DR. FERNANDO IBARRA MD NPI 1013082726
Internal Medicine - Gastroenterology in Monterey Park, CA
About DR. FERNANDO IBARRA MD
Fernando Ibarra is an internist established in Monterey Park, California and his medical specialization is Internal Medicine with a focus in gastroenterology with more than 45 years of experience. The healthcare provider is registered in the NPI registry with number 1013082726 assigned on November 2006. The practitioner's primary taxonomy code is 207RG0100X with license number A38493 (CA). The provider is registered as an individual and his NPI record was last updated 4 years ago.
| NPI | 1013082726 |
| Provider Name | DR. FERNANDO IBARRA MD |
| Location Address | 850 S ATLANTIC BLVD SUITE # 101 MONTEREY PARK, CA 91754 |
| Location Phone | (626) 284-1350 |
| Mailing Address | 850 S ATLANTIC BLVD SUITE # 101 MONTEREY PARK, CA 91754 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 1979 |
| Is Sole Proprietor? | Yes |
| Enumeration Date | 11-21-2006 |
| Last Update Date | 05-01-2019 |
An internist like Fernando Ibarra is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.Fernando Ibarra 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.
Fernando Ibarra 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 White Memorial Medical Center, Beverly Hospital and Monterey Park 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 60, 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 following quality measures were reported for this provider: chronic care and preventative care management for empaneled patients, engagement of new medicaid patients and follow-up, evidenced-based techniques to promote self-management into usual care and use of decision support and standardized treatment protocols.
The typical physician office visit costs for Medicare beneficiaries in this area are: $36.95 for a new patient copayment and $28.72 for an established patient copayment.
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.
| Taxonomy Code | 207RG0100X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | Gastroenterology |
| License No. | A38493 |
| License State | CA |
| Taxonomy Description | An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
Business Address
850 S ATLANTIC BLVD
SUITE # 101
MONTEREY PARK, CA
ZIP 91754
Phone: (626) 284-1350
Fax: (626) 284-2454
Mailing Address
850 S ATLANTIC BLVD
SUITE # 101
MONTEREY PARK, CA
ZIP 91754
Phone: (626) 284-1350
Fax: (626) 284-2454
Location Map
PECOS Enrollment and Medicare Participation Status
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 Medicare providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in the Medicare program need to enroll in PECOS with their NPI number to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 9739148214 |
| PECOS Enrollment ID | I20150409001583 |
| 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 Imaging | Yes |
| Eligible order or refer Durable Medical Equipment (DMEPOS) | Yes |
| Eligible order r refer Home Health Agency (HHA) | Yes |
| Eligible order r refer Power Mobility Devices | Yes |
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 91754 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99204 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $65.18 | $194.87 | $147.83 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $16.29 | $48.71 | $36.95 |
| Established Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for established patients office visits: 99214 | ||
| Minimum Established Patient Pricing | Maximum Established Patient Pricing | Typical Established Patient Pricing |
| $20.89 | $159.82 | $114.88 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $5.22 | $39.95 | $28.72 |
* 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% | N/A | |
|
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. |
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| 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. |
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| Improvement Activities | 15% | N/A | |
|
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. |
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| Cost | 20% | 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. |
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| MIPS Final Score | - | 60 | |
| 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 Reporting
The following quality measures meet Medicare's statistical reporting standards for the year 2018. 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 |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| Evidenced-based techniques to promote self-management into usual care | Yes | N/A |
| Incorporate evidence-based techniques to promote self-management into usual care, using techniques such as goal setting with structured follow-up, Teach Back, action planning or motivational interviewing. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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.
- 229Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43239)
- 89Biopsy of large bowel using an endoscope (HCPCS:45380)
- 62Diagnostic examination of large bowel using an endoscope (HCPCS:45378)
- 42Removal of polyps or growths of large bowel using an endoscope (HCPCS:45385)
- 18Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS:G0105)
- 17Diagnostic 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. Fernando Ibarra is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| WHITE MEMORIAL MEDICAL CENTER | 1720 E CESAR AVENUE LOS ANGELES, CA 90033 | (323) 268-5000 | Acute Care Hospitals | 50103 | |
| BEVERLY HOSPITAL | 309 W BEVERLY BLVD MONTEBELLO, CA 90640 | (323) 726-1222 | Acute Care Hospitals | 50350 | |
