SUSAN MADELEINE GUERRA FNP NPI 1003021700

Nurse Practitioner (Family) in Linwood, NJ

NPI 1003021700 Individual Female Years of Experience 30 Nurse Practitioner Family PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 59.9

NPI Profile for SUSAN MADELEINE GUERRA FNP

Susan Guerra is a provider established in Linwood, New Jersey and her medical specialization is nurse practitioner (family) with more than 30 years of experience. The NPI number of Susan Guerra is 1003021700 and was assigned on May 2007. The practitioner's primary taxonomy code is 363LF0000X with license number 26NJ00174000 (NJ). The provider is registered as an individual and her NPI record was last updated 4 years ago.

A nurse practitioner (NP) like Susan Madeleine Guerra Fnp is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Susan Guerra 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.

Susan Guerra 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 59.9, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $24.6 for a new patient copayment and $28.36 for an established patient copayment.

NPI

1003021700

Provider Name SUSAN MADELEINE GUERRA FNP
Provider Location Address2106 NEW RD SUITE D4 LINWOOD, NJ 08221
Provider Mailing Address2099 NEW ALBANY RD CINNAMINSON, NJ 08077
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1993
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date05-14-2007
Last Update Date09-26-2018


Primary Taxonomy

Taxonomy Code363LF0000X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationFamily
License No.26NJ00174000
License StateNJ

Business Address

SUSAN MADELEINE GUERRA FNP
2106 NEW RD
SUITE D4
LINWOOD, NJ
ZIP 08221
Phone: (609) 926-8899

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Mailing Address

SUSAN MADELEINE GUERRA FNP
2099 NEW ALBANY RD
CINNAMINSON, NJ
ZIP 08077
Phone: (609) 926-8899
Fax: (856) 772-1997



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 ID4183770530
PECOS Enrollment IDI20090925000536
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

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 08221 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$64.36 $193.06 $98.42
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$16.09 $48.26 $24.6
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$20.44 $158.01 $113.47
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.11 $39.5 $28.36

* 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% 45.6
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% 53
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% 64.6
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 - 59.9
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.

  • 147Destruction of up to 14 skin growths (HCPCS:17110)
  • 108Destruction of 2-14 skin growths (HCPCS:17003)
  • 66Biopsy of single growth of skin and/or tissue (HCPCS:11100)
  • 63Destruction of skin growth (HCPCS:17000)

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.
1003021700
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200302270
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 + 7 + 0 + 24 = 40
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1003021700 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
1275534497DR. VYTAS B SILIUNAS DO
Individual
Otolaryngology (Otolaryngic Allergy)2106 NEW RD C9
LINWOOD, NJ 08221
(609) 927-8881
1770585762DR. PRYIA J WAGLE MD
Individual
Otolaryngology2106 NEW RD C9
LINWOOD, NJ 08221
(609) 927-8881
1326040155DR. CLODUALDO S ORQUIZA MD
Individual
Otolaryngology (Otolaryngology/Facial Plastic Surgery)2106 NEW RD C9
LINWOOD, NJ 08221
(609) 927-8881
1750376141DR. MUKESH JAY SHANKER MD
Individual
Internal Medicine (Cardiovascular Disease)2106 NEW RD STE E-4
LINWOOD, NJ 08221
(609) 653-1611
1679547798DR. MATTHEW STEPHEN ALTMAN DC
Individual
Chiropractor2106 NEW RD SUITE D-2
LINWOOD, NJ 08221
(609) 927-7922
1811940620 MARK PERNICE D.O.
Individual
Family Medicine2106 NEW RD SUITE D1
LINWOOD, NJ 08221
(609) 927-9545
1285672048DR. MARIA A KLEIBER M.D.
Individual
Internal Medicine2106 NEW RD C-3
LINWOOD, NJ 08221
(609) 653-2966
1487660882MRS. KIM MAZAK PA-C
Individual
Physician Assistant2106 NEW RD STE D4
LINWOOD, NJ 08221
(609) 926-8899
1689764524DR. CURTIS H WAECHTLER PH.D.
Individual
Clinical Neuropsychologist2106 NEW RD SUITE F-3
LINWOOD, NJ 08221
(610) 574-3367
1043377542MS. LAURA JANIS HUBERMAN LCSW
Individual
Social Worker (Clinical)2106 NEW RD SUITE E-1
LINWOOD, NJ 08221
(609) 926-8000
1811045214 ELEANORE KEEFE MSW, LCSW, LMFT
Individual
Social Worker (Clinical)2106 NEW RD LINWOOD COMMONS, E-1
LINWOOD, NJ 08221
(609) 927-9797
1215190293L.C. JANES, D.O., P.C.
Organization
Family Medicine2106 NEW RD SUITE D7
LINWOOD, NJ 08221
(609) 653-2101
1508013715MRS. ROBERTA B AUNGST M.S.
Individual
Audiologist2106 NEW RD
LINWOOD, NJ 08221
(609) 927-8881
1467607465DR. CLOEY ANN TALOTTA PSY.D
Individual
Psychologist2106 NEW RD SUITE F3
LINWOOD, NJ 08221
(609) 289-1952
1649418286LAURA JANIS HUBERMAN, LLC
Organization
Social Worker (Clinical)2106 NEW RD SUITE E-1
LINWOOD, NJ 08221
(609) 926-8000
1083852792 LAUREN CINCOTTA PA-C
Individual
Physician Assistant (Medical)2106 NEW RD STE D4
LINWOOD, NJ 08221
(609) 926-8899
1811298649KENNETH A. LEIGHT PHD NEW ROADS LLC
Organization
Psychologist2106 NEW RD SUITE F3
LINWOOD, NJ 08221
(609) 926-1165
1235485178MR. SEAN ALAN ADAIR PA-C
Individual
Physician Assistant (Medical)2106 NEW RD SUITE D-4
LINWOOD, NJ 08221
(609) 926-8899
1316958507 MARY ELLEN C SHUPE PHD
Individual
Psychologist2106 NEW RD STE F3
LINWOOD, NJ 08221
(609) 926-1165
1124376827ROBERT CHORNEY PSYD AT NEW ROADS LLC
Organization
Psychologist2106 NEW RD SUITE F3
LINWOOD, NJ 08221
(609) 926-1165

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
Susan Madeleine Guerra Fnp 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.