ANDREW CRIGHTON RUTHERFORD MD
NPI 1003046020
Emergency Medicine in Mesquite, TX
NPI Status: Active since July 24, 2009
Contact Information
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
Phone: (214) 320-7000
- Individual
- Male
- Emergency Medicine
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About ANDREW RUTHERFORD
This page provides the complete NPI Profile along with additional information for Andrew Rutherford, a provider established in Mesquite, Texas with a medical specialization in Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1003046020 assigned on July 2009. The practitioner's primary taxonomy code is 207P00000X with license number N7483 (TX). The provider is registered as an individual and his NPI record was last updated 11 years ago.
- NPI
- 1003046020
- Provider Name
- ANDREW CRIGHTON RUTHERFORD MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1011 N GALLOWAY AVE MESQUITE, TX 75149
- Location Phone
- (214) 320-7000
- Mailing Address
- 9203 MILL HOLLOW DR DALLAS, TX 75243
- Mailing Phone
- (214) 221-2965
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-24-2009
- Last Update Date
- 12-04-2014
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- N7483
- License State
- TX
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic - EPO
- Gold Classic Guided Care - HMO
- Gold Classic Standard - EPO
- Gold Classic Standard Guided Care - HMO
- Gold Elite - EPO
- Gold Simple Guided Care - HMO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Classic Standard Guided Care - HMO
- Silver Simple Chronic Care CKM Guided Care - HMO
- Silver Simple Diabetes Guided Care - HMO
- Silver Simple Guided Care - HMO
- Silver Simple PCP Saver - EPO
- Silver Simple PCP Saver Guided Care - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Andrew Rutherford 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.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Critical care, first 30-74 minutes
Emergency department visit for life threatening or functioning severity
Emergency department visit for problem of high severity
Emergency department visit for problem of moderate severity
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
This service was performed 81 times for 80 patientsAn emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
This service was performed 277 times for 267 patientsAn emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
This service was performed 40 times for 40 patientsAn emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
This service was performed 29 times for 29 patientsA routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
This service was performed 277 times for 263 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 75149 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $88.19
- Minimum New Patient Price $57.18
- Maximum New Patient Price $172.86
- Average New Patient Copayment $22.04
- Minimum New Patient Copayment $14.29
- Maximum New Patient Copayment $43.21
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.8
- Minimum Established Patient Price $18.48
- Maximum Established Patient Price $141.2
- Average Established Patient Copayment $25.2
- Minimum Established Patient Copayment $4.62
- Maximum Established Patient Copayment $35.3
* The physician office visit costs information is generated by 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 provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. 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 |
|---|---|---|
| Implementation of an ASP | Yes | N/A |
| Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance | ||
| Implementation of formal quality improvement methods, practice changes, or other practice improvement processes | Yes | N/A |
| Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Participation in an AHRQ-listed patient safety organization. | Yes | N/A |
| Participation in an AHRQ-listed patient safety organization. | ||
Reviews for ANDREW CRIGHTON RUTHERFORD MD
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
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. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 4 | 6 | 0 | 2 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 4 | 12 | 0 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 0 + 4 + 1 + 2 + 0 + 4 + 24 = 40 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1003046020 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.
REBHI A AWAD MD
Radiology
(Diagnostic Radiology)
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
HMA MESQUITE HOSPITAL INC
General Acute Care Hospital
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
HMA MESQUITE HOSPITAL INC
General Acute Care Hospital
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
MRS. SONYA VERNICE BLOCKER CRNA
Nurse Anesthetist, Certified Registered
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
EMCARE MSQ EMERGENCY PHYSICIANS
Emergency Medicine
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
TEXAS EM-1 MEDICAL SERVICES PA
Emergency Medicine
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
DR. KIMBERLY REAGANS M.D.
Emergency Medicine
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
MESQUITE PHYSICIANS GROUP, PLLC
Emergency Medicine
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
JENCY VARUGHESE LVN
Licensed Vocational Nurse
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
DR. TRACY JENNIFER HERNANDEZ M.D.
Internal Medicine
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
COMPREHENSIVE HOSPITALIST SERVICES OF TEXAS, PLLC
Hospitalist
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
DENNIS RANDALL ASKINS M.D.
Pathology
(Anatomic Pathology & Clinical Pathology)
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
DR. RICHARD L ALDRIDGE JR. MD
Emergency Medicine
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
VIVIAN OU FNP
Clinical Nurse Specialist
(Acute Care)
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
DANA A WINGATE D.O.
Emergency Medicine
(Emergency Medical Services)
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
JANET RODRIGUEZ NP-C
Nurse Practitioner
(Family)
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
STAR MD, PLLC
Hospitalist
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
HMA MESQUITE HOSPITAL, INC.
General Acute Care Hospital
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
LIVE OAK EMERGENCY PHYSICIANS PLLC
Emergency Medicine
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
ANDREA CALDWELL PA-C
Physician Assistant
1011 N GALLOWAY AVE
MESQUITE, TX
ZIP 75149
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003046020, enumerated as an "individual" on July 24, 2009.
The provider is located at 1011 N GALLOWAY AVE MESQUITE, TX 75149 and the phone number is (214) 320-7000.
Emergency Medicine with taxonomy code 207P00000X.
The provider might be accepting Accepts: Aetna CVS Health, Blue Cross and Blue Shield of. Please consult your insurance carrier or call the provider to verify.
