SHELBY EDWARD JARRELL III MD NPI 1003023276

Orthopaedic Surgery (Sports Medicine) in Albuquerque, NM

NPI 1003023276 Individual Male Years of Experience 19 Orthopaedic Surgery Sports Medicine PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 59.7 Medicare Quality Reporting

NPI Profile for SHELBY EDWARD JARRELL III MD

Shelby Jarrell is a provider established in Albuquerque, New Mexico and his medical specialization is orthopaedic surgery (sports medicine) with more than 19 years of experience. He graduated from Virginia Commonwealth University, School Of Medicine in 2004. The NPI number of Shelby Jarrell is 1003023276 and was assigned on May 2007. The practitioner's primary taxonomy code is 207XX0005X with license number MD2014-0957 (NM). The provider is registered as an individual and his NPI record was last updated 7 years ago.

Shelby Jarrell 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.

Shelby Jarrell 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 he has hospital affiliations with Presbyterian Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 59.7, 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. The provider also has detailed performance information the following quality measures: e-prescribing, falls: plan of care, leveraging a qcdr for use of standard questionnaires, participation in a qcdr, that promotes use of patient engagement tools., participation in cahps or other supplemental questionnaire, preventive care and screening: body mass index (bmi) screening and follow-up plan, preventive care and screening: tobacco use: screening and cessation intervention, promote use of patient-reported outcome tools, provide patients electronic access to their health information, security risk analysis and use of qcdr for feedback reports that incorporate population health.

NPI

1003023276

Provider Name SHELBY EDWARD JARRELL III MD
Provider Location Address201 CEDAR ST SE SUITE 6600 ALBUQUERQUE, NM 87106
Provider Mailing Address201 CEDAR ST SE SUITE 6600 ALBUQUERQUE, NM 87106
GenderMale
NPI Entity TypeIndividual
Medical School NameVIRGINIA COMMONWEALTH UNIVERSITY, SCHOOL OF MEDICINE
Graduation Year2004
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date05-17-2007
Last Update Date07-16-2015


Primary Taxonomy

Taxonomy Code207XX0005X
ClassificationOrthopaedic Surgery
TypeAllopathic & Osteopathic Physicians
SpecializationSports Medicine
License No.MD2014-0957
License StateNM
Taxonomy DescriptionAn orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

Business Address

SHELBY EDWARD JARRELL III MD
201 CEDAR ST SE
SUITE 6600
ALBUQUERQUE, NM
ZIP 87106
Phone: (505) 724-4300
Fax: (505) 724-4384

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Mailing Address

SHELBY EDWARD JARRELL III MD
201 CEDAR ST SE
SUITE 6600
ALBUQUERQUE, NM
ZIP 87106
Phone: (505) 724-4300
Fax: (505) 724-4384



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 ID8022287994
PECOS Enrollment IDI20150221000102
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

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% N/A
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% 43.6
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 - 59.7
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.

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
e-Prescribing 87% 414
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT.
Falls: Plan of Care 96% 25
Percentage of patients aged 65 years and older with a history of falls that had a plan of care for falls documented within 12 months
Leveraging a QCDR for use of standard questionnairesYesN/A
Participation in a QCDR, demonstrating performance of activities for use of standard questionnaires for assessing improvements in health disparities related to functional health status (e.g., use of Seattle Angina Questionnaire, MD Anderson Symptom Inventory, and/or SF-12/VR-12 functional health status assessment).
Participation in a QCDR, that promotes use of patient engagement tools.YesN/A
Participation in a QCDR, that promotes use of patient engagement tools.
Participation in CAHPS or other supplemental questionnaireYesN/A
Participation in the Consumer Assessment of Healthcare Providers and Systems Survey or other supplemental questionnaire items (e.g., Cultural Competence or Health Information Technology supplemental item sets).
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 24% 1447
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
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 100% 22
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Promote Use of Patient-Reported Outcome ToolsYesN/A
Demonstrate performance of activities for employing patient-reported outcome (PRO) tools and corresponding collection of PRO data such as the use of PQH-2 or PHQ-9, PROMIS instruments, patient reported Wound-Quality of Life (QoL), patient reported Wound Outcome, and patient reported Nutritional Screening.
Provide Patients Electronic Access to Their Health Information 37% 2355
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.
Use of QCDR for feedback reports that incorporate population healthYesN/A
Use of a QCDR to generate regular feedback reports that summarize local practice patterns and treatment outcomes, including for vulnerable populations.

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.

