BLONIE WAYNE DUDNEY JR. MD NPI 1003019019

Ophthalmology (Retina Specialist) in Florissant, MO

NPI 1003019019 Individual Male Years of Experience 19 Ophthalmology Retina Specialist PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 100 Medicare Quality Reporting

NPI Profile for BLONIE WAYNE DUDNEY JR. MD

Blonie Dudney is a provider established in Florissant, Missouri and his medical specialization is ophthalmology (retina specialist) with more than 19 years of experience. He graduated from University Of Tennessee, Hsc, College Of Medicine in 2004. The NPI number of Blonie Dudney is 1003019019 and was assigned on June 2007. The practitioner's primary taxonomy code is 207WX0107X with license number 2010014075 (MO). The provider is registered as an individual and his NPI record was last updated 4 years ago.

Blonie Dudney 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.

Blonie Dudney 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 100, 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 following quality measures were reported for this provider: age-related macular degeneration (amd): counseling on antioxidant supplement, age-related macular degeneration (amd): dilated macular examination, diabetes: eye exam, diabetic retinopathy: communication with the physician managing ongoing diabetes care, diabetic retinopathy: documentation of presence or absence of macular edema and level of severity of retinopathy, documentation of current medications in the medical record, e-prescribing, falls: screening for future fall risk, medication reconciliation, primary open-angle glaucoma (poag): optic nerve evaluation, provide patient access, secure messaging, security risk analysis, use of high-risk medications in the elderly and use of qcdr for feedback reports that incorporate population health.

The typical physician office visit costs for Medicare beneficiaries in this area are: $33.46 for a new patient copayment and $18.2 for an established patient copayment.

NPI

1003019019

Provider Name BLONIE WAYNE DUDNEY JR. MD
Provider Location Address1224 GRAHAM RD 3011 FLORISSANT, MO 63031
Provider Mailing Address1224 GRAHAM RD 3011 FLORISSANT, MO 63031
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year2004
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-07-2007
Last Update Date01-30-2018


Primary Taxonomy

Taxonomy Code207WX0107X
ClassificationOphthalmology
TypeAllopathic & Osteopathic Physicians
SpecializationRetina Specialist
License No.2010014075
License StateMO
Taxonomy DescriptionAn ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.

Business Address

BLONIE WAYNE DUDNEY JR. MD
1224 GRAHAM RD
3011
FLORISSANT, MO
ZIP 63031
Phone: (314) 839-1211
Fax: (314) 839-8429

Get Directions


Mailing Address

BLONIE WAYNE DUDNEY JR. MD
1224 GRAHAM RD
3011
FLORISSANT, MO
ZIP 63031
Phone: (314) 839-1211
Fax: (314) 839-8429



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 ID9638247414
PECOS Enrollment IDI20100921001066, I20150414002127
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 63031 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
$58.16 $176.77 $133.86
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.54 $44.19 $33.46
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
$18.08 $144.4 $72.82
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.52 $36.1 $18.2

* 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% 100
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 (PI) 25% 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 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.
Cost 20% 91.1
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.
MIPS Final Score - 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 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
Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement 94% 623
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for preventing progression of AMD
Age-Related Macular Degeneration (AMD): Dilated Macular Examination 100% 623
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage AND the level of macular degeneration severity during one or more office visits within 12 months
Diabetes: Eye Exam 99% 314
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care 99% 343
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months
Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy 99% 343
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months
Documentation of Current Medications in the Medical Record 100% 5230
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
e-Prescribing 100% 1002
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Falls: Screening for Future Fall Risk 1% 1296
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Medication Reconciliation 98% 396
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation 89% 129
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
Provide Patient Access 3% 1889
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 5% 1889
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Use of High-Risk Medications in the Elderly 0% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
1272
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication
Use of QCDR for feedback reports that incorporate population healthYesN/A
Use of a QCDR to generate regular feedback reports that summarize local practice patterns and treatment outcomes, including for vulnerable populations.

