DR. NATHAN LEE MAUST MD NPI 1003019720

Emergency Medicine in Fishersville, VA

Individual Male Emergency Medicine PECOS Enrolled MIPS Quality Score 92.4

About DR. NATHAN LEE MAUST MD

Nathan Maust is a provider established in Fishersville, Virginia and his medical specialization is Emergency Medicine. The NPI number of Nathan Maust is 1003019720 and was assigned on June 2007. The practitioner's primary taxonomy code is 207P00000X with license number 0101251755 (VA). The provider is registered as an individual and his NPI record was last updated 10 years ago.

NPI

1003019720

Provider NameDR. NATHAN LEE MAUST MD
Provider Location Address78 MEDICAL CENTER DR FISHERSVILLE, VA 22939
Provider Mailing Address628 WYNDHAM WOODS CIR HARRISONBURG, VA 22801
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Enumeration Date06-08-2007
Last Update Date06-25-2012



Nathan Maust 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..

Nathan Maust is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.4, 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.



Primary Taxonomy

Taxonomy Code207P00000X
ClassificationEmergency Medicine
TypeAllopathic & Osteopathic Physicians
License No.0101251755
License StateVA
Taxonomy DescriptionAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Business Address

DR. NATHAN LEE MAUST MD
78 MEDICAL CENTER DR
FISHERSVILLE, VA
ZIP 22939
Phone: (540) 332-4000

Get Directions


Mailing Address

DR. NATHAN LEE MAUST MD
628 WYNDHAM WOODS CIR
HARRISONBURG, VA
ZIP 22801
Phone: (540) 434-3837


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
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

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% 66.3
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% 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.
MIPS Final Score - 92.4
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.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine2011-0267NCNo

Taxonomy Description: an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

2390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program4301090166MINo

Taxonomy Description: an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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.
1003019720
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003011874
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 + 7 + 4 + 24 = 50
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1003019720 is valid because the calculated check digit 0 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
1396746939MR. JAMES A KINDER III PA-C
Individual
Physician Assistant78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4464
1295720712DR. TIMOTHY J NITZSCHE MD
Individual
Anesthesiology78 MEDICAL CENTER DR ANESTHESIA DEPT
FISHERSVILLE, VA 22939
(540) 427-4406
1437138187 JOHN D ULMER MD
Individual
Anesthesiology78 MEDICAL CENTER DR AUGUSTA MEDICAL CENTER, ANESTHESIA DEPARTMENT
FISHERSVILLE, VA 22939
(540) 427-4406
1629040159 ROGER F GILDERSLEEVE MD
Individual
Hospitalist78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4075
1396719886 WILLIAM PETER SCHOFIELD MD
Individual
Psychiatry & Neurology (Psychiatry)78 MEDICAL CENTER DR CROSSROADS
FISHERSVILLE, VA 22939
(540) 213-2525
1629042817 JONATHAN CHRISTIAN ANDERSON MD
Individual
Psychiatry & Neurology (Psychiatry)78 MEDICAL CENTER DR CROSSROADS
FISHERSVILLE, VA 22939
(540) 213-2525
1023082229 BARRY HOWARD BLUMENTHAL MD
Individual
Psychiatry & Neurology (Psychiatry)78 MEDICAL CENTER DR CROSSROADS
FISHERSVILLE, VA 22939
(540) 213-2525
1194799973 ANTHONY G PATRIARCO MD
Individual
Internal Medicine78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4075
1306808225DR. ROBERT GINSBERG MD
Individual
Hospitalist78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4075
1245282250DR. JOSEPH S JUST MD
Individual
Emergency Medicine78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4465
1740232636DR. SALLY I TUCKER MD
Individual
Emergency Medicine78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4465
1881647444 CATHERINE EASTER NP
Individual
Nurse Practitioner78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4465
1083667802DR. WILLIAM L HARRELL MD
Individual
Emergency Medicine78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4465
1659325926DR. ASHER BRAND MD
Individual
Emergency Medicine78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4465
1992759286 RANDY A GALLAGHER DO
Individual
Emergency Medicine78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4465
1306891999DR. CHARLES THOMAS CARTER MD
Individual
Emergency Medicine78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4465
1851346308DR. JENNIFER M KING MD
Individual
Emergency Medicine78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4465
1912013293AUGUSTA HEALTH CARE, INC
Organization
Internal Medicine78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 932-4075
1487766002DR. DAVID WHITNEY CAULKINS M.D.
Individual
Surgery78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(540) 245-7230
1841389434 JENNIFER JOHNSTONE PA
Individual
Physician Assistant78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
(330) 932-4473

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
Dr. Nathan Lee Maust 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.