| MONTEREY PARK HOSPITAL | 900 S ATLANTIC BLVD MONTEREY PARK, CA 91754 | (626) 570-9000 | Acute Care Hospitals | 50736 |
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. | |||||||||
| 1 | 0 | 1 | 3 | 0 | 8 | 2 | 7 | 2 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 2 | 3 | 0 | 8 | 4 | 7 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 2 + 3 + 0 + 8 + 4 + 7 + 4 + 24 = 54 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 54 = 6 | 6 | ||||||||
The NPI number 1013082726 is valid because the calculated check digit 6 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 |
|---|---|---|---|
| 1225039092 | CALVIN ENG M.D. Individual | Ophthalmology | 850 S ATLANTIC BLVD SUITE 301 MONTEREY PARK, CA 91754 (626) 289-8260 |
| 1225073562 | KHIEM PV NGUYEN MD CARDIOLOGY ASSOCIATES MEDICAL GROUP INC Organization | Specialist | 850 S ATLANTIC BLVD SUITE 305 MONTEREY PARK, CA 91754 (626) 282-5541 |
| 1699703991 | PLAZA SURGICAL MEDICAL CENTER Organization | Clinic/Center (Ambulatory Surgical) | 850 S ATLANTIC BLVD SUITE 201 MONTEREY PARK, CA 91754 (626) 289-2894 |
| 1427165638 | DR. ALLAN MARK EFFRON M.D. Individual | Internal Medicine (Gastroenterology) | 850 S ATLANTIC BLVD SUITE #101 MONTEREY PARK, CA 91754 (626) 284-1350 |
| 1124101084 | DR. EVELYN PEREZ OD Individual | Optometrist | 850 S ATLANTIC BLVD SUITE 301 MONTEREY PARK, CA 91754 (626) 289-7699 |
| 1811059371 | DOMINIC YAU WAI CHU MD Individual | Urology | 850 S ATLANTIC BLVD #300 MONTEREY PARK, CA 91754 (626) 458-0281 |
| 1568609683 | MARTHA PECK ANESTHESIA NURSING INC Organization | Nurse Anesthetist, Certified Registered | 850 S ATLANTIC BLVD STE 201 MONTEREY PARK, CA 91754 (310) 937-2780 |
| 1578790234 | M.A. MEDICAL GROUP, INC Organization | Family Medicine | 850 S ATLANTIC BLVD SUITE 102 MONTEREY PARK, CA 91754 (626) 607-0333 |
| 1730493198 | SERGIO A. FUENZALIDA MD INC. Organization | Psychiatry & Neurology (Addiction Medicine) | 850 S ATLANTIC BLVD SUITE 103 MONTEREY PARK, CA 91754 (626) 576-7481 |
| 1629358916 | DOCTOR'S LAB, LLC Organization | Clinical Medical Laboratory | 850 S ATLANTIC BLVD SUITE 305 MONTEREY PARK, CA 91754 (626) 284-2881 |
| 1750588034 | DR. ANNE MY NGUYEN M.D. Individual | Ophthalmology | 850 S ATLANTIC BLVD SUITE 301 MONTEREY PARK, CA 91754 (626) 289-7699 |
| 1326380643 | JAQUELYN LORENZO MACARAEG NP Individual | Nurse Practitioner (Adult Health) | 850 S ATLANTIC BLVD SUITE 305 MONTEREY PARK, CA 91754 (310) 550-6886 |
| 1962566653 | MR. KUANG J HUANG MD Individual | Psychiatry & Neurology (Psychiatry) | 850 S ATLANTIC BLVD #304 MONTEREY PARK, CA 91754 (626) 284-6408 |
| 1427435395 | NAZARICA RICAFRENTE Individual | Nurse Practitioner (Family) | 850 S ATLANTIC BLVD SUITE 101 MONTEREY PARK, CA 91754 (626) 284-1350 |
| 1205064722 | DR. DAVID BARBA M.D. Individual | Orthopaedic Surgery | 850 S ATLANTIC BLVD SUITE #201 MONTEREY PARK, CA 91754 (626) 289-0178 |
| 1851587141 | MRS. ALLISON ANNE STAVARIDIS CRNA Individual | Nurse Anesthetist, Certified Registered | 850 S ATLANTIC BLVD STE 201 MONTEREY PARK, CA 91754 (626) 289-2894 |
| 1083083653 | ALLISON STAVARIDIS CRNA INC Organization | Anesthesiology | 850 S ATLANTIC BLVD STE 201 MONTEREY PARK, CA 91754 (626) 289-2894 |
| 1235524836 | YANIRA PEREZ MD INC Organization | General Practice | 850 S ATLANTIC BLVD STE 305 MONTEREY PARK, CA 91754 (626) 570-6920 |
| 1831342195 | JAMES JABER M.D. Individual | Otolaryngology | 850 S ATLANTIC BLVD STE 305 MONTEREY PARK, CA 91754 (310) 514-2640 |
| 1912180969 | FERNANDO IBARRA M D INC Organization | Internal Medicine (Gastroenterology) | 850 S ATLANTIC BLVD STE # 101 MONTEREY PARK, CA 91754 (626) 284-1350 |
Frequently Asked Questions
What is Dr. Fernando Ibarra MD NPI number?
The NPI number assigned to this healthcare provider is 1013082726, enumerated in the NPI registry as an "individual" on November 21, 2006
Where is the provider located?
The provider is located at 850 S Atlantic Blvd Suite # 101 Monterey Park, Ca 91754 and the phone number is (626) 284-1350
What is the provider specialty code?
The provider's speciality is Internal Medicine with taxonomy code 207RG0100X with a focus in Gastroenterology
How many years of experience does Dr. Fernando Ibarra MD have?
The provider has more than 45 years of experience.
Is Dr. Fernando Ibarra MD registered in PECOS?
Yes, as of September 14, 2023 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: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
How much is a visit to Dr. Fernando Ibarra MD?
Medicare beneficiaries should expect a typical cost of $147.83 with an average copayment of $36.95 for new patient appointments. Established patients should expect a typical charge of $114.88 and an average copayment of 28.72. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Dr. Fernando Ibarra MD?
The most common procedures or services performed by this practitioner are: Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope, Biopsy of large bowel using an endoscope, Diagnostic examination of large bowel using an endoscope, Removal of polyps or growths of large bowel using an endoscope, Colorectal cancer screening; colonoscopy on individual at high risk and Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope.
Is Dr. Fernando Ibarra MD affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: WHITE MEMORIAL MEDICAL CENTER, BEVERLY HOSPITAL and MONTEREY PARK HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
This NPI record was last updated on November 21, 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].
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