTN JULIE L
GRAND RAPIDS, MI 49503
(616) 643-9347
1255306833 CRAIG M KINNEY MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)100 MICHIGAN ST NE MC 109 ATTN JULIE L
GRAND RAPIDS, MI 49503
(616) 643-9347
1477527166 NICHOLAS J LAURIA PA
Individual
Physician Assistant100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1680
1275507949 LEONARD L RADECKI MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)100 MICHIGAN ST NE MC 109
GRAND RAPIDS, MI 49503
(616) 643-9347
1043285489 THOMAS R SHAW MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)100 MICHIGAN ST NE MC 109 ATTN JULIE L
GRAND RAPIDS, MI 49503
(616) 391-1714
1265480263 CHRISTOPHER E CAHILL DO
Individual
Emergency Medicine100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1680
1619926649 JOANNA J CHILDERS PA-C
Individual
Physician Assistant (Medical)100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1680
1265483861 JOHN A OOSTEMA MD
Individual
Emergency Medicine100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
(616) 391-1680

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003015736, enumerated in the NPI registry as an "individual" on July 12, 2007

The provider is located at 100 Michigan St Ne Suite A721 Grand Rapids, Mi 49503 and the phone number is (616) 391-3139

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 20 years of experience.

The provider might be accepting Accepts: Molina Healthcare. 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.

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 $130.74 with an average copayment of $32.68 for new patient appointments. Established patients should expect a typical charge of $100.65 and an average copayment of 25.16. Please review your insurance plan or contact the provider directly to determine your specific costs.

The practitioner is affiliated to the following hospital(s): SPECTRUM HEALTH. 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 12, 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.