ROBERT MARC ABRAMS M.D. NPI 1003016965
Obstetrics & Gynecology - Maternal & Fetal Medicine in Springfield, IL
About ROBERT MARC ABRAMS M.D.
Robert Abrams is a women's health care provider established in Springfield, Illinois and his medical specialization is Obstetrics & Gynecology with a focus in maternal & fetal medicine with more than 26 years of experience. He graduated from Rush Medical College Of Rush University in 1997. The NPI number of this provider is 1003016965 and was assigned on July 2007. The practitioner's primary taxonomy code is 207VM0101X with license number 036-102660 (IL). The provider is registered as an individual and his NPI record was last updated 3 years ago.
| NPI | 1003016965 |
| Provider Name | ROBERT MARC ABRAMS M.D. |
| Location Address | 415 N 9TH ST 6W100 SPRINGFIELD, IL 62702 |
| Location Phone | (217) 545-5117 |
| Mailing Address | PO BOX 19640 SPRINGFIELD, IL 62794 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY |
| Graduation Year | 1997 |
| Is Sole Proprietor? | No |
| Enumeration Date | 07-19-2007 |
| Last Update Date | 10-16-2020 |
Women's health care providers like Robert Abrams treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.Robert Abrams 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.
Robert Abrams 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.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90.06, 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: $33.02 for a new patient copayment and $17.85 for an established patient copayment.
Primary Taxonomy
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.
| Taxonomy Code | 207VM0101X |
| Classification | Obstetrics & Gynecology |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | Maternal & Fetal Medicine |
| License No. | 036-102660 |
| License State | IL |
| Taxonomy Description | An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
415 N 9TH ST
6W100
SPRINGFIELD, IL
ZIP 62702
Phone: (217) 545-5117
Fax: (217) 545-4912
Mailing Address
PO BOX 19640
SPRINGFIELD, IL
ZIP 62794
Phone: (217) 545-5117
Fax: (217) 545-4912
Location Map
PECOS Enrollment and Medicare Participation Status
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 ID | 8224139530 |
| PECOS Enrollment ID | I20070730000799 |
| 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 Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
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 62702 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99204 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $56.93 | $174.63 | $132.1 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $14.23 | $43.65 | $33.02 |
| 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 |
| $17.32 | $142.11 | $71.4 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.33 | $35.52 | $17.85 |
* 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% | 93.39 | |
|
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. |
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| Promoting Interoperability (PI) | 25% | 79 | |
|
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. |
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| 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. |
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| 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. |
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| MIPS Final Score | - | 90.06 | |
| 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. | |||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| 036102660 | MEDICAID (05) | IL |
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. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 1 | 6 | 9 | 6 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 1 | 12 | 9 | 12 | |
| 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 + 9 + 1 + 2 + 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 = 5 | 5 | ||||||||
The NPI number 1003016965 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 |
|---|---|---|---|
| 1235128109 | KRISHNA A RAO M.D. Individual | Internal Medicine (Hematology & Oncology) | 415 N 9TH ST SPRINGFIELD, IL 62702 (217) 545-5817 |
| 1710968789 | PATRICIA J KNOD M.D. Individual | Obstetrics & Gynecology | 415 N 9TH ST 6TH FLOOR SPRINGFIELD, IL 62702 (217) 545-5117 |