  • 60Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
  • 36X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • 34X-ray of ribs of one side of body, minimum of 2 views (HCPCS:73510)
  • 32Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
  • 30X-ray of wrist, minimum of 3 views (HCPCS:73110)
  • 23X-ray of knee, 4 or more views (HCPCS:73564)

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. Shelby Jarrell is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
PRESBYTERIAN HOSPITAL1100 CENTRAL AVENUE SE
ALBUQUERQUE, NM 87106
(505) 923-5364Acute Care Hospitals320021

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
1207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryMD2014-0957NMNo

Taxonomy Description: an orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
391992YLBBMEDICARE PIN (08)NM
74881736MEDICAID (05)NM

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.
1003023276
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003026214
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 2 + 6 + 2 + 1 + 4 + 24 = 44
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 44 = 66

The NPI number 1003023276 is valid because the calculated check digit 6 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
1063490597 MICHAEL E MCCUTCHEON M.D.
Individual
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)201 CEDAR ST SE SUITE 6600
ALBUQUERQUE, NM 87106
(505) 724-4300
1225016751 KATHRYN R GOTTFRIED RANDALL O.T.
Individual
Occupational Therapist201 CEDAR ST SE SUITE 6600
ALBUQUERQUE, NM 87106
(505) 724-4300
1790744316 JON M AASE MD
Individual
Pediatrics201 CEDAR ST SE PRESBYTERIAN HOSPITAL PICU
ALBUQUERQUE, NM 87106
(505) 841-1163
1427015064 TIMOTHY J FILUTZE PT
Individual
Physical Therapist201 CEDAR ST SE SUITE 6600
ALBUQUERQUE, NM 87106
(505) 724-4300
1679526933 JAMES N ST.JOHN MD
Individual
Neurological Surgery201 CEDAR ST SE 5TH FLOOR, PROFESSIONAL BLDG, SUITE 5630
ALBUQUERQUE, NM 87106
(510) 339-3448
1558385930DR. LUCY FOX MD
Individual
Internal Medicine (Nephrology)201 CEDAR ST SE SUITE 800
ALBUQUERQUE, NM 87106
(505) 563-2800
1821012386MR. JAY WADEMAN PETERSON CNP
Individual
Nurse Practitioner (Family)201 CEDAR ST SE STE 800
ALBUQUERQUE, NM 87106
(505) 563-2800
1437262151DR. FRANCISCO AMPUERO MD
Individual
Obstetrics & Gynecology (Gynecologic Oncology)201 CEDAR ST SE SUITE 304
ALBUQUERQUE, NM 87106
(505) 843-7813
1831290790 KYLE J CHRISTENSEN PA-C
Individual
Physician Assistant (Medical)201 CEDAR ST SE SUITE 6600
ALBUQUERQUE, NM 87106
(505) 724-4300
1730275710MRS. SVETLANA A GORBUNOVA NP
Individual
Nurse Practitioner (Adult Health)201 CEDAR ST SE SUITE 800
ALBUQUERQUE, NM 87106
(505) 563-2800
1255411633DR. HECTOR DAVID ARREDONDO M.D.
Individual
Surgery201 CEDAR ST SE STE 306
ALBUQUERQUE, NM 87106
(505) 563-1000
1386718922 KRISTIN SCHREURS CRNP
Individual
Nurse Practitioner (Obstetrics & Gynecology)201 CEDAR ST SE STE. 5640
ALBUQUERQUE, NM 87106
(505) 843-6168
1861566499 LORI SAIZ MD
Individual
Obstetrics & Gynecology201 CEDAR ST SE STE. 5640
ALBUQUERQUE, NM 87106
(505) 843-6168
1144394792 SUZANNE STALLS CNM
Individual
Midwife201 CEDAR ST SE STE. 5640
ALBUQUERQUE, NM 87106
(505) 843-6168
1700924321MS. MARGARET ELAINE JAEGER RPH
Individual
Pharmacist201 CEDAR ST SE SUITE 7600
ALBUQUERQUE, NM 87106
(505) 563-2500
1376678227 CATHERINE ALICE HOOPER PA-C
Individual
Physician Assistant (Medical)201 CEDAR ST SE
ALBUQUERQUE, NM 87106
(505) 563-2500
1912022708 VICTORIA BORGES CNNP
Individual
Clinical Nurse Specialist (Neonatal)201 CEDAR ST SE PRESBYTERIAN HOSPITAL NICU
ALBUQUERQUE, NM 87106
(505) 841-1163
1972781987 LINDA G MARTINEZ RN
Individual
Registered Nurse201 CEDAR ST SE SUITE 7600
ALBUQUERQUE, NM 87106
(505) 563-2500
1558534883DR. BHARAT SRICHAND DARA M.D.
Individual
Pediatrics (Pediatric Cardiology)201 CEDAR ST SE SUITE 700
ALBUQUERQUE, NM 87106
(505) 848-3700
1588986798 KRISTIN LEIGH WHITTINGTON R.D.
Individual
Dietitian, Registered201 CEDAR ST SE STE. 5640
ALBUQUERQUE, NM 87106
(505) 843-6168

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
Shelby Edward Jarrell Iii Md 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.