|Provider Name||DR. DANNY W CROSS OD|
|Location Address||18730 ALBERTA ST ONEIDA, TN 37841|
|Location Phone||(423) 569-6822|
|Mailing Address||PO BOX 4509 ONEIDA, TN 37841|
|NPI Entity Type||Individual|
|Is Sole Proprietor?||Yes|
|Last Update Date||04-06-2015|
Danny Cross 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: Durable Medical Equipment (DME)..
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 54.3, 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 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.
|Type||Eye and Vision Services Providers|
|Taxonomy Description||Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.|
The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
DR. DANNY W CROSS OD
18730 ALBERTA ST
Phone: (423) 569-6822
Fax: (423) 569-6823
DR. DANNY W CROSS OD
PO BOX 4509
Phone: (423) 569-6822
Fax: (423) 569-6823
PECOS Enrollment and Medicare Participation Status
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|
|Eligible order / refer Part B Clinical Laboratory and Imaging||No|
|Eligible order / refer Durable Medical Equipment||Yes|
|Eligible order / refer Home Health Agency (HHA)||No|
|Eligible order / refer Power Mobility Devices||No|
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|
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%||N/A|
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.
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.
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||-||54.3|
|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.|
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.
- 155Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
- 60Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)
- 32Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
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|
|103I416993||OTHER (01)||MEDICARE PTAN|
|1326310822||MEDICARE NSC (07)||TN|
|T61187||MEDICARE UPIN (02)||TN|
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.|
|Step 1: Double the value of the alternate digits, beginning with the rightmost digit.|
|Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.|
|2 + 0 + 2 + 3 + 0 + 7 + 1 + 8 + 4 + 1 + 4 + 24 = 56|
|Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.|
|60 - 56 = 4||4|
The NPI number 1013079474 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
|NPI||Name / Type||Taxonomy||Address|
|1326310822||DANNY W CROSS OD PC |
|Optometrist||18730 ALBERTA ST |
ONEIDA, TN 37841
Frequently Asked Questions
What is Dr. Danny Cross OD NPI number?
The NPI number assigned to Dr. Danny Cross OD is 1013079474, registered as an "individual" on December 14, 2006
Where is Dr. Danny Cross OD located?
The provider is located at 18730 Alberta St Oneida, Tn 37841 and the phone number is (423) 569-6822
Which is Dr. Danny Cross OD specialty?
The provider's speciality is Optometrist
What insurance does Dr. Danny Cross OD accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.
Is Dr. Danny Cross OD registered in PECOS?
Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Durable Medical Equipment (DME).
How much is a visit to Dr. Danny Cross OD?
Medicare beneficiaries should expect a typical cost of $126.52 with an average copayment of $31.63 for new patient appointments. Established patients should expect a typical charge of $68.78 and an average copayment of 17.19. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Dr. Danny Cross OD?
The most common procedures or services performed by this practitioner are: Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits, Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits and Eye and medical examination for diagnosis and treatment, established patient.
How do I update my NPI information?
The NPI record of Dr. Danny Cross OD was last updated on December 14, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]