DONA MARIE ALVAREZ M.D. NPI 1013087147
Orthopaedic Surgery in Oakland, MD

About DONA MARIE ALVAREZ M.D.

Dona Alvarez is a provider established in Oakland, Maryland and her medical specialization is Orthopaedic Surgery with more than 39 years of experience. She graduated from West Virginia University School Of Medicine in 1984. The NPI number of Dona Alvarez is 1013087147 and was assigned on November 2006. The practitioner's primary taxonomy code is 207X00000X with license number D0038801 (MD). The provider is registered as an individual and her NPI record was last updated 15 years ago.

NPI
1013087147
Provider Name DONA MARIE ALVAREZ M.D.
Location Address311 N 4TH ST SUITE 3 OAKLAND, MD 21550
Location Phone(301) 334-1034
Mailing Address311 N 4TH ST SUITE 3 OAKLAND, MD 21550
GenderFemale
NPI Entity TypeIndividual
Medical School NameWEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year1984
Is Sole Proprietor?No
Enumeration Date11-08-2006
Last Update Date07-08-2007

Dona Alvarez 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.

Dona Alvarez 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 she has hospital affiliations with Garrett County Memorial Hospital.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: documentation of current medications in the medical record, elder maltreatment screen and follow-up plan, engagement of new medicaid patients and follow-up, e-prescribing, falls: plan of care, falls: risk assessment, patient-specific education, preventive care and screening: body mass index (bmi) screening and follow-up plan, preventive care and screening: unhealthy alcohol use: screening & brief counseling, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, provide patient access and security risk analysis. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

The typical physician office visit costs for Medicare beneficiaries in this area are: $23.33 for a new patient copayment and $18.96 for an established patient copayment.



Primary Taxonomy

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.

Taxonomy Code207X00000X
ClassificationOrthopaedic Surgery
TypeAllopathic & Osteopathic Physicians
License No.D0038801
License StateMD
Taxonomy DescriptionAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Blue Cross Blue Shield
  • Medicaid
  • Medicare

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

Business Address

DONA MARIE ALVAREZ M.D.
311 N 4TH ST
SUITE 3
OAKLAND, MD
ZIP 21550
Phone: (301) 334-1034
Fax: (301) 334-3350

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Mailing Address

DONA MARIE ALVAREZ M.D.
311 N 4TH ST
SUITE 3
OAKLAND, MD
ZIP 21550
Phone: (301) 334-1034
Fax: (301) 334-3350


Location Map

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 ID7618145053
PECOS Enrollment IDI20110729000382
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 21550 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
$60.77 $183.88 $93.34
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.19 $45.97 $23.33
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
$18.98 $150.13 $75.85
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.74 $37.53 $18.96

* 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.

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
Documentation of Current Medications in the Medical Record 100% 1883
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Elder Maltreatment Screen and Follow-Up Plan 100% 261
Percentage of patients aged 65 years and older with a documented elder maltreatment screen using an Elder Maltreatment Screening Tool on the date of encounter AND a documented follow-up plan on the date of the positive screen
Engagement of New Medicaid Patients and Follow-upYesN/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.
e-Prescribing 45% 62
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Falls: Plan of Care 100% 78
Percentage of patients aged 65 years and older with a history of falls that had a plan of care for falls documented within 12 months
Falls: Risk Assessment 100% 78
Percentage of patients aged 65 years and older with a history of falls that had a risk assessment for falls completed within 12 months
Patient-Specific Education 14% 303
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 100% 288
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling 85% 306
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical RecordYesN/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access 90% 303
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.

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.

  • 151Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
  • 105Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
  • 28X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • 12Repair of knee joint (HCPCS:27447)

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. Dona Alvarez is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
GARRETT COUNTY MEMORIAL HOSPITAL251 NORTH FOURTH STREET
OAKLAND, MD 21550
(301) 533-4173Acute Care Hospitals210017

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 Identifier Issuer
E16802MEDICARE UPIN (02)MD
KN38GAOTHER (01)MDCAREFIRST BLUE SHIELD
216542OTHER (01)MDALLIANCE
216542OTHER (01)MDMD IPA
216542OTHER (01)MDMAMSI
521805318-00OTHER (01)MDWV WORKMENS COMPENSATION
KN38KC88MEDICARE ID-TYPE UNSPECIFIED (04)MD
216542OTHER (01)MDOPTIMUM CHOICE
E214001OTHER (01)MDFEDERAL BLUE SHIELD
521805318-00OTHER (01)MDBRICKSTREET

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.
1013087147
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2023081418
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 + 4 + 1 + 8 + 24 = 53
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 53 = 77

The NPI number 1013087147 is valid because the calculated check digit 7 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
1427042811 KARL EDWARD SCHWALM M.D.
Individual
Family Medicine311 N 4TH ST
OAKLAND, MD 21550
(301) 334-8171
1790704914 KENNETH ROBERT BUCZYNSKI M.D.
Individual
Family Medicine311 N 4TH ST SUITE 1
OAKLAND, MD 21550
(301) 334-7855
1194744359WELLSPRING FAMILY MEDICINE, PC
Organization
Family Medicine311 N 4TH ST SUITE 1
OAKLAND, MD 21550
(301) 334-7855
1487751608GARRETT MEDICAL GROUP, PA
Organization
Family Medicine311 N 4TH ST
OAKLAND, MD 21550
(301) 334-8171
1548445968MR. EARL W DUVALL III LCPC
Individual
Counselor (Professional)311 N 4TH ST SUITE 1
OAKLAND, MD 21550
(301) 334-7855
1114103652TRINITY FAMILY CARE SERVICES LLC
Organization
Counselor (Professional)311 N 4TH ST SUITE 1
OAKLAND, MD 21550
(301) 334-7855
1356529465MR. CHRISTOPHER DARON BAKER PA-C
Individual
Physician Assistant311 N 4TH ST SUITE 1
OAKLAND, MD 21550
(301) 334-7855
1386822856 JEAN CHRISTINE BAKER PA
Individual
Physician Assistant311 N 4TH ST SUITE 1
OAKLAND, MD 21550
(301) 334-7855
1346238003 CAROLYN SHEAFFER CRNP
Individual
Nurse Practitioner311 N 4TH ST
OAKLAND, MD 21550
(301) 334-8171
1255561312 DANIEL L MOON CRNP
Individual
Nurse Practitioner (Family)311 N 4TH ST SUITE 101
OAKLAND, MD 21550
(301) 334-8171
1427047240 KENNETH W. HAWK NP
Individual
Nurse Practitioner (Family)311 N 4TH ST
OAKLAND, MD 21550
(301) 334-7420
1184646341DR. RICHARD ALLEN PORTER D.O.
Individual
Family Medicine311 N 4TH ST SUITE 1
OAKLAND, MD 21550
(301) 334-7855
1053702894GARRETT MEDICAL GROUP, PA
Organization
Clinical Medical Laboratory311 N 4TH ST
OAKLAND, MD 21550
(301) 334-8171
1326249392DR. TODD WILLIAM FEATHERS M.D.
Individual
Orthopaedic Surgery311 N 4TH ST SUITE #3
OAKLAND, MD 21550
(301) 334-1034
1588111884 JENNIFER RESH CRNP
Individual
Nurse Practitioner (Family)311 N 4TH ST SUITE 1
OAKLAND, MD 21550
(301) 334-7588
1265884464 ELYZABETH RUTA SAVAGE GORALSKI CRNP
Individual
Nurse Practitioner (Family)311 N 4TH ST
OAKLAND, MD 21550
(301) 334-8171
1164860250 ALEA LYNNE MCCLINTOCK-DONAHUE CRNP
Individual
Nurse Practitioner (Family)311 N 4TH ST
OAKLAND, MD 21550
(301) 334-8171
1558432765ALVAREZ & ORTHOPAEDIC ASSOCIATES
Organization
Orthopaedic Surgery311 N 4TH ST SUITE 3
OAKLAND, MD 21550
(301) 334-1034
1437141066DR. HANCHONG J PARK MD
Individual
Orthopaedic Surgery311 N 4TH ST
OAKLAND, MD 21550
(301) 334-1034
1770819518 DIANA L PEPE CRNP
Individual
Nurse Practitioner (Family)311 N 4TH ST
OAKLAND, MD 21550
(301) 334-8171

Frequently Asked Questions

What is Dona Alvarez M.D. NPI number?

The NPI number assigned to Dona Alvarez M.D. is 1013087147, registered as an "individual" on November 08, 2006

Where is Dona Alvarez M.D. located?

The provider is located at 311 N 4th St Suite 3 Oakland, Md 21550 and the phone number is (301) 334-1034

Which is Dona Alvarez M.D. specialty?

The provider's speciality is Orthopaedic Surgery

How many years of experience does Dona Alvarez M.D. have?

The provider has more than 39 years of experience. She graduated from West Virginia University School Of Medicine in 1984.

What insurance does Dona Alvarez M.D. accept?

The provider might be accepting Blue Cross Blue Shield, Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Dona Alvarez 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.

How much is a visit to Dona Alvarez M.D.?

Medicare beneficiaries should expect a typical cost of $93.34 with an average copayment of $23.33 for new patient appointments. Established patients should expect a typical charge of $75.85 and an average copayment of 18.96. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dona Alvarez M.D.?

The most common procedures or services performed by this practitioner are: Aspiration and/or injection of large joint or joint capsule, Injection, methylprednisolone acetate, 40 mg, X-ray of shoulder, minimum of 2 views and Repair of knee joint.

Is Dona Alvarez M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: GARRETT COUNTY MEMORIAL 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?

The NPI record of Dona Alvarez M.D. was last updated on November 08, 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]