ALEXANDER TOPALA MD
NPI 1003017989
Anesthesiology in Cincinnati, OH


Quality Rating: 87.52 out of 100 score

NPI Status: Active since May 30, 2007

Contact Information

234 GOODMAN ST
MAIL LOCATION 0796
CINCINNATI, OH
ZIP 45219
Phone: (513) 584-1000

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  • Individual
  • Male
  • Years of Experience 19
  • Anesthesiology
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About ALEXANDER TOPALA

Alexander Topala is an anesthesiologist established in Cincinnati, Ohio and his medical specialization is Anesthesiology with more than 19 years of experience. He graduated from University Of Cincinnati College Of Medicine in 2005. The healthcare provider is registered in the NPI registry with number 1003017989 assigned on May 2007. The practitioner's primary taxonomy code is 207L00000X with license number 57011171 (OH). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1003017989
Provider Name
ALEXANDER TOPALA MD
Other Name
ALEXANDER TOPALA SR. MD
Other Name Type
Other Name (5)
Gender
Male
Entity Type
Individual
Location Address
234 GOODMAN ST MAIL LOCATION 0796 CINCINNATI, OH 45219
Location Phone
(513) 584-1000
Mailing Address
PO BOX 636256 CENTRAL CREDENTIALING CINCINNATI, OH 45263
Mailing Phone
(513) 585-5502
Mailing Fax
Medical School Name
UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduation Year
2005
Is Sole Proprietor?
Yes
Enumeration Date
05-30-2007
Last Update Date
06-06-2017
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An anesthesiologist like Alexander Topala 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.

Alexander Topala is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 87.52, 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

Anesthesiology

Taxonomy Code
207L00000X
Type
Allopathic & Osteopathic Physicians
License No.
57011171
License State
OH
Taxonomy Description
An 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.

Insurance Plans Accepted

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

  • Anthem Blue Cross and Blue Shield

    • Anthem Bronze Pathway HMO 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
    • Anthem Bronze Pathway HMO 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
    • Anthem Bronze Pathway HMO 7450/0% (+ Incentives) - HMO
    • Anthem Bronze Pathway HMO 7500/50% Standard (Cleveland) - HMO
    • Anthem Bronze Pathway HMO 9450 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
    • Anthem Bronze Pathway HMO 9450 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
    • Anthem Catastrophic Pathway HMO 9450 ( + Incentives) - HMO
    • Anthem Gold Pathway HMO 2000/25% Standard (Cincinnati) - HMO
    • Anthem Silver Pathway HMO 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
    • Anthem Silver Pathway HMO 5000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
    • Anthem Silver Pathway HMO 5000 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
    • Anthem Silver Pathway HMO 5400/0% ( + Incentives) - HMO
    • Anthem Silver Pathway HMO 5800/40% Standard (Cleveland) - HMO
    • Anthem Silver Pathway HMO 6000/25% ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Molina Healthcare

    • Gold 1 - HMO
    • Gold 1 with Adult Vision Services - HMO
    • Gold 8 - HMO
    • Silver 1 - HMO
    • Silver 1 with Adult Vision Services - HMO
    • Silver 12 with first 4 free PCP or MH visits - HMO
    • Silver 8 - HMO
  • Oscar Health Insurance

    • Bronze Classic 4700 (Select) - HMO
    • Bronze Classic PCP Saver (Select) - HMO
    • Bronze Classic Standard (Select) - HMO
    • Bronze Elite + PCP Saver Plus (Select) - HMO
    • Bronze Elite + Specialist Saver Plus (Select) - HMO
    • Gold Classic (Select) - HMO
    • Gold Classic Standard (Select) - HMO
    • Gold Elite Saver Plus (Select) - HMO
    • Secure (Select) - HMO
    • Silver Classic (Select) - HMO
    • Silver Classic Standard (Select) - HMO
    • Silver Elite Saver Plus (Select) - HMO
    • Silver Simple (Select) - HMO
    • Silver Simple PCP Saver (Select) - HMO
  • Oscar Insurance Corporation of Ohio

    • Gold Elite Saver Plus - HMO

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

PECOS Enrollment and Medicare Participation Status

Alexander Topala 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

  • PECOS PAC ID: 6901951672

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20090901000443

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • 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 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

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: 87.52 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: 85.32

    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: 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 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.

Clinician Services

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 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 14

    Anesthesia for procedure on esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:00731)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Alexander Topala is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
UNIVERSITY OF CINCINNATI MEDICAL CENTER, LLC234 GOODMAN STREET
CINCINNATI, OH 45219
(513) 584-1000Acute Care Hospitals
WEST CHESTER HOSPITAL7700 UNIVERSITY DRIVE
WEST CHESTER, OH 45069
(513) 298-7701Acute Care Hospitals

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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.
1003017989
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20030114916
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 + 4 + 9 + 1 + 6 + 24 = 51
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 51 = 99

The NPI number 1003017989 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 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1780687079 SUSAN KATHRYN COMTE CNM
Individual
Advanced Practice Midwife234 GOODMAN ST
CINCINNATI, OH 45219
(513) 584-4081
1831189224 HANAN KERR M.D.
Individual
Internal Medicine (Cardiovascular Disease)234 GOODMAN ST
CINCINNATI, OH 45219
(513) 584-1000
1629048616 ALAN THOMAS FLANIGAN M.D.
Individual
Emergency Medicine234 GOODMAN ST
CINCINNATI, OH 45219
(513) 558-5281
1144297235DR. PETER C MUSKAT MD
Individual
Surgery (Trauma Surgery)234 GOODMAN ST
CINCINNATI, OH 45219
(513) 584-4318
1316905300DR. GINA RENEE DORLAC MD
Individual
Surgery (Trauma Surgery)234 GOODMAN ST
CINCINNATI, OH 45219
(513) 584-4318
1326006271 LESLIE OLEKSOWICZ M.D.
Individual
Internal Medicine (Medical Oncology)234 GOODMAN ST BARRETT CENTER
CINCINNATI, OH 45219
(513) 584-6928
1780642652DR. JOSEFA MARIA RANGEL M.D.
Individual
Internal Medicine234 GOODMAN ST BARRETT CENTER
CINCINNATI, OH 45219
(513) 584-6928
1649238536 JOHN RICHARD PANCOAST M.D.
Individual
Internal Medicine (Medical Oncology)234 GOODMAN ST BARRETT CENTER
CINCINNATI, OH 45219
(513) 584-6928
1417994880ACADEMIC PATHOLOGY ASSOCIATES INC
Organization
Pathology (Anatomic Pathology & Clinical Pathology)234 GOODMAN ST
CINCINNATI, OH 45219
(513) 584-3832
1538100524 WANDA O WILSON CRNA, PHD
Individual
Nurse Anesthetist, Certified Registered234 GOODMAN ST
CINCINNATI, OH 45219
(513) 872-7388
1649211640 ELEANOR JALIPA CANOS MD
Individual
Anesthesiology234 GOODMAN ST
CINCINNATI, OH 45219
(513) 872-7388
1760423941GREATER CINCINNATI OB/GYN, INC.
Organization
Obstetrics & Gynecology234 GOODMAN ST
CINCINNATI, OH 45219
(513) 584-4081
1679514855GREATER CINCINNATI PERINATAL ASSOCIATES, LLC
Organization
Obstetrics & Gynecology (Maternal & Fetal Medicine)234 GOODMAN ST
CINCINNATI, OH 45219
(513) 584-4800
1386688026 MARY ELIZABETH GORMAN CRNA
Individual
Nurse Anesthetist, Certified Registered234 GOODMAN ST
CINCINNATI, OH 45219
(513) 872-7388
1730105628 NANCY HEINK CNP
Individual
Nurse Practitioner234 GOODMAN ST
CINCINNATI, OH 45219
(513) 584-3683
1598783110MRS. ANNE ETGES C.N.P.
Individual
Nurse Practitioner (Women's Health)234 GOODMAN ST
CINCINNATI, OH 45219
(513) 584-8212
1346269859 ELBERT J NELSON M.D.
Individual
Obstetrics & Gynecology234 GOODMAN ST
CINCINNATI, OH 45219
(513) 584-4081
1699794032 REGINA M REICHARD CRNA
Individual
Nurse Anesthetist, Certified Registered234 GOODMAN ST
CINCINNATI, OH 45219
(513) 872-7388
1609880673 YUKITAKA SHIZUKUDA MD
Individual
Internal Medicine (Cardiovascular Disease)234 GOODMAN ST
CINCINNATI, OH 45219
(513) 584-1000
1194739474 SAMATA R PAIDY MD
Individual
Anesthesiology234 GOODMAN ST
CINCINNATI, OH 45219
(513) 872-7388

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003017989, enumerated in the NPI registry as an "individual" on May 30, 2007

The provider is located at 234 Goodman St Mail Location 0796 Cincinnati, Oh 45219 and the phone number is (513) 584-1000

The provider's speciality is Anesthesiology with taxonomy code 207L00000X

The provider has more than 19 years of experience. He graduated from University Of Cincinnati College Of Medicine in 2005.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Molina. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 17, 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.

The most common procedures or services performed by this practitioner are: Anesthesia for procedure on esophagus, stomach, and/or upper small bowel using an endoscope.

The practitioner is affiliated to the following hospital(s): UNIVERSITY OF CINCINNATI MEDICAL CENTER, LLC and WEST CHESTER HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on May 30, 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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