MR. JESSE RYAN POOLER M.P.T. NPI 1003020520

Physical Therapist in Tacoma, WA

Individual Male Years of Experience 21 Physical Therapist Accepts Medicare Approved Payment Medicare Quality Reporting

About MR. JESSE RYAN POOLER M.P.T.

Jesse Pooler is a provider established in Tacoma, Washington and his medical specialization is Physical Therapist with more than 21 years of experience. The NPI number of Jesse Pooler is 1003020520 and was assigned on May 2007. The practitioner's primary taxonomy code is 225100000X with license number PT0008913 (WA). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI

1003020520

Provider NameMR. JESSE RYAN POOLER M.P.T.
Provider Location Address621 S PINE ST TACOMA, WA 98405
Provider Mailing Address621 S PINE ST TACOMA, WA 98405
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2002
Is Sole Proprietor?Yes
Enumeration Date05-10-2007
Last Update Date07-08-2007

Jesse Pooler 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 and the following quality measures were reported: preventive care and screening: body mass index (bmi) screening and follow-up plan. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

The typical physician office visit costs for Medicare beneficiaries in this area are: $33.77 for a new patient copayment and $18.43 for an established patient copayment.



Primary Taxonomy

Taxonomy Code225100000X
ClassificationPhysical Therapist
TypeRespiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.PT0008913
License StateWA
Taxonomy DescriptionPhysical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Business Address

MR. JESSE RYAN POOLER M.P.T.
621 S PINE ST
TACOMA, WA
ZIP 98405
Phone: (253) 835-8091

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Mailing Address

MR. JESSE RYAN POOLER M.P.T.
621 S PINE ST
TACOMA, WA
ZIP 98405
Phone:


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.

PECOS PAC ID3072743269
PECOS Enrollment IDI20140310000981
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.

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 98405 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
$58.96 $178.29 $135.09
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.74 $44.57 $33.77
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
$18.53 $145.92 $73.74
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.63 $36.48 $18.43

* 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.

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
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 97% 63
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2

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.

  • 500Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes (HCPCS:97530)
  • 423Manual (physical) therapy techniques to 1 or more regions, each 15 minutes (HCPCS:97140)
  • 72Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes (HCPCS:97110)
  • 43Physical therapy evaluation (HCPCS:97001)

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.
1003020520
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200302054
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 2 + 0 + 5 + 4 + 24 = 40
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1003020520 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

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
Mr. Jesse Ryan Pooler M.p.t. 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.