THOMAS MICHAEL DONAHUE MD NPI 1003016585

Anesthesiology in Chicago, IL

NPI 1003016585 Individual Male Years of Experience 15 Anesthesiology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 96.8

NPI Profile for THOMAS MICHAEL DONAHUE MD

Thomas Donahue is a provider established in Chicago, Illinois and his medical specialization is anesthesiology with more than 15 years of experience. He graduated from Ohio State University College Of Medicine in 2007. The NPI number of Thomas Donahue is 1003016585 and was assigned on July 2007. The practitioner's primary taxonomy code is 207L00000X with license number 036.128362 (IL). The provider is registered as an individual and his NPI record was last updated 5 years ago.

An anesthesiologist like Thomas Michael Donahue Md manages the care of surgical patients and pain relief through drug administration that reduces or eliminates pain during an operation, medical procedure or during labor and delivery of babies. During surgical procedures anesthesiologists are responsible for adjusting the amount of anesthetic, monitoring the patient's heart rate, body temperature, blood pressure and breathing.

Thomas Donahue 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.

Thomas Donahue 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 Genesis Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 96.8, 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.

NPI

1003016585

Provider Name THOMAS MICHAEL DONAHUE MD
Provider Location Address1653 W CONGRESS PKWY CHICAGO, IL 60612
Provider Mailing Address730 S CLARK ST APT 508 CHICAGO, IL 60605
GenderMale
NPI Entity TypeIndividual
Medical School NameOHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year2007
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-23-2007
Last Update Date04-10-2017


Primary Taxonomy

Taxonomy Code207L00000X
ClassificationAnesthesiology
TypeAllopathic & Osteopathic Physicians
License No.036.128362
License StateIL
Taxonomy DescriptionAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.

Business Address

THOMAS MICHAEL DONAHUE MD
1653 W CONGRESS PKWY
CHICAGO, IL
ZIP 60612
Phone: (312) 942-8858

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Mailing Address

THOMAS MICHAEL DONAHUE MD
730 S CLARK ST APT 508
CHICAGO, IL
ZIP 60605
Phone: (614) 354-4442



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 ID2668694670
PECOS Enrollment IDI20170621002024
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

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% 92.5
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% 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.
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% 98.5
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 - 96.8
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.

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.

  • 150Anesthesia for procedure on lower intestine using an endoscope (HCPCS:00810)
  • 118Anesthesia for procedure on gastrointestinal tract using an endoscope (HCPCS:00740)
  • 57Anesthesia for lens surgery (HCPCS:00142)
  • 24Insertion of arterial catheter for blood sampling or infusion, accessed through the skin (HCPCS:36620)

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. Thomas Donahue is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
GENESIS HOSPITAL2951 MAPLE AVENUE
ZANESVILLE, OH 43701
(740) 454-4000Acute Care Hospitals360039

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.
1003016585
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20030112516
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 + 5 + 1 + 6 + 24 = 45
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 45 = 55

The NPI number 1003016585 is valid because the calculated check digit 5 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
1649272154MRS. BETH NACHTSHEIM BOLICK RN CNP
Individual
Nurse Practitioner (Pediatrics, Critical Care)1653 W CONGRESS PKWY
CHICAGO, IL 60612
(312) 942-3646
1285623785DR. KOUSIKI PATRA MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)1653 W CONGRESS PKWY MURDOCK 622
CHICAGO, IL 60612
(312) 942-6640
1053395582DR. KALLIOPI SIZIOPIKOU MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)1653 W CONGRESS PKWY
CHICAGO, IL 60612
(312) 942-5700
1629053897DR. ALEXANDER C TEMPLETON MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)1653 W CONGRESS PKWY
CHICAGO, IL 60612
(312) 942-5700
1992780035DR. ABBAS ZARIF MD
Individual
Specialist1653 W CONGRESS PKWY
CHICAGO, IL 60612
(312) 942-5700
1336110691DR. MARILYN MAY HALLOCK M.D.
Individual
Emergency Medicine1653 W CONGRESS PKWY 177 MURDOCK
CHICAGO, IL 60612
(312) 942-6909
1588630743 GALETA CAROLYN CLAYTON M.D.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1326014408 DINO PETER RUMORO D.O.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1740256825 YANINA PURIM SHEM TOV M.D.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1952377020 RAHUL G PATWARI M.D.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1780650663 EDWARD WARD M.D.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1801862925 JULIO C SILVA M.D.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1174599112 JOSEPH JULIUS BRAWKA M.D.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1205802147 JEFFREY L GRASSLE M.D.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1568438687 PAULA OLDEG M.D.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1578539417 JANE E KRAMER M.D.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1346216470RUSH UNIVERSITY MEDICAL CENTER
Organization
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1164499406 ANDREAS SKOUBIS D.O.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149
1366403768 BRUCE C MCLEOD MD
Individual
Specialist1653 W CONGRESS PKWY
CHICAGO, IL 60612
(312) 942-5254
1982666285 KAMENO BELL M.D.
Individual
Emergency Medicine1653 W CONGRESS PKWY SUITE 177
CHICAGO, IL 60612
(312) 942-8149

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
Thomas Michael Donahue Md 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.