Clinician Utilization

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 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 2033Diagnostic imaging of retina (HCPCS:92134)
  • 1773Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
  • 509Photography of the retina (HCPCS:92250)
  • 118Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • 31Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)

NPI Validation Check Digit Calculation


The following table explains step by step the 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.
1003019019
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003011802
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 + 8 + 0 + 2 + 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 1003019019 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
1871574525 IRWIN PLISCO M.D.
Individual
Internal Medicine1224 GRAHAM RD SUITE 2003
FLORISSANT, MO 63031
(314) 839-4554
1487634408DR. ANITA STIFFELMAN M.D.
Individual
Pediatrics1224 GRAHAM RD SUITE 3009
FLORISSANT, MO 63031
(314) 839-7500
1447212626 CHINDA ROJANASATHIT M.D.
Individual
Specialist1224 GRAHAM RD SUITE 1113
FLORISSANT, MO 63031
(314) 839-4500
1275564585 ROBERT F. SCHWARZE D.O.
Individual
Dermatology1224 GRAHAM RD BUILDING 2, SUITE 1110
FLORISSANT, MO 63031
(314) 831-2464
1851467997PHYSICIAN GROUPS LC
Organization
Clinic/Center (Primary Care)1224 GRAHAM RD SUITE 3003
FLORISSANT, MO 63031
(314) 831-6883
1689729741HINKLEY MEDICINE & CARDIOLOGY LLC
Organization
Internal Medicine (Cardiovascular Disease)1224 GRAHAM RD SUITE 117
FLORISSANT, MO 63031
(314) 831-5553
1962557009 WILLIAM E. HINKLEY MD
Individual
Internal Medicine1224 GRAHAM RD SUITE 117
FLORISSANT, MO 63031
(314) 831-5553
1902949126DR. ELLIOTT HENRY FARBERMAN M.D.
Individual
Pediatrics1224 GRAHAM RD SUITE 3010
FLORISSANT, MO 63031
(314) 921-7509
1831234665DR. ERIC PITTS M.D.
Individual
Dermatology1224 GRAHAM RD SUITE 1108
FLORISSANT, MO 63031
(314) 953-6200
1689703290LRVS MEDICAL LLC
Organization
Obstetrics & Gynecology1224 GRAHAM RD SUITE 2003
FLORISSANT, MO 63031
(314) 504-6032
1578745170RAINBOW PEDIATRICS INC.
Organization
Pediatrics1224 GRAHAM RD SUITE 3009
FLORISSANT, MO 63031
(314) 839-7500
1750564647MOTOG INC.
Organization
Internal Medicine1224 GRAHAM RD SUITE 3008
FLORISSANT, MO 63031
(314) 837-3720
1891958187ROBERT F. SCHWARZE, P.C.
Organization
Clinic/Center (Medical Specialty)1224 GRAHAM RD BUILDING 2, SUITE 1110
FLORISSANT, MO 63031
(314) 831-2470
1912145608ELLIOTT FARBERMAN M.D.,P.C.
Organization
Pediatrics1224 GRAHAM RD SUITE 2005
FLORISSANT, MO 63031
(314) 921-7509
1700026374MRS. EDITA B MERCADO NP
Individual
Nurse Practitioner (Obstetrics & Gynecology)1224 GRAHAM RD 1113
FLORISSANT, MO 63031
(314) 839-4500
1326355348CHANDRA S. KAUP,M.D.,P.C.
Organization
Internal Medicine1224 GRAHAM RD SUITE 2006
FLORISSANT, MO 63031
(314) 830-5233
1932497682 JAMIE L PIPER R.D.
Individual
Dietitian, Registered1224 GRAHAM RD SUITE C-1330
FLORISSANT, MO 63031
(314) 839-4554
1144336058CHRISTIAN HOSPITAL NORTHEAST NORTHWEST
Organization
Pharmacy (Community/Retail Pharmacy)1224 GRAHAM RD
FLORISSANT, MO 63031
(314) 953-6740
1720332018HAMID A HOSSEINI MD PC
Organization
Obstetrics & Gynecology1224 GRAHAM RD SUITE 1104
FLORISSANT, MO 63031
(314) 831-6517
1720180193DR. HAMID A. HOSSEINI M.D.
Individual
Obstetrics & Gynecology1224 GRAHAM RD SUITE 1104
FLORISSANT, MO 63031
(314) 831-6517

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
Blonie Wayne Dudney Jr. 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.