JOHN B ADAMS II MD
NPI 1013081678
Urology in Charleston, SC


Quality Rating: 100 out of 100 score

NPI Status: Active since November 17, 2006

Contact Information

171 ASHLEY AVE
CHARLESTON, SC
ZIP 29425
Phone: (843) 792-1414

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  • Individual
  • Male
  • Years of Experience 36
  • Urology
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About JOHN ADAMS

John Adams is a provider established in Charleston, South Carolina and his medical specialization is Urology with more than 36 years of experience. He graduated from Emory University School Of Medicine in 1988. The healthcare provider is registered in the NPI registry with number 1013081678 assigned on November 2006. The practitioner's primary taxonomy code is 208800000X with license number 21437 (SC). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1013081678
Provider Name
JOHN B ADAMS II MD
Gender
Male
Entity Type
Individual
Location Address
171 ASHLEY AVE CHARLESTON, SC 29425
Location Phone
(843) 792-1414
Mailing Address
PO BOX 751461 CHARLOTTE, NC 28275
Mailing Phone
(843) 792-6200
Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
1988
Is Sole Proprietor?
No
Enumeration Date
11-17-2006
Last Update Date
03-16-2023
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John Adams is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, 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: $32.11 for a new patient copayment and $17.43 for an established patient copayment.

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

Urology

Taxonomy Code
208800000X
Type
Allopathic & Osteopathic Physicians
License No.
21437
License State
SC
Taxonomy Description
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Insurance Plans Accepted

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

  • Ambetter from Absolute Total Care

    • Ambetter Virtual Access Bronze (Virtual PCP selection required) - HMO
    • Ambetter Virtual Access Silver (Virtual PCP selection required) - HMO
    • Clear Silver - HMO
    • Clear Silver + Vision + Adult Dental - HMO
    • Complete Gold - HMO
    • Complete Gold + Vision + Adult Dental - HMO
    • Elite Bronze - HMO
    • Elite Bronze + Vision + Adult Dental - HMO
    • Elite Gold - HMO
    • Elite Gold + Vision + Adult Dental - HMO
  • Ambetter from Peach State Health Plan

    • Choice Bronze HSA - HMO
    • Choice Bronze HSA + Vision + Adult Dental - HMO
    • Clear Bronze - HMO
    • Clear Bronze + Vision + Adult Dental - HMO
    • Clear Gold - HMO
    • Clear Gold + Vision + Adult Dental - HMO
    • Clear Silver - HMO
    • Clear Silver + Vision + Adult Dental - HMO
    • Complete Gold - HMO
    • Complete Gold + Vision + Adult Dental - HMO
  • Ambetter of North Carolina

    • Ambetter Virtual Access Bronze (Virtual PCP selection required) - HMO
    • Ambetter Virtual Access Gold (Virtual PCP selection required) - HMO
    • Ambetter Virtual Access Silver (Virtual PCP selection required) - HMO
    • Choice Bronze HSA - HMO
    • Choice Bronze HSA + Vision + Adult Dental - HMO
    • Choice Bronze HSA with Atrium Health - HMO
    • Choice Bronze HSA with Atrium Health + Vision + Adult Dental - HMO
    • Clear Silver - HMO
    • Clear Silver + Vision + Adult Dental - HMO
    • Clear Silver with Atrium Health - HMO
  • BlueCross BlueShield of South Carolina

    • Blue Cooper Bronze 1 - HMO
    • Blue Cooper Gold 1 - HMO
    • Blue Cooper HD Silver 3 - HMO
    • Blue Cooper Silver 1 - HMO
    • Blue Cooper Silver 2 - HMO
    • Blue Cooper Standard Expanded Bronze - HMO
    • Blue Cooper Standard Gold - HMO
    • Blue Cooper Standard Silver - HMO
    • Blue VirtuConnect Bronze 1 - EPO
    • Blue VirtuConnect Gold 1 - EPO
  • Molina Healthcare

    • Gold 1 - HMO
    • Gold 1 with Adult Vision Services - HMO
    • Gold 8 - HMO
    • Silver 1 - HMO
    • Silver 1 with Adult Vision Services - HMO
    • Silver 12 - HMO
    • Silver 8 - HMO
  • Blue Cross Blue Shield

  • Medicare

  • Medicaid


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

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
2573767323OTHER (01)SCBLUE SHIELD
571087172OTHER (01)SCAENTA
571087172OTHER (01)SCBLUE CROSS

PECOS Enrollment and Medicare Participation Status

John Adams 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

  • PECOS PAC ID: 1052507803

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20110223000217

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • 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 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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Medical/surgical supplies (D1A)

    Male external catheter, with or without adhesive, disposable, each (HCPCS:A4349)

    3 DME suppliers used 15 Medicare Claims 665 Services Paid

Prosthetic and Orthotic Devices

  • Prosthetic/Orthotic devices (D1F)

    Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each (HCPCS:A4352)

    6 DME suppliers used 11 Medicare Claims 2660 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Intermittent urinary catheter, with insertion supplies (HCPCS:A4353)

    2 DME suppliers used 13 Medicare Claims 2340 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each (HCPCS:A4357)

    8 DME suppliers used 35 Medicare Claims 112 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each (HCPCS:A4385)

    3 DME suppliers used 14 Medicare Claims 350 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4407)

    4 DME suppliers used 16 Medicare Claims 400 Services Paid

Physician 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 29425 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $128.46
  • Minimum New Patient Price $55.43
  • Maximum New Patient Price $169.76
  • Average New Patient Copayment $32.11
  • Minimum New Patient Copayment $13.85
  • Maximum New Patient Copayment $42.44

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $69.73
  • Minimum Established Patient Price $17.06
  • Maximum Established Patient Price $138.69
  • Average Established Patient Copayment $17.43
  • Minimum Established Patient Copayment $4.26
  • Maximum Established Patient Copayment $34.67

* 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.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS 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.