| 1699756668 | VICTORIA R NICHOLS-JOHNSON M.D. Individual | Obstetrics & Gynecology (Obstetrics) | 415 N 9TH ST 6TH FLOOR SPRINGFIELD, IL 62702 (217) 545-5117 |
| 1760463665 | REBECCA A ANTONACCI RD, CDE Individual | Nutritionist (Nutrition, Education) | 415 N 9TH ST STE 6W162 SPRINGFIELD, IL 62702 (217) 545-3848 |
| 1104807007 | PAMELA R YODER M.D. Individual | Obstetrics & Gynecology (Maternal & Fetal Medicine) | 415 N 9TH ST 6TH FLOOR SPRINGFIELD, IL 62702 (217) 545-5117 |
| 1790766699 | MEGAN F ZANGER CFNP Individual | Nurse Practitioner (Family) | 415 N 9TH ST 6TH FLOOR SPRINGFIELD, IL 62702 (217) 545-5117 |
| 1770564338 | WILLIAM H SCHULTZ M.D. Individual | Obstetrics & Gynecology (Gynecology) | 415 N 9TH ST 6TH FLOOR SPRINGFIELD, IL 62702 (217) 545-5117 |
| 1932182656 | DR GURPREET S MANDER M.D. Individual | Pediatrics (Pediatric Critical Care Medicine) | 415 N 9TH ST SPRINGFIELD, IL 62702 (217) 544-6464 |
| 1629052485 | DHARMENDRA J NIMAVAT M.D. Individual | Pediatrics (Neonatal-Perinatal Medicine) | 415 N 9TH ST SUITE 4W16 SPRINGFIELD, IL 62702 (217) 544-6464 |
| 1346225836 | NARINDER N KHANNA M.D. Individual | Pediatrics (Neonatal-Perinatal Medicine) | 415 N 9TH ST SPRINGFIELD, IL 62702 (800) 331-2229 |
| 1952370868 | DANIEL G BATTON MD Individual | Pediatrics (Neonatal-Perinatal Medicine) | 415 N 9TH ST SUITE 4W16 SPRINGFIELD, IL 62702 (800) 331-2229 |
| 1710931902 | MAGALI D.M. JEAN-LOUIS M.D. Individual | Pediatrics (Neonatal-Perinatal Medicine) | 415 N 9TH ST ROOM 4W16 SPRINGFIELD, IL 62702 (217) 544-6464 |
| 1699702316 | DR. AZIZ KHAN M.D. Individual | Internal Medicine (Hematology & Oncology) | 415 N 9TH ST 2W106 SPRINGFIELD, IL 62702 (217) 545-5817 |
| 1215037494 | DR. BEAU JACOB BATTON M.D. Individual | Pediatrics (Neonatal-Perinatal Medicine) | 415 N 9TH ST SUITE 4W16 SPRINGFIELD, IL 62702 (800) 331-2229 |
| 1235351818 | JODY HANNAH LACK MD Individual | Pediatrics | 415 N 9TH ST STE 4W64 SPRINGFIELD, IL 62702 (217) 545-0003 |
| 1730395963 | OMAR AL-NOURHJI M.D. Individual | Obstetrics & Gynecology | 415 N 9TH ST SPRINGFIELD, IL 62702 (217) 545-5117 |
| 1144437815 | RUTH V JACKSON NNP Individual | Nurse Practitioner | 415 N 9TH ST 4W16 SPRINGFIELD, IL 62702 (800) 331-2229 |
| 1447467121 | JANICE SHERMAN NNP, PH.D Individual | Nurse Practitioner | 415 N 9TH ST 4W16 SPRINGFIELD, IL 62702 (800) 331-2229 |
| 1295942951 | BRENDA L BIGLEY NNP Individual | Nurse Practitioner | 415 N 9TH ST 4W16 SPRINGFIELD, IL 62702 (800) 331-2229 |
| 1386851053 | KATHLEEN ANN NACKE NNP Individual | Nurse Practitioner | 415 N 9TH ST 4W16 SPRINGFIELD, IL 62702 (800) 331-2229 |
Frequently Asked Questions
What is Robert Abrams M.D. NPI number?
The NPI number assigned to this healthcare provider is 1003016965, registered as an "individual" on July 19, 2007
Where is Robert Abrams M.D. located?
The provider is located at 415 N 9th St 6w100 Springfield, Il 62702 and the phone number is (217) 545-5117
Which is Robert Abrams M.D. specialty?
The provider's speciality is Obstetrics & Gynecology with a focus in Maternal & Fetal Medicine
How many years of experience does Robert Abrams M.D. have?
The provider has more than 26 years of experience. He graduated from Rush Medical College Of Rush University in 1997.
What insurance does Robert Abrams M.D. accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Robert Abrams M.D. registered in PECOS?
Yes, as of May 11, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare 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.
What are Robert Abrams M.D. Quality Ratings?
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.
How much is a visit to Robert Abrams M.D.?
Medicare beneficiaries should expect a typical cost of $132.1 with an average copayment of $33.02 for new patient appointments. Established patients should expect a typical charge of $71.4 and an average copayment of 17.85. Please review your insurance plan or contact the provider directly to determine your specific costs.
How do I update my NPI information?
The NPI record of Robert Abrams M.D. was last updated on July 19, 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]
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