DR. ZACHARY TYLER BAUMGARDNER MD NPI 1003016809

Family Medicine in Reno, NV

Individual Male Years of Experience 16 Family Medicine PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About DR. ZACHARY TYLER BAUMGARDNER MD

Zachary Baumgardner is a primary care provider established in Reno, Nevada and his medical specialization is Family Medicine with more than 16 years of experience. The NPI number of Zachary Baumgardner is 1003016809 and was assigned on July 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 13559 (NV). The provider is registered as an individual and his NPI record was last updated 11 years ago.

A primary care provider (PCP) like Dr. Zachary Tyler Baumgardner Md 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

NPI

1003016809

Provider NameDR. ZACHARY TYLER BAUMGARDNER MD
Provider Location Address601 RALSTON ST SUITE 100 RENO, NV 89503
Provider Mailing Address601 RALSTON ST SUITE 100 RENO, NV 89503
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2007
Is Sole Proprietor?No
Enumeration Date07-19-2007
Last Update Date07-07-2011



Zachary Baumgardner 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.

Zachary Baumgardner 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 Renown Regional Medical Center, Renown South Meadows Medical Center and Saint Mary's Regional Medical Center.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: documentation of current medications in the medical record and preventive care and screening: body mass index (bmi) screening and follow-up plan. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

The typical physician office visit costs for Medicare beneficiaries in this area are: $23.17 for a new patient copayment and $26.65 for an established patient copayment.



Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.13559
License StateNV
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

DR. ZACHARY TYLER BAUMGARDNER MD
601 RALSTON ST
SUITE 100
RENO, NV
ZIP 89503
Phone: (775) 786-1110

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Mailing Address

DR. ZACHARY TYLER BAUMGARDNER MD
601 RALSTON ST
SUITE 100
RENO, NV
ZIP 89503
Phone: (775) 786-1110


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 ID7517091341
PECOS Enrollment IDI20100816001025
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 89503 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
$60.19 $183.01 $92.69
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.04 $45.75 $23.17
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$18.54 $149 $106.6
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.63 $37.25 $26.65

* 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.

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
Documentation of Current Medications in the Medical Record 100% 20
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 65% 20
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2

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. Zachary Baumgardner is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
RENOWN REGIONAL MEDICAL CENTER1155 MILL STREET
RENO, NV 89502
(775) 982-4100Acute Care Hospitals290001
RENOWN SOUTH MEADOWS MEDICAL CENTER10101 DOUBLE R BLVD
RENO, NV 89521
(775) 982-7063Acute Care Hospitals290049
SAINT MARY'S REGIONAL MEDICAL CENTER235 W 6TH ST
RENO, NV 89503
(775) 770-3000Acute Care Hospitals290009

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.
1003016809
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003011280
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 + 8 + 0 + 24 = 41
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 41 = 99

The NPI number 1003016809 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1023005303MRS. SHANNON L ZAMBONI MD
Individual
Family Medicine601 RALSTON ST SUITE 100
RENO, NV 89503
(775) 786-1110
1841287026MR. THOMAS D OGARA MD
Individual
Family Medicine601 RALSTON ST #100
RENO, NV 89503
(775) 786-1110
1013240159LADAWN M. TALBOTT, MD, APC
Organization
Plastic Surgery601 RALSTON ST SUITE 200
RENO, NV 89503
(775) 348-4790
1790861516MS. CYNDI LEE BREWER PA-C
Individual
Physician Assistant (Medical)601 RALSTON ST STE 100
RENO, NV 89503
(775) 786-1110

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
Dr. Zachary Tyler Baumgardner 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.