MR. SEAN MICHAEL SYLVIA PA-C
NPI 1003215062
Physician Assistant - Medical in Fort Bliss, TX

NPI Status: Active since August 15, 2014

Contact Information

11335 SSG SIMS ST
MENDOZA SOLDIER AND FAMILY CARE CENTER
FORT BLISS, TX
ZIP 79916
Phone: (915) 742-1628

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  • Individual
  • Male
  • Physician Assistant
  • Medical
  • Accepts Insurance
  • PECOS Enrolled
  • Medicare Quality Reporting

About SEAN SYLVIA

This page provides the complete NPI Profile along with additional information for Sean Sylvia, a primary care provider established in Fort Bliss, Texas with a medical specialization in Physician Assistant, focusing in medical . The healthcare provider is registered in the NPI registry with number 1003215062 assigned on August 2014. The practitioner's primary taxonomy code is 363AM0700X. The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1003215062
Provider Name
MR. SEAN MICHAEL SYLVIA PA-C
Gender
Male
Entity Type
Individual
Location Address
11335 SSG SIMS ST MENDOZA SOLDIER AND FAMILY CARE CENTER FORT BLISS, TX 79916
Location Phone
(915) 742-1628
Mailing Address
11335 SSG SIMS ST MENDOZA SOLDIER AND FAMILY CARE CENTER FORT BLISS, TX 79916
Mailing Phone
(915) 742-1628
Is Sole Proprietor?
No
Enumeration Date
08-15-2014
Last Update Date
08-15-2014
Code Navigator

A primary care provider (PCP) like Sean Sylvia sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

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

Physician Assistant Medical

Taxonomy Code
363AM0700X
Type
Physician Assistants & Advanced Practice Nursing Providers

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • 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
  • CHRISTUS Bronze (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Bronze + Dental & Vision (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Bronze Essential - HMO
  • CHRISTUS Bronze Essential (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Bronze Essential + Dental & Vision (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Bronze Essential Plus - HMO
  • CHRISTUS Catastrophic (3 Free PCP visits) - HMO
  • CHRISTUS Gold - HMO
  • CHRISTUS Gold + Dental & Vision + Fitness ($0 Deductible, $5 PCP, $0 Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Gold + Fitness ($0 Deductible, $5 PCP, $0 Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Gold Essential - HMO
  • CHRISTUS Gold Essential ($0 Rx Deductible, $5 PCP, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Gold Essential + Dental & Vision ($0 Rx Deductible, $5 PCP, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Gold Essential Plus - HMO
  • CHRISTUS Gold Plus - HMO
  • CHRISTUS Silver Essential - HMO
  • CHRISTUS Silver Essential 70 ($5 PCP, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Silver Essential 70 + Dental & Vision ($5 PCP, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Silver Essential Plus - HMO
  • CHRISTUS Standard Expanded Bronze - HMO
  • Bronze Classic 4700 - EPO
  • Bronze Classic 4700 | MercyOne - EPO
  • Bronze Classic Standard - EPO
  • Bronze Classic Standard | MercyOne - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Elite + PCP Saver Plus | MercyOne - EPO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - EPO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits | MercyOne - EPO
  • Bronze Simple Chronic Care CKM - EPO
  • Bronze Simple Chronic Care CKM | MercyOne - EPO
  • Bronze Simple Diabetes - EPO
  • Bronze Simple Diabetes | MercyOne - EPO
  • Gold Classic - EPO
  • Gold Classic Standard - EPO
  • Gold Classic Standard | MercyOne - EPO
  • Gold Elite - EPO
  • Gold Elite | MercyOne - EPO
  • Secure - EPO
  • Secure | MercyOne - EPO
  • Silver Classic - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Sean Sylvia 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.

Emergency department visit for life threatening or functioning severity

An 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 92 times for 90 patients

Emergency department visit for problem of high severity

An 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 52 times for 50 patients

Emergency department visit for problem of moderate severity

An 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 30 times for 30 patients

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 ASPYesN/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 processesYesN/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 LevelYesN/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.YesN/A
Participation in an AHRQ-listed patient safety organization.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1003215062, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 38. The final step is to find the difference between that total and the next multiple of ten (40 - 38 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
0
Doubled → 0
Pos 4
3
Unchanged
Pos 5
2
Doubled → 4
Pos 6
1
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
0
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 2 → 4 5 → 10 → 1 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 0 + 3 + 4 + 1 + 1 + 0 + 0 + 1 + 2 + 24 = 38

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 38 is 40. The difference is the calculated check digit.

40 - 38 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1003215062.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003215062, enumerated as an "individual" on August 15, 2014.

The provider is located at 11335 SSG SIMS ST MENDOZA SOLDIER AND FAMILY CARE CENTER FORT BLISS, TX 79916 and the phone number is (915) 742-1628.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, CHRISTUS. Please consult your insurance carrier or call the provider to verify.