DR. DEAN KENTON AMUNDSEN O.D. NPI 1003021205

Optometrist in Camarillo, CA

NPI 1003021205 Individual Male Years of Experience 39 Optometrist PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 100 Medicare Quality Reporting CLIA Number 05D2170065 CLIA Certificate of Waiver

NPI Profile for DR. DEAN KENTON AMUNDSEN O.D.

Dean Amundsen is a provider established in Camarillo, California and his medical specialization is optometrist with more than 39 years of experience. He graduated from Southern California College Of Optometry in 1984. The NPI number of Dean Amundsen is 1003021205 and was assigned on May 2007. The practitioner's primary taxonomy code is 152W00000X with license number OPT 7925 TPA (CA). The provider is registered as an individual and his NPI record was last updated 15 years ago.

Dean Amundsen 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) and a Home Health Agency (HHA).

Dean Amundsen 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 provider also has detailed performance information the following quality measures: comprehensive eye exams, diabetes: eye exam, diabetic retinopathy: communication with the physician managing ongoing diabetes care, documentation of current medications in the medical record, e-prescribing, preventive care and screening: body mass index (bmi) screening and follow-up plan, primary open-angle glaucoma (poag): optic nerve evaluation, provide patients electronic access to their health information, security risk analysis, tcpi participation and use of high-risk medications in the elderly.

The typical physician office visit costs for Medicare beneficiaries in this area are: $36.58 for a new patient copayment and $20.1 for an established patient copayment.

The CLIA number of Dr. Dean Kenton Amundsen O.d. is 05D2170065 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Dr. Dean Kenton Amundsen O.d. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1003021205

Provider NameDR. DEAN KENTON AMUNDSEN O.D.
Provider Location Address2460 N PONDEROSA DR SUITE A-101 CAMARILLO, CA 93010
Provider Mailing Address2460 N PONDEROSA DR SUITE A-101 CAMARILLO, CA 93010
GenderMale
NPI Entity TypeIndividual
Medical School NameSOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Graduation Year1984
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date05-11-2007
Last Update Date07-08-2007


Primary Taxonomy

Taxonomy Code152W00000X
ClassificationOptometrist
TypeEye and Vision Services Providers
License No.OPT 7925 TPA
License StateCA
Taxonomy DescriptionDoctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Business Address

DR. DEAN KENTON AMUNDSEN O.D.
2460 N PONDEROSA DR
SUITE A-101
CAMARILLO, CA
ZIP 93010
Phone: (805) 482-1136
Fax: (805) 388-8499

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Mailing Address

DR. DEAN KENTON AMUNDSEN O.D.
2460 N PONDEROSA DR
SUITE A-101
CAMARILLO, CA
ZIP 93010
Phone: (805) 482-1136
Fax: (805) 388-8499



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 ID345144069
PECOS Enrollment IDI20031124000785
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 DevicesNo

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 93010 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
$64.68 $192.84 $146.33
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$16.17 $48.21 $36.58
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
$20.83 $158.24 $80.43
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.2 $39.56 $20.1

* 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% 98
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 - 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.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Comprehensive Eye ExamsYesN/A
In order to receive credit for this activity, MIPS eligible clinicians must promote the importance of a comprehensive eye exam, which may be accomplished by providing literature and/or facilitating a conversation about this topic using resources such as the "Think About Your Eyes" campaign72 and/or referring patients to resources providing no-cost eye exams, such as the American Academy of Ophthalmology's EyeCare America73 and the American Optometric Association's VISION USA74. This activity is intended for: (1) non- ophthalmologists / optometrist who refer patients to an ophthalmologist/optometrist; (2) ophthalmologists/optometrists caring for underserved patients at no cost; or (3) any clinician providing literature and/or resources on this topic. This activity must be targeted at underserved and/or high- risk populations that would benefit from engagement regarding their eye health with the aim of improving their access to comprehensive eye exams.
Diabetes: Eye Exam 100% 44
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 or dilated eye exam (no evidence of retinopathy) in the 12 months prior to the measurement period
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care 100% 50
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
Documentation of Current Medications in the Medical Record 100% 1619
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% 402
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 54% 196
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 encounterNormal Parameters: Age 18 years and older BMI => 18.5 and < 25 kg/m2
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation 100% 154
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 Patients Electronic Access to Their Health Information 97% 1592
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified electronic health record technology (CEHRT).
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 electronic health record technology (CEHRT) in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 164.306(d)(3), implement security updates as necessary, and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
TCPI ParticipationYesN/A
Participation in the CMS Transforming Clinical Practice Initiative
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.
512
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 medication2) Percentage of patients who were ordered at least two of the same high-risk medication

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.

  • 408Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
  • 299Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
  • 223Photography of the retina (HCPCS:92250)
  • 219Measurement of field of vision during daylight conditions (HCPCS:92083)
  • 160Diagnostic imaging of optic nerve of eye (HCPCS:92133)
  • 121Diagnostic imaging of retina (HCPCS:92134)
  • 19Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003021205 is:

CLIA Number05D2170065
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

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.
1003021205
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200302220
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 + 2 + 0 + 24 = 35
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
40 - 35 = 55

The NPI number 1003021205 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 10 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1518953512 BONNIE CASEY QUINTON L.C.S.W.
Individual
Social Worker (Clinical)2460 N PONDEROSA DR SUITE A-110
CAMARILLO, CA 93010
(805) 384-9399
1558330340 CYNTHIA ANN GIANGRECO R.P.T.
Individual
Physical Therapist2460 N PONDEROSA DR STE. A109
CAMARILLO, CA 93010
(805) 484-9199
1760581003ANACAPA AMBULATORY SURGICAL CENTER
Organization
Clinic/Center (Ambulatory Surgical)2460 N PONDEROSA DR A116
CAMARILLO, CA 93010
(805) 484-4226
1417240862ROBERT S IMPROTA MD, A MEDICAL CORP
Organization
Plastic Surgery2460 N PONDEROSA DR # A117
CAMARILLO, CA 93010
(805) 484-2855
1598006652DANIEL GENE KOLDER, M.D. A CALIFORNIA PROFESSIONAL CORPORATION
Organization
Plastic Surgery2460 N PONDEROSA DR SUITE A-117
CAMARILLO, CA 93010
(805) 484-2855
1801230719CAMARILLO SURGICAL CENTER ASSOCIATES INC
Organization
Clinic/Center (Ambulatory Surgical)2460 N PONDEROSA DR SUITE A-116
CAMARILLO, CA 93010
(805) 484-4226
1134362312 HAIMESH SHAH M.D.
Individual
Phlebology2460 N PONDEROSA DR SUTIE A101
CAMARILLO, CA 93010
(805) 389-5944
1063733426 LARISSA LARSEN M.D.
Individual
Dermatology2460 N PONDEROSA DR STE A117
CAMARILLO, CA 93010
(805) 430-0002
1033305677DR. HAI-EN PENG DPM
Individual
Podiatrist (Foot & Ankle Surgery)2460 N PONDEROSA DR STE A105
CAMARILLO, CA 93010
(805) 482-0711
1073044236ALIGN FOOT AND ANKLE CENTER INC A
Organization
Podiatrist (Foot & Ankle Surgery)2460 N PONDEROSA DR A-105
CAMARILLO, CA 93010
(805) 482-0711

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. Dean Kenton Amundsen O.d. 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.