DR. ROSS BERLIN M.D. NPI 1013088095
Physical Medicine & Rehabilitation in Pomona, NJ

About DR. ROSS BERLIN M.D.

Ross Berlin is a provider established in Pomona, New Jersey and his medical specialization is Physical Medicine & Rehabilitation with more than 32 years of experience. He graduated from New York Medical College in 1991. The NPI number of Ross Berlin is 1013088095 and was assigned on November 2006. The practitioner's primary taxonomy code is 208100000X with license number MA62121 (NJ). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1013088095
Provider NameDR. ROSS BERLIN M.D.
Location Address61 W. JIMMIE LEEDS ROAD POMONA, NJ 08240
Location Phone(609) 748-5380
Mailing Address125 KENSINGTON DR GALLOWAY, NJ 08205
GenderMale
NPI Entity TypeIndividual
Medical School NameNEW YORK MEDICAL COLLEGE
Graduation Year1991
Is Sole Proprietor?Yes
Enumeration Date11-13-2006
Last Update Date12-20-2020

Ross Berlin 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.

Ross Berlin 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 Atlanticare Regional Medical Center - City Campus, Shore Medical Center and Hospital Of Univ Of Pennsylvania.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 95.2, 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 provider also has detailed performance information the following quality measures: pneumococcal vaccination status for older adults.



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 Code208100000X
ClassificationPhysical Medicine & Rehabilitation
TypeAllopathic & Osteopathic Physicians
License No.MA62121
License StateNJ
Taxonomy DescriptionPhysical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.

Accepted Insurance

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

  • Medicaid
  • Medicare

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

Business Address

DR. ROSS BERLIN M.D.
61 W. JIMMIE LEEDS ROAD
POMONA, NJ
ZIP 08240
Phone: (609) 748-5380
Fax: (609) 652-8749

Get Directions


Mailing Address

DR. ROSS BERLIN M.D.
125 KENSINGTON DR
GALLOWAY, NJ
ZIP 08205
Phone: (609) 748-5380
Fax: (609) 652-8749


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 ID345258273
PECOS Enrollment IDI20060404000012
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

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% 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 (PI) 25% 76.1
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 15% 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 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 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.
MIPS Final Score - 95.2
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.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Pneumococcal Vaccination Status for Older Adults 72% 65
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

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.

  • 15Needle measurement and recording of electrical activity of muscles of arm or leg complete study (HCPCS:95886)
  • 11Nerve transmission studies, 5-6 studies (HCPCS:95909)

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. Ross Berlin is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
ATLANTICARE REGIONAL MEDICAL CENTER - CITY CAMPUS1925 PACIFIC AVENUE
ATLANTIC CITY, NJ 8401
(609) 441-8020Acute Care Hospitals310064
SHORE MEDICAL CENTER100 MEDICAL CENTER WAY
SOMERS POINT, NJ 8244
(609) 653-3500Acute Care Hospitals310047
HOSPITAL OF UNIV OF PENNSYLVANIA34TH & SPRUCE STS
PHILADELPHIA, PA 19104
(215) 662-3227Acute Care Hospitals390111

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
6614507MEDICAID (05)NJ

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.
1013088095
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20230816018
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 + 6 + 0 + 1 + 8 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1013088095 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1578634473MS. CHERYL WEBER N.P.
Individual
Nurse Practitioner61 W. JIMMIE LEEDS ROAD
POMONA, NJ 08240
(609) 652-7000
1386715274MR. WILLIAM BEDSOLE N.P.
Individual
Nurse Practitioner61 W. JIMMIE LEEDS ROAD
POMONA, NJ 08240
(609) 652-7000
1407927478DR. CRAIG J. ANMUTH D.O.
Individual
Physical Medicine & Rehabilitation61 W. JIMMIE LEEDS ROAD
POMONA, NJ 08240
(609) 748-5380
1962573923DR. ABRAHAM ALFARO D.O., PH.D.
Individual
Physical Medicine & Rehabilitation61 W. JIMMIE LEEDS ROAD
POMONA, NJ 08240
(609) 748-5380

Frequently Asked Questions

What is Dr. Ross Berlin M.D. NPI number?

The NPI number assigned to Dr. Ross Berlin M.D. is 1013088095, registered as an "individual" on November 13, 2006

Where is Dr. Ross Berlin M.D. located?

The provider is located at 61 W. Jimmie Leeds Road Pomona, Nj 08240 and the phone number is (609) 748-5380

Which is Dr. Ross Berlin M.D. specialty?

The provider's speciality is Physical Medicine & Rehabilitation

How