|Provider Name||DR. PAUL CASINELLI M.D|
|Location Address||40 TUPELO HILL DR CRANSTON, RI 02920|
|Location Phone||(401) 456-2125|
|Mailing Address||PO BOX 6064 PROVIDENCE, RI 02904|
|NPI Entity Type||Individual|
|Medical School Name||UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED|
|Is Sole Proprietor?||No|
|Last Update Date||09-25-2013|
An anesthesiologist like Dr. Paul Casinelli M.d manages the care of surgical patients and pain relief through drug administration that reduces or eliminates pain during an operation, medical procedure or during labor and delivery of babies. During surgical procedures anesthesiologists are responsible for adjusting the amount of anesthetic, monitoring the patient's heart rate, body temperature, blood pressure and breathing.Paul Casinelli 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.
Paul Casinelli 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 South County Hospital Inc.
The provider participated in Medicare's 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 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||Allopathic & Osteopathic Physicians|
|Taxonomy Description||An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.|
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. PAUL CASINELLI M.D
40 TUPELO HILL DR
Phone: (401) 456-2125
DR. PAUL CASINELLI M.D
PO BOX 6064
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|
|PECOS PAC ID||5294892378|
|PECOS Enrollment ID||I20090317000021|
|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 / refer Durable Medical Equipment||Yes|
|Eligible order / refer Home Health Agency (HHA)||Yes|
|Eligible order / refer Power Mobility Devices||Yes|
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||-||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.|
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.
- 60Anesthesia for procedure on gastrointestinal tract using an endoscope (HCPCS:00740)
- 47Anesthesia for procedure on lower intestine using an endoscope (HCPCS:00810)
- 17Anesthesia for procedure in upper abdomen including use of an endoscope (HCPCS:00790)
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. Paul Casinelli is affiliated with the following medical facilities:
|Hospital Name||Address||Phone||Hospital Type||CMS Certification Number (CCN)||Overall Rating|
|SOUTH COUNTY HOSPITAL INC||100 KENYON AVE|
WAKEFIELD, RI 2879
|(401) 782-8020||Acute Care Hospitals||410008|
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|
|F53806||MEDICARE UPIN (02)|
|007005925||MEDICARE PIN (08)||RI|
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 + 8 + 1 + 2 + 5 + 1 + 0 + 24 = 48|
|Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.|
|50 - 48 = 2||2|
The NPI number 1013086552 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
What is Dr. Paul Casinelli M.D NPI number?
The NPI number assigned to Dr. Paul Casinelli M.D is 1013086552, registered as an "individual" on November 07, 2006
Where is Dr. Paul Casinelli M.D located?
The provider is located at 40 Tupelo Hill Dr Cranston, Ri 02920 and the phone number is (401) 456-2125
Which is Dr. Paul Casinelli M.D specialty?
The provider's speciality is Anesthesiology
How many years of experience does Dr. Paul Casinelli M.D have?
The provider has more than 43 years of experience. He graduated from Uniformed Services Uhs Fe Hebert School Of Med in 1980.
What insurance does Dr. Paul Casinelli M.D 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. Paul Casinelli M.D 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: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What are some of the services provided by Dr. Paul Casinelli M.D?
The most common procedures or services performed by this practitioner are: Anesthesia for procedure on gastrointestinal tract using an endoscope, Anesthesia for procedure on lower intestine using an endoscope and Anesthesia for procedure in upper abdomen including use of an endoscope.
Is Dr. Paul Casinelli M.D affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: SOUTH COUNTY HOSPITAL INC. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
The NPI record of Dr. Paul Casinelli M.D was last updated on November 07, 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]