HERON RODRIGUEZ MD NPI 1003883778

Surgery (Vascular Surgery) in Chicago, IL

NPI 1003883778 Individual Male Years of Experience 28 Surgery Vascular Surgery PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 87.3

About HERON RODRIGUEZ

Heron Rodriguez is a provider established in Chicago, Illinois and his medical specialization is surgery (vascular surgery) with more than 28 years of experience. The NPI number of Heron Rodriguez is 1003883778 and was assigned on March 2006. The practitioner's primary taxonomy code is 2086S0129X with license number 36096947 (IL). The provider is registered as an individual and his NPI record was last updated 15 years ago.

Heron Rodriguez is enrolled in PECOS and is eligible to order or refer healthcare 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

Heron Rodriguez 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 Northwestern Memorial 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 87.3, 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.

The typical physician office visit costs for Medicare beneficiaries in this area are: $24.24 for a new patient copayment and $19.58 for an established patient copayment.

NPI

1003883778

Provider Name HERON RODRIGUEZ MD
Provider Location Address675 N SAINT CLAIR ST NORTHWESTERN MEMORIAL HOSPIALT GALTER 19-100 CHICAGO, IL 60611
Provider Mailing Address251 E HURON ST NORTHWESTERN MEMORIAL HOSPIALT GALTER 10-105 CHICAGO, IL 60611
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1994
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date03-02-2006
Last Update Date07-08-2007


Primary Taxonomy

Taxonomy Code2086S0129X
ClassificationSurgery
TypeAllopathic & Osteopathic Physicians
SpecializationVascular Surgery
License No.36096947
License StateIL
Taxonomy DescriptionA surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Business Address

HERON RODRIGUEZ MD
675 N SAINT CLAIR ST
NORTHWESTERN MEMORIAL HOSPIALT GALTER 19-100
CHICAGO, IL
ZIP 60611
Phone: (312) 695-2714

Get Directions


Mailing Address

HERON RODRIGUEZ MD
251 E HURON ST
NORTHWESTERN MEMORIAL HOSPIALT GALTER 10-105
CHICAGO, IL
ZIP 60611
Phone: (312) 695-4857



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 ID8022044429
PECOS Enrollment IDI20050715000861
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 60611 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
$63 $191.32 $96.99
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.75 $47.83 $24.24
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$19.29 $155.26 $78.33
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.82 $38.81 $19.58

* 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% 88.3
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% 79
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% 72.9
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 - 87.3
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.

  • 1043Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers (HCPCS:93970)
  • 262Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)
  • 68Ultrasound study of arteries and arterial grafts of one leg or limited (HCPCS:93926)
  • 52Ultrasound study of arteries of both arms and legs (HCPCS:93922)
  • 34Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers (HCPCS:93971)
  • 18Ultrasound guidance for accessing into blood vessel (HCPCS:76937)

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. Heron Rodriguez is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
NORTHWESTERN MEMORIAL HOSPITAL251 E HURON ST
CHICAGO, IL 60611
(312) 926-2000Acute Care Hospitals140281

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
204111MEDICARE ID-TYPE UNSPECIFIED (04)IL
K01217MEDICARE ID-TYPE UNSPECIFIED (04)IL
H76745MEDICARE UPIN (02)

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1962492611 OLGA FRANKFURT MD
Individual
Internal Medicine (Hematology)675 N SAINT CLAIR ST SUITE 21-100
CHICAGO, IL 60611
(312) 695-0990
1881678050 MARY DOI MD
Individual
Internal Medicine675 N SAINT CLAIR ST SUITE 18-200
CHICAGO, IL 60611
(312) 695-0113
1821072919 DAVID BENTREM MD
Individual
Surgery (Surgical Oncology)675 N SAINT CLAIR ST SUITE 100
CHICAGO, IL 60611
(312) 695-1130
1952386054MRS. ANJU PETERS M.D.
Individual
Allergy & Immunology675 N SAINT CLAIR ST STE 18-250
CHICAGO, IL 60611
(312) 695-8624
1134199367 RISHI ARORA MD
Individual
Internal Medicine (Clinical Cardiac Electrophysiology)675 N SAINT CLAIR ST
CHICAGO, IL 60611
(312) 695-4965
1124098066 DAVID BAKER MD
Individual
Internal Medicine675 N SAINT CLAIR ST GALTER 18-#200
CHICAGO, IL 60611
(312) 695-8630
1932172889 DENISE AU MD
Individual
Internal Medicine675 N SAINT CLAIR ST
CHICAGO, IL 60611
(312) 695-8630
1457325037 DANIEL BATTLE MD
Individual
Internal Medicine (Nephrology)675 N SAINT CLAIR ST SUITE #250
CHICAGO, IL 60611
(312) 695-2887
1316911928 RANDALL BARNES MD
Individual
Obstetrics & Gynecology (Reproductive Endocrinology)675 N SAINT CLAIR ST SUITE #200
CHICAGO, IL 60611
(312) 695-7269
1790750909 DIANE BRESLOW LCSW
Individual
Social Worker (Clinical)675 N SAINT CLAIR ST GALTER 20-100
CHICAGO, IL 60611
(312) 695-7950
1508831470 PATRICK TOSETTI
Individual
Internal Medicine675 N SAINT CLAIR ST GALTER 18-200
CHICAGO, IL 60611
(312) 695-8630
1891761532 AL BENSON MD
Individual
Internal Medicine (Medical Oncology)675 N SAINT CLAIR ST SUITE 100
CHICAGO, IL 60611
(312) 695-0990
1063488898 CHARLES BENNETT MD
Individual
Internal Medicine (Medical Oncology)675 N SAINT CLAIR ST GALTER 21-100
CHICAGO, IL 60611
(312) 695-6180
1285600031 HONORIO BENZON MD
Individual
Anesthesiology (Pain Medicine)675 N SAINT CLAIR ST SUITE 100
CHICAGO, IL 60611
(312) 695-2500
1326014184 KEITH BENZULY MD
Individual
Internal Medicine (Cardiovascular Disease)675 N SAINT CLAIR ST SUITE 100
CHICAGO, IL 60611
(312) 695-4965
1447227269 ROBERT BONOW MD
Individual
Internal Medicine (Cardiovascular Disease)675 N SAINT CLAIR ST GALTER 19-100
CHICAGO, IL 60611
(312) 695-4965
1316906860 MICHELE BRYK PA
Individual
Physician Assistant675 N SAINT CLAIR ST GALTER 21-100
CHICAGO, IL 60611
(312) 695-0990
1750340113 SERDAR BULUN MD
Individual
Obstetrics & Gynecology (Reproductive Endocrinology)675 N SAINT CLAIR ST GALTER 14-200
CHICAGO, IL 60611
(312) 695-7269
1093774457 ANDREW BUNTA MD
Individual
Orthopaedic Surgery675 N SAINT CLAIR ST GALTER 17-100
CHICAGO, IL 60611
(312) 695-6800
1114986536 PAUL BRYAR MD
Individual
Ophthalmology675 N SAINT CLAIR ST GALTER 15-150
CHICAGO, IL 60611
(312) 695-8150

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
The code describing 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.