DR. ROSALIA AYUSO MD, PHD NPI 1003021114
Allergy & Immunology in Woodside, NY
NPI Profile for DR. ROSALIA AYUSO MD, PHD
Rosalia Ayuso is a provider established in Woodside, New York and her medical specialization is allergy & immunology with more than 34 years of experience. The NPI number of Rosalia Ayuso is 1003021114 and was assigned on May 2007. The practitioner's primary taxonomy code is 207K00000X with license number 241199 (NY). The provider is registered as an individual and her NPI record was last updated 11 years ago.
Rosalia Ayuso 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.
Rosalia Ayuso 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 63.7, 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.
| NPI | 1003021114 |
| Provider Name | DR. ROSALIA AYUSO MD, PHD |
| Provider Location Address | 4902 QUEENS BLVD 4TH FLOOR WOODSIDE, NY 11377 |
| Provider Mailing Address | 5528 MAIN ST FLUSHING, NY 11355 |
| Gender | Female |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 1989 |
| Is Sole Proprietor? | No |
| Is Organization Subpart? | N/A |
| Enumeration Date | 05-11-2007 |
| Last Update Date | 10-14-2011 |
Primary Taxonomy
| Taxonomy Code | 207K00000X |
| Classification | Allergy & Immunology |
| Type | Allopathic & Osteopathic Physicians |
| License No. | 241199 |
| License State | NY |
| Taxonomy Description | An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
Business Address
DR. ROSALIA AYUSO MD, PHD
4902 QUEENS BLVD
4TH FLOOR
WOODSIDE, NY
ZIP 11377
Phone: (718) 249-2009
Fax: (347) 291-8185
Mailing Address
DR. ROSALIA AYUSO MD, PHD
5528 MAIN ST
FLUSHING, NY
ZIP 11355
Phone: (718) 445-5100
Fax: (718) 886-7466
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 ID | 9739273244 |
| PECOS Enrollment ID | I20070914000165 |
| 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 Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
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% | 20 | |
|
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. |
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| Promoting Interoperability (PI) | 25% | 99 | |
|
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. |
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| 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. |
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| Cost | 20% | 81.5 | |
|
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. |
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| MIPS Final Score | - | 63.7 | |
| 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. | |||
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.
- 1166Injection of allergenic extracts into skin, accessed through the skin (HCPCS:95004)
- 38Diagnostic examination of nasal passages using an endoscope (HCPCS:31231)
- 16Measurement and graphic recording of total and timed exhaled air capacity (HCPCS:94010)
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. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 2 | 1 | 1 | 1 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 2 | 2 | 1 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 0 + 2 + 2 + 1 + 2 + 24 = 36 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 40 - 36 = 4 | 4 | ||||||||
The NPI number 1003021114 is valid because the calculated check digit 4 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 |
|---|---|---|---|
| 1063690113 | DREAM DENTAL, PC Organization | Dentist (General Practice) | 4902 QUEENS BLVD 3RD FLOOR WOODSIDE, NY 11377 (718) 803-7326 |
| 1417197542 | BRIGHTON MEDICAL PLAZA PC Organization | Internal Medicine (Cardiovascular Disease) | 4902 QUEENS BLVD WOODSIDE, NY 11377 (718) 424-4344 |
| 1669707881 | MR. BRYAN WHITMAN SEGALL SCLA, CSAA Individual | Contractor | 4902 QUEENS BLVD WOODSIDE, NY 11377 (718) 458-5333 |
| 1346575016 | MISS MALIHA SAJJAD PHARMD Individual | Pharmacist | 4902 QUEENS BLVD WOODSIDE, NY 11377 (718) 205-0550 |
| 1265769814 | JAI SAI PHARMACY INC Organization | Pharmacy | 4902 QUEENS BLVD WOODSIDE, NY 11377 (718) 205-0550 |
| 1639408529 | BIANA MAKHOVER PHARM D Individual | Pharmacist | 4902 QUEENS BLVD FLUSHING, NY 11377 (718) 205-0550 |
| 1437426715 | KMS PHARMACY INC Organization | Pharmacy (Community/Retail Pharmacy) | 4902 QUEENS BLVD WOODSIDE, NY 11377 (718) 205-0550 |
| 1871861856 | PADDU ENDO INC Organization | Internal Medicine (Gastroenterology) | 4902 QUEENS BLVD WOODSIDE, NY 11377 (718) 555-4545 |
| 1497797708 | PADMANABH U PADDU MD Individual | Internal Medicine (Gastroenterology) | 4902 QUEENS BLVD LOWER LEVEL WOODSIDE, NY 11377 (718) 784-4502 |
| 1982646253 | NALINI U PADDU MD Individual | Physical Medicine & Rehabilitation (Sports Medicine) | 4902 QUEENS BLVD LOWER LEVEL WOODSIDE, NY 11377 (718) 784-4502 |
| 1124366885 | SUNRISE RX PHARMACY INC Organization | Pharmacy (Community/Retail Pharmacy) | 4902 QUEENS BLVD WOODSIDE, NY 11377 (718) 205-0550 |
| 1134529035 | STRATEGY ANESTHESIA NEW YORK PLLC Organization | Anesthesiology | 4902 QUEENS BLVD WOODSIDE, NY 11377 (718) 784-4502 |
| 1194771162 | DR. KRISHNA RAO BADHEY MD Individual | Internal Medicine (Pulmonary Disease) | 4902 QUEENS BLVD WOODSIDE, NY 11377 (718) 424-4646 |
| 1285821892 | MS. AYSE ZUHAL ERTAMAY R/PA-C Individual | Physician Assistant | 4902 QUEENS BLVD ENT ASSOCIATES OF NEW YORK WOODSIDE, NY 11377 (718) 249-2009 |
| 1366851586 | JSK PHARMACY INC Organization | Pharmacy (Community/Retail Pharmacy) | 4902 QUEENS BLVD WOODSIDE, NY 11377 (718) 205-0550 |
| 1407828924 | DR. JEFFREY SCHNELLER D.P.M. Individual | Podiatrist (Primary Podiatric Medicine) | 4902 QUEENS BLVD WOODSIDE, NY 11377 (718) 729-1952 |
| 1417491986 | MS. MONICA ABADIR Individual | Psychologist (Counseling) | 4902 QUEENS BLVD WOODSIDE, NY 11377 (646) 656-0164 |
| 1336729946 | ERICA VASSELL Individual | Counselor (Mental Health) | 4902 QUEENS BLVD WOODSIDE, NY 11377 (646) 272-8058 |
| 1326628843 | MS. ANDREA PAZ MHC-LP Individual | Counselor (Mental Health) | 4902 QUEENS BLVD WOODSIDE, NY 11377 (646) 656-0164 |
| 1821679879 | ERICA JAMES Individual | Art Therapist | 4902 QUEENS BLVD WOODSIDE, NY 11377 (646) 656-0164 |
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. Rosalia Ayuso Md, Phd 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.