DR. RAHUL JAIN M.D.
NPI 1003018201
Internal Medicine - Clinical Cardiac Electrophysiology in Columbia, MO


Quality Rating: 94.15 out of 100 score

NPI Status: Active since June 01, 2007

Contact Information

1 HOSPITAL DR
COLUMBIA, MO
ZIP 65212
Phone: (573) 884-2296
Fax: (573) 884-7743

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  • Individual
  • Male
  • Years of Experience 23
  • Internal Medicine
  • Clinical Cardiac Electrophysiology
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About RAHUL JAIN

Rahul Jain is an internist established in Columbia, Missouri and his medical specialization is Internal Medicine with a focus in clinical cardiac electrophysiology with more than 23 years of experience. The healthcare provider is registered in the NPI registry with number 1003018201 assigned on June 2007. The practitioner's primary taxonomy code is 207RC0001X with license number 2020040971 (MO). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1003018201
Provider Name
DR. RAHUL JAIN M.D.
Gender
Male
Entity Type
Individual
Location Address
1 HOSPITAL DR COLUMBIA, MO 65212
Location Phone
(573) 884-2296
Location Fax
(573) 884-7743
Mailing Address
PO BOX 843966 KANSAS CITY, MO 64184
Mailing Phone
(573) 884-3300
Mailing Fax
(573) 884-7743
Medical School Name
OTHER
Graduation Year
2002
Is Sole Proprietor?
No
Enumeration Date
06-01-2007
Last Update Date
02-02-2023
Code Navigator

An internist like Rahul Jain is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Rahul Jain 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 94.15, 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: $31.6 for a new patient copayment and $24.31 for an established patient copayment.

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

Internal Medicine Clinical Cardiac Electrophysiology

Taxonomy Code
207RC0001X
Type
Allopathic & Osteopathic Physicians
License No.
2020040971
License State
MO
Taxonomy Description
A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

D0068254 (MD)
2207RC0000XAllopathic & Osteopathic Physicians

Internal Medicine
Cardiovascular Disease

2020040971 (MO)
3207RC0001XAllopathic & Osteopathic Physicians

Internal Medicine
Clinical Cardiac Electrophysiology

01071122A (IN)
4208M00000XAllopathic & Osteopathic Physicians

Hospitalist

MD459063 (PA)

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 Essentials 4500 (3 $0 PCP Visits + $0 Virtual PCP + $0 Select Drugs) - HMO
    • Anthem Bronze Pathway Essentials 5500 ($0 Virtual PCP + $0 Virtual Chat + $0 Select Drugs) - HMO
    • Anthem Bronze Pathway Essentials 6500 HSA - HMO
    • Anthem Bronze Pathway Essentials 7500 Standard - HMO
    • Anthem Bronze Pathway Essentials 9450 ($0 Virtual PCP + $0 Virtual Chat + $0 Select Drugs) - HMO
    • Anthem Bronze Pathway Essentials POS 5000 ($0 Virtual PCP + $0 Virtual Chat + $0 Select Drugs) - POS
    • Anthem Bronze Pathway Essentials POS 7500 Standard - POS
    • Anthem Gold Pathway Essentials 1500 Standard - HMO
    • Anthem Gold Pathway Essentials 2700 ($0 Virtual PCP + $0 Virtual Chat + $0 Select Drugs) - HMO
    • Anthem Silver Pathway Essentials 3000 ($0 Virtual PCP + $0 Virtual Chat + $0 Select Drugs) - HMO
    • Anthem Silver Pathway Essentials 4000 HSA - HMO
    • Anthem Silver Pathway Essentials 5000 ($0 Virtual PCP + $0 Virtual Chat + $0 Select Drugs) - HMO
    • Anthem Silver Pathway Essentials 5900 Standard - HMO
    • Anthem Silver Pathway Essentials 7200 ($0 Virtual PCP + $0 Virtual Chat + $0 Select Drugs) - HMO
  • CareSource

    • CareSource Marketplace Bronze First - HMO
    • CareSource Marketplace Bronze First Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Core Gold - HMO
    • CareSource Marketplace Core Gold Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Core Silver - HMO
    • CareSource Marketplace Core Silver Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Diabetes Gold - HMO
    • CareSource Marketplace Diabetes Gold Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Diabetes Silver - HMO
    • CareSource Marketplace Diabetes Silver Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Essential Silver - HMO
    • CareSource Marketplace Essential Silver Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Gold - HMO
    • CareSource Marketplace Gold Dental, Vision, & Fitness - HMO
    • CareSource Marketplace HSA Eligible Bronze - 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
200093348MEDICAID (05)MO 
0060384MEDICAID (05)OH 
H076050OTHER (01)OHMEDICARE PTAN

PECOS Enrollment and Medicare Participation Status

Rahul Jain 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: 9133281009

    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: I20210402000249

    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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Prosthetic and Orthotic Devices

  • Prosthetic/Orthotic devices (D1F)

    Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf (HCPCS:L0648)

    4 DME suppliers used 23 Medicare Claims 23 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf (HCPCS:L0650)

    10 DME suppliers used 49 Medicare Claims 49 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf (HCPCS:L1833)

    9 DME suppliers used 63 Medicare Claims 111 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf (HCPCS:L1851)

    6 DME suppliers used 16 Medicare Claims 20 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment (HCPCS:L1971)

    7 DME suppliers used 14 Medicare Claims 22 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Addition to lower extremity orthosis, suspension sleeve (HCPCS:L2397)

    15 DME suppliers used 70 Medicare Claims 111 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each (HCPCS:L3170)

    6 DME suppliers used 15 Medicare Claims 23 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf (HCPCS:L3916)

    15 DME suppliers used 51 Medicare Claims 84 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment (HCPCS:L3960)

    7 DME suppliers used 19 Medicare Claims 19 Services Paid

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 65212 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $126.4
  • Minimum New Patient Price $54.2
  • Maximum New Patient Price $167.17
  • Average New Patient Copayment $31.6
  • Minimum New Patient Copayment $13.55
  • Maximum New Patient Copayment $41.79

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $97.26
  • Minimum Established Patient Price $16.43
  • Maximum Established Patient Price $136.28
  • Average Established Patient Copayment $24.31
  • Minimum Established Patient Copayment $4.1
  • Maximum Established Patient Copayment $34.07

* 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: 94.15 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: 89.36

    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: 100

    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.

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. Rahul Jain is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
UNIVERSITY OF MISSOURI HEALTH CAREONE HOSPITAL DRIVE
COLUMBIA, MO 65212
(573) 882-4141Acute Care Hospitals

Reviews for DR. RAHUL JAIN 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.
1003018201
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003011620
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 + 6 + 2 + 0 + 24 = 39
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
40 - 39 = 11

The NPI number 1003018201 is valid because the calculated check digit 1 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
1407852882DR. CATHERINE M DUNN M.D.
Individual
Anesthesiology1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-2568
1285632158CURATORS OF THE UNIVERSITY OF MISSOURI
Organization
Otolaryngology1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-4141
1710974415CURATORS OF THE UNIVERSITY OF MISSOURI
Organization
Psychiatry & Neurology (Psychiatry)1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-4141
1649255076 ALEJANDRO MENDEZ CASTILLO M.D.
Individual
Radiology (Diagnostic Radiology)1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-1026
1831167626DR. GEORGE K PARKINS II M.D.
Individual
Orthopaedic Surgery1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-3104
1588623391 JESSICA RAE NITTLER M.D.
Individual
Psychiatry & Neurology (Psychiatry)1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-1483
1205892247 JAMES PHILLIP CONNORS M.D.
Individual
Radiology (Diagnostic Radiology)1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-1161
1376591008MS. BETHANY L COREY PA
Individual
Physician Assistant (Surgical)1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-1647
1699729350 JAMES R SOWERS MD
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-2273
1023048824 DEREK G HEBERT MD
Individual
Emergency Medicine1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-6003
1235140559DR. ILYAS BURNY MD
Individual
Pediatrics (Pediatric Critical Care Medicine)1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-6544
1932216017 CHRISTOPHER L GIPSON MD
Individual
Anesthesiology1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-2568
1477655538 JEAN DONTEE TYLER MD
Individual
Pediatrics1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-4438
1093818874 EVA GARCIA RABUY MD
Individual
Family Medicine1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-6061
1689777815 LENORA MAE ADAMS-HADDADIN DO
Individual
Internal Medicine1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 884-5176
1962505180 THOMAS RICHARD RANDOLL DO
Individual
Internal Medicine1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 884-8176
1588763288DR. GAURAV KUMAR MD
Individual
Radiology (Vascular & Interventional Radiology)1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-1026
1992806251DR. GEOFFREY DANIEL NEWCOMB M.D.
Individual
Family Medicine1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 884-9338
1760573463 MARTHA SOPHIA PAZ CHAVEZ MD
Individual
Pediatrics1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-4438
1669567244 DUSTIN CHRISTIANSEN MD
Individual
Surgery1 HOSPITAL DR
COLUMBIA, MO 65212
(573) 882-2275

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003018201, enumerated in the NPI registry as an "individual" on June 01, 2007

The provider is located at 1 Hospital Dr Columbia, Mo 65212 and the phone number is (573) 884-2296

The provider's speciality is Internal Medicine with taxonomy code 207RC0001X with a focus in Clinical Cardiac Electrophysiology

The provider has more than 23 years of experience.

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

Yes, as of July 02, 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 , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $126.4 with an average copayment of $31.6 for new patient appointments. Established patients should expect a typical charge of $97.26 and an average copayment of 24.31. Please review your insurance plan or contact the provider directly to determine your specific costs.

The practitioner is affiliated to the following hospital(s): UNIVERSITY OF MISSOURI HEALTH CARE. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 01, 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.