TRICIA PUNSALAN M.D. NPI 1003020504

Family Medicine in Conroe, TX

NPI 1003020504 Individual Female Years of Experience 16 Family Medicine PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About TRICIA PUNSALAN

Tricia Punsalan is a primary care provider established in Conroe, Texas and her medical specialization is family medicine with more than 16 years of experience. She graduated from University Of Texas Medical School At San Antonio in 2006. The NPI number of Tricia Punsalan is 1003020504 and was assigned on May 2007. The practitioner's primary taxonomy code is 207Q00000X with license number N2740 (TX). The provider is registered as an individual and her NPI record was last updated 5 years ago.

A primary care provider (PCP) like Tricia Punsalan M.d. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Tricia Punsalan is enrolled in PECOS and is eligible to order or refer healthcare 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

Tricia Punsalan 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. According to Medicare claims data she has hospital affiliations with Hca Houston Healthcare Conroe.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: advance care planning, care plan, documentation of current medications in the medical record, implementation of condition-specific chronic disease self-management support programs, implementation of medication management practice improvements and use evidence-based decision aids to support shared decision-making.. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

NPI

1003020504

Provider Name TRICIA PUNSALAN M.D.
Provider Location Address704 OLD MONTGOMERY RD CONROE, TX 77301
Provider Mailing Address504 MEDICAL CENTER BLVD CONROE, TX 77304
GenderFemale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Graduation Year2006
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date05-10-2007
Last Update Date07-05-2016


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.N2740
License StateTX
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

TRICIA PUNSALAN M.D.
704 OLD MONTGOMERY RD
CONROE, TX
ZIP 77301
Phone: (936) 539-4004
Fax: (936) 521-3964

Get Directions


Mailing Address

TRICIA PUNSALAN M.D.
504 MEDICAL CENTER BLVD
CONROE, TX
ZIP 77304
Phone: (936) 718-3831
Fax: (888) 501-5341



Medicare Participation

Registered in PECOS? Yes 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.
PECOS PAC ID6800075201
PECOS Enrollment IDI20110131000597
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

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.

  • 178Management and supervision of oxygen chamber therapy per session (HCPCS:99183)

Quality Reporting

The following quality measures meets 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 Rate Number of Patients
Care Plan 97% 370
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Documentation of Current Medications in the Medical Record 100% 227
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

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Tricia Punsalan is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
HCA HOUSTON HEALTHCARE CONROE504 MEDICAL CENTER BLVD
CONROE, TX 77304
(936) 539-1111Acute Care Hospitals450222

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
1208M00000XAllopathic & Osteopathic PhysiciansHospitalistN2740TXNo

Taxonomy Description: hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Other Providers at the same location


The following 7 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1851396212DR. WILLIAM BROWN MD
Individual
Family Medicine704 OLD MONTGOMERY RD
CONROE, TX 77301
(936) 539-4004
1316946692DR. C. ALVIN JONES M.D.
Individual
Family Medicine704 OLD MONTGOMERY RD
CONROE, TX 77301
(936) 539-4004
1528247871MS. ELLEN SHEILA FIESINGER FNP
Individual
Nurse Practitioner (Family)704 OLD MONTGOMERY RD
CONROE, TX 77301
(936) 539-4004
1497907356 KATHRYN VIRGINIA HAUSER R.PH.
Individual
Pharmacist704 OLD MONTGOMERY RD
CONROE, TX 77301
(936) 539-4004
1467783977 ESTELLA SALINAS CDE
Individual
Nutritionist (Nutrition, Education)704 OLD MONTGOMERY RD
CONROE, TX 77301
(936) 539-4004
1649407933 JOHN ALBERT HEALY MD
Individual
Family Medicine704 OLD MONTGOMERY RD
CONROE, TX 77301
(936) 539-4004
1164427530DR. ANGELA C THOMAS BROWN MD
Individual
Family Medicine704 OLD MONTGOMERY RD
CONROE, TX 77301
(936) 539-4004

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
The code describing 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.