ROBERT MARC ABRAMS M.D.
NPI 1003016965
Obstetrics & Gynecology - Maternal & Fetal Medicine in Springfield, IL


Quality Rating: 90.06 out of 100 score

NPI Status: Active since July 19, 2007

Contact Information

415 N 9TH ST
6W100
SPRINGFIELD, IL
ZIP 62702
Phone: (217) 545-5117
Fax: (217) 545-4912

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  • Individual
  • Male
  • Obstetrics & Gynecology
  • Maternal & Fetal Medicine
  • PECOS Enrolled

About ROBERT ABRAMS

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 . The healthcare provider is registered in the NPI registry with number 1003016965 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 4 years ago.

NPI
1003016965
Provider Name
ROBERT MARC ABRAMS M.D.
Gender
Male
Entity Type
Individual
Location Address
415 N 9TH ST 6W100 SPRINGFIELD, IL 62702
Location Phone
(217) 545-5117
Location Fax
(217) 545-4912
Mailing Address
PO BOX 19640 SPRINGFIELD, IL 62794
Mailing Phone
(217) 545-5117
Mailing Fax
(217) 545-4912
Is Sole Proprietor?
No
Enumeration Date
07-19-2007
Last Update Date
10-16-2020
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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.

The provider participated in CMS 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.

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

Obstetrics & Gynecology Maternal & Fetal Medicine

Taxonomy Code
207VM0101X
Type
Allopathic & Osteopathic Physicians
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.

Insurance Plans Accepted

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

  • Aetna CVS Health

    • Bronze 1: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay - HMO
    • Bronze 4: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
    • Bronze S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
    • Gold 3: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay - HMO
    • Gold S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
    • Silver 5: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
    • Silver 6: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay - HMO
    • Silver 7: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay - HMO
    • Silver S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Medicare

  • Medicaid


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

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
036102660MEDICAID (05)IL 

PECOS Enrollment and Medicare Participation Status

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.

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

  • 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

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 62702 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $132.1
  • Minimum New Patient Price $56.93
  • Maximum New Patient Price $174.63
  • Average New Patient Copayment $33.02
  • Minimum New Patient Copayment $14.23
  • Maximum New Patient Copayment $43.65

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $71.4
  • Minimum Established Patient Price $17.32
  • Maximum Established Patient Price $142.11
  • Average Established Patient Copayment $17.85
  • Minimum Established Patient Copayment $4.33
  • Maximum Established Patient Copayment $35.52

* 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: 90.06 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: 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.

  • Promoting Interoperability Score: 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.

  • 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.

Reviews for ROBERT MARC ABRAMS 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.
1003016965
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20030112912
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 = 55

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 & Gynecology415 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
1699702316DR. AZIZ KHAN M.D.
Individual
Internal Medicine (Hematology & Oncology)415 N 9TH ST 2W106
SPRINGFIELD, IL 62702
(217) 545-5817
1215037494DR. 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
Pediatrics415 N 9TH ST STE 4W64
SPRINGFIELD, IL 62702
(217) 545-0003
1730395963 OMAR AL-NOURHJI M.D.
Individual
Obstetrics & Gynecology415 N 9TH ST
SPRINGFIELD, IL 62702
(217) 545-5117
1144437815 RUTH V JACKSON NNP
Individual
Nurse Practitioner415 N 9TH ST 4W16
SPRINGFIELD, IL 62702
(800) 331-2229
1447467121 JANICE SHERMAN NNP, PH.D
Individual
Nurse Practitioner415 N 9TH ST 4W16
SPRINGFIELD, IL 62702
(800) 331-2229
1295942951 BRENDA L BIGLEY NNP
Individual
Nurse Practitioner415 N 9TH ST 4W16
SPRINGFIELD, IL 62702
(800) 331-2229
1386851053 KATHLEEN ANN NACKE NNP
Individual
Nurse Practitioner415 N 9TH ST 4W16
SPRINGFIELD, IL 62702
(800) 331-2229

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003016965, enumerated in the NPI registry as an "individual" on July 19, 2007

The provider is located at 415 N 9th St 6w100 Springfield, Il 62702 and the phone number is (217) 545-5117

The provider's speciality is Obstetrics & Gynecology with taxonomy code 207VM0101X with a focus in Maternal & Fetal Medicine

The provider might be accepting Accepts: Aetna CVS Health, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 21, 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.

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.

This NPI record 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].
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.