  • Final Score: 100 out of 100

    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.

  • Quality Score: 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 Score: 100

    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 Score: 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 activities measure category compromises 15% providers final MPIS scores.

    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 Score: N/A

    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.

  • Cost Score: N/A

    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.

Clinician Services

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 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 1097

    Urinalysis, manual test (HCPCS:81002)

  • 306

    Ultrasound measurement of bladder capacity after voiding (HCPCS:51798)

  • 215

    Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope (HCPCS:52000)

  • 31

    Ultrasound of rectum (HCPCS:76872)

  • 25

    Insertion of stent in urinary duct (ureter) using an endoscope (HCPCS:52332)

  • 24

    Biopsy of prostate gland (HCPCS:55700)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. John Adams is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
MUSC MEDICAL CENTER169 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-2300Acute Care Hospitals
BEAUFORT COUNTY MEMORIAL HOSPITAL955 RIBAUT RD
BEAUFORT, SC 29902
(843) 522-5200Acute Care Hospitals
HAMPTON REGIONAL MEDICAL CENTER595 WEST CAROLINA AVENUE
VARNVILLE, SC 29944
(803) 943-2771Acute Care Hospitals

Reviews for JOHN B ADAMS II MD

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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.
1013081678
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2023082614
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 8 + 2 + 6 + 1 + 4 + 24 = 52
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 52 = 88

The NPI number 1013081678 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 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1811987407MRS. VICKI E ALLEN PA C
Individual
Physician Assistant171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1932183373DR. CHRISTINA L BOURNE MD
Individual
Emergency Medicine171 ASHLEY AVE EMERGENCY MEDICINE
CHARLESTON, SC 29425
(843) 792-1414
1831174861 MUNAZZA ANIS MD
Individual
Radiology (Diagnostic Radiology)171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1902883580 ROY B SESSIONS MD
Individual
Otolaryngology171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1033198353 STEVEN STEUER GLAZIER MD
Individual
Neurological Surgery171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1427020726DR. WALTER S BARTYNSKI MD
Individual
Radiology (Neuroradiology)171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1508839051DR. STACY MARIE PRUTTING BS,PHARMD, BCPS, CDE
Individual
Pharmacist (Pharmacotherapy)171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-2300
1255305876MEDICAL UNIVERSITY HOSPITAL AUTHORITY
Organization
Nurse Anesthetist, Certified Registered171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1780658641DR. CHERYL P LYNCH MD
Individual
Internal Medicine171 ASHLEY AVE
CHARLESTON, SC 29425
(412) 876-1344
1992779128 MINOO N KAVARANA M.D.
Individual
Thoracic Surgery (Cardiothoracic Vascular Surgery)171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1518936574 RITA MARIE RYAN MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1124097753 LINDA A. THOMAS L.I.S.W.
Individual
Social Worker (Clinical)171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1265492284MS. SUSAN C CRAVEN CRNA
Individual
Nurse Anesthetist, Certified Registered171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1598726465 R. BHANU VIKRAMAN PILLAI M.D
Individual
Pediatrics (Pediatric Gastroenterology)171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-7653
1336102581 ANGELA MARIE SAVATIEL MD
Individual
Obstetrics & Gynecology171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1356305494MS. JENNIFER LEE PELTIER ATC
Individual
Specialist/Technologist (Athletic Trainer)171 ASHLEY AVE MSC 622
CHARLESTON, SC 29425
(843) 792-8147
1366409161DR. STEPHEN AUSTIN FANN M.D.
Individual
Surgery (Surgical Critical Care)171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1275591299DR. MARIA F EGIDI MD
Individual
Internal Medicine (Nephrology)171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1700834868DR. BARTON LEWIS SACHS M.D.
Individual
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414
1255382958MS. ELIZABETH BLAIR TILLER CNM
Individual
Midwife171 ASHLEY AVE
CHARLESTON, SC 29425
(843) 792-1414

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013081678, enumerated in the NPI registry as an "individual" on November 17, 2006

The provider is located at 171 Ashley Ave Charleston, Sc 29425 and the phone number is (843) 792-1414

The provider's speciality is Urology with taxonomy code 208800000X

The provider has more than 36 years of experience. He graduated from Emory University School Of Medicine in 1988.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter from. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 11, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $128.46 with an average copayment of $32.11 for new patient appointments. Established patients should expect a typical charge of $69.73 and an average copayment of 17.43. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Urinalysis, manual test, Ultrasound measurement of bladder capacity after voiding, Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope, Ultrasound of rectum, Insertion of stent in urinary duct (ureter) using an endoscope and Biopsy of prostate gland.

The practitioner is affiliated to the following hospital(s): MUSC MEDICAL CENTER, BEAUFORT COUNTY MEMORIAL HOSPITAL and HAMPTON REGIONAL MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on November 17, 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.