PHILLIP RICHTER PARAS M.D. NPI 1003016064

Pediatrics in Grand Rapids, MI

Individual Male Pediatrics PECOS Enrolled MIPS Quality Score 88.6

About PHILLIP RICHTER PARAS M.D.

Phillip Paras is a pediatrician established in Grand Rapids, Michigan and his medical specialization is Pediatrics. The NPI number of Phillip Paras is 1003016064 and was assigned on July 2007. The practitioner's primary taxonomy code is 208000000X with license number 4301090796 (MI). The provider is registered as an individual and his NPI record was last updated 2 years ago.

A pediatrician like Phillip Richter Paras M.d. is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

NPI

1003016064

Provider Name PHILLIP RICHTER PARAS M.D.
Provider Location Address330 BARCLAY AVE NE SUITE 300 GRAND RAPIDS, MI 49503
Provider Mailing Address100 MICHIGAN ST NE MC 845 GRAND RAPIDS, MI 49503
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Enumeration Date07-18-2007
Last Update Date01-05-2021



Phillip Paras 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..

Phillip Paras is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 88.6, 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.



Primary Taxonomy

Taxonomy Code208000000X
ClassificationPediatrics
TypeAllopathic & Osteopathic Physicians
License No.4301090796
License StateMI
Taxonomy DescriptionA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Business Address

PHILLIP RICHTER PARAS M.D.
330 BARCLAY AVE NE
SUITE 300
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 391-8810
Fax: (616) 391-8897

Get Directions


Mailing Address

PHILLIP RICHTER PARAS M.D.
100 MICHIGAN ST NE
MC 845
GRAND RAPIDS, MI
ZIP 49503
Phone:


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
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

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% 63
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% 58.2
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 - 88.6
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.

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.
1003016064
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20030112012
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 + 2 + 0 + 1 + 2 + 24 = 36
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
40 - 36 = 44

The NPI number 1003016064 is valid because the calculated check digit 4 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
1821088220 MELINDA E JOHNSON MD
Individual
Specialist330 BARCLAY AVE NE SUITE 304
GRAND RAPIDS, MI 49503
(616) 391-2967
1578501573DR. DANIEL JOHN ROBERTSON M.D.
Individual
Surgery (Pediatric Surgery)330 BARCLAY AVE NE SUITE 202
GRAND RAPIDS, MI 49503
(616) 458-1722
1255373270 JAMES A CHAMNESS MD
Individual
Pediatrics330 BARCLAY AVE NE STE 200
GRAND RAPIDS, MI 49503
(616) 391-2125
1073542395MRS. ANGELA KAY BARTON
Individual
Audiologist330 BARCLAY AVE NE SUITE GL1
GRAND RAPIDS, MI 49503
(616) 459-2424
1679622765DR. ROBERT ROBERT CONNORS MD
Individual
Surgery (Pediatric Surgery)330 BARCLAY AVE NE SUITE 202
GRAND RAPIDS, MI 49503
(616) 458-1722
1326197625DR. JAMES MICHAEL DECOU MD
Individual
Surgery (Pediatric Surgery)330 BARCLAY AVE NE SUITE 202
GRAND RAPIDS, MI 49503
(616) 458-1722
1326197476DR. NEAL DUANE UITVLUGT MD
Individual
Surgery (Pediatric Surgery)330 BARCLAY AVE NE SUITE 202
GRAND RAPIDS, MI 49503
(616) 458-1722
1235288317DR. MARC GODFREY SCHLATTER MD
Individual
Surgery (Pediatric Surgery)330 BARCLAY AVE NE SUITE202
GRAND RAPIDS, MI 49503
(616) 458-1722
1679701601GRAND RAPIDS MEDICAL EDUCATION AND RESEARCH CENTER
Organization
General Acute Care Hospital330 BARCLAY AVE NE SUITE 304
GRAND RAPIDS, MI 49503
(616) 391-2160
1861705022 LAAMY NASSARA TIADJERI M.D.
Individual
Obstetrics & Gynecology330 BARCLAY AVE NE SUITE 304
GRAND RAPIDS, MI 49503
(616) 391-1929
1609180389SPECTRUM HEALTH PRIMARY CARE PARTNERS
Organization
Ophthalmology330 BARCLAY AVE NE SUITE 104
GRAND RAPIDS, MI 49503
(616) 391-7948
1265734933SPECTRUM HEALTH PRIMARY CARE PARTNERS
Organization
Pediatrics330 BARCLAY AVE NE SUITE 303
GRAND RAPIDS, MI 49503
(616) 391-7999
1619274834SPECTRUM HEALTH HOSPITAL
Organization
Pediatrics330 BARCLAY AVE NE SUITE 303
GRAND RAPIDS, MI 49503
(616) 391-7999
1710240551DR. JONATHAN MCKEE M.D.
Individual
Obstetrics & Gynecology330 BARCLAY AVE NE SUITE 102
GRAND RAPIDS, MI 49503
(616) 391-1929
1083977813DR. DAVID JAMES DEWITT M.D.
Individual
Obstetrics & Gynecology330 BARCLAY AVE NE SUITE 102
GRAND RAPIDS, MI 49503
(616) 391-1929
1659341790 BENJAMIN G SARVER MD
Individual
Pediatrics330 BARCLAY AVE NE SUITE 300
GRAND RAPIDS, MI 49503
(616) 391-1719
1356508295DR. JARED LYON SKILLINGS PHD
Individual
Psychologist (Clinical)330 BARCLAY AVE NE
GRAND RAPIDS, MI 49503
(616) 391-2802
1952384372DR. ANGELA KAY THOMPSON-BUSCH M.D.,PH.D
Individual
Pediatrics330 BARCLAY AVE NE SUITE 300
GRAND RAPIDS, MI 49503
(616) 391-8100
1760792311 ASGHAR KHAGHANI MD
Individual
Transplant Surgery330 BARCLAY AVE NE SUITE 200
GRAND RAPIDS, MI 49503
(616) 391-2802
1386694958 EMILY T DURKIN M.D.
Individual
Surgery (Pediatric Surgery)330 BARCLAY AVE NE SUITE 202
GRAND RAPIDS, MI 49503
(616) 458-1722

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
Phillip Richter Paras M.d. 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.