DR. DIEGO ALONZO GOMEZ MD NPI 1003815408

Specialist in Charlottesville, VA

NPI 1003815408 Individual Male Years of Experience 35 Specialist PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 89.3

NPI Profile for DR. DIEGO ALONZO GOMEZ MD

Diego Gomez is a provider established in Charlottesville, Virginia and his medical specialization is specialist with more than 35 years of experience. He graduated from Eastern Virginia Medical School in 1988. The NPI number of Diego Gomez is 1003815408 and was assigned on July 2005. The practitioner's primary taxonomy code is 174400000X with license number 0101044147 (VA). The provider is registered as an individual and his NPI record was last updated 13 years ago.

Diego Gomez 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.

Diego Gomez 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 Sentara Martha Jefferson Hospital, University Of Virginia Medical Center and Greenbrier Valley Medical Center.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 89.3, 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.

NPI

1003815408

Provider NameDR. DIEGO ALONZO GOMEZ MD
Provider Location Address1139 E HIGH ST CHARLOTTESVILLE, VA 22902
Provider Mailing Address1139 E HIGH ST CHARLOTTESVILLE, VA 22902
GenderMale
NPI Entity TypeIndividual
Medical School NameEASTERN VIRGINIA MEDICAL SCHOOL
Graduation Year1988
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-18-2005
Last Update Date01-29-2009


Primary Taxonomy

Taxonomy Code174400000X
ClassificationSpecialist
TypeOther Service Providers
License No.0101044147
License StateVA
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Business Address

DR. DIEGO ALONZO GOMEZ MD
1139 E HIGH ST
CHARLOTTESVILLE, VA
ZIP 22902
Phone: (434) 817-8484
Fax: (434) 817-8490

Get Directions


Mailing Address

DR. DIEGO ALONZO GOMEZ MD
1139 E HIGH ST
CHARLOTTESVILLE, VA
ZIP 22902
Phone: (434) 817-8484
Fax: (434) 817-8490



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 ID4183755283
PECOS Enrollment IDI20100707000354
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% 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% 65
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% 79
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 - 89.3
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.

  • 121Removal of polyps or growths of large bowel using an endoscope (HCPCS:45385)
  • 114Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43239)
  • 73Biopsy of large bowel using an endoscope (HCPCS:45380)
  • 48Diagnostic examination of large bowel using an endoscope (HCPCS:45378)
  • 40Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 19Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43235)

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. Diego Gomez is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
SENTARA MARTHA JEFFERSON HOSPITAL500 MARTHA JEFFERSON DRIVE
CHARLOTTESVILLE, VA 22911
(434) 654-7000Acute Care Hospitals490077
UNIVERSITY OF VIRGINIA MEDICAL CENTER1215 LEE STREET
CHARLOTTESVILLE, VA 22908
(800) 251-3627Acute Care Hospitals490009
GREENBRIER VALLEY MEDICAL CENTER1320 MAPLEWOOD AVENUE
RONCEVERTE, WV 24970
(304) 647-4411Acute Care Hospitals510002

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 Identifier Issuer
005856825MEDICAID (05)VA
100000283MEDICARE ID-TYPE UNSPECIFIED (04)VAMEDICARE NUMBER
F57193MEDICARE UPIN (02)VA

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.
1003815408
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20031611040
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 1 + 6 + 1 + 1 + 0 + 4 + 0 + 24 = 42
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 42 = 88

The NPI number 1003815408 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 11 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1689671448CHARLOTTESVILLE GASTROENTEROLOGY ASSOCIATES PC
Organization
Specialist1139 E HIGH ST SUITE 203
CHARLOTTESVILLE, VA 22902
(434) 817-8484
1760489488DR. DANIEL JOHN PAMBIANCO MD
Individual
Specialist1139 E HIGH ST
CHARLOTTESVILLE, VA 22902
(434) 817-8484
1386641157DR. BYRD STUART LEAVELL JR. MD
Individual
Specialist1139 E HIGH ST
CHARLOTTESVILLE, VA 22902
(434) 817-8484
1225035959DR. DAVID HOWARD BALABAN MD
Individual
Specialist1139 E HIGH ST
CHARLOTTESVILLE, VA 22902
(434) 817-8484
1174520951DR. MICHAEL JOHN OBLINGER MD
Individual
Specialist1139 E HIGH ST
CHARLOTTESVILLE, VA 22902
(434) 817-8484
1952300352MRS. LYNN ELLEN VALENTINE D.N.SC.
Individual
Nurse Practitioner1139 E HIGH ST
CHARLOTTESVILLE, VA 22902
(434) 817-8484
1558360651 VIRGINIA PENDER MICHEL ANP
Individual
Nurse Practitioner (Adult Health)1139 E HIGH ST
CHARLOTTESVILLE, VA 22902
(434) 817-8484
1770582702 AMY ELIZABETH MCDONNELL NP
Individual
Nurse Practitioner1139 E HIGH ST
CHARLOTTESVILLE, VA 22902
(434) 817-8484
1396744231 DONNA HARTNETT SMITH NP
Individual
Nurse Practitioner1139 E HIGH ST
CHARLOTTESVILLE, VA 22902
(434) 817-8484
1083677199 EMILY CHRISTMAN M.D.
Individual
Internal Medicine (Gastroenterology)1139 E HIGH ST SUITE 203
CHARLOTTESVILLE, VA 22902
(434) 817-8484
1861406910 CARLY M HUNT MD
Individual
Anesthesiology1139 E HIGH ST STE 203
CHARLOTTESVILLE, VA 22902
(434) 817-8484

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. Diego Alonzo Gomez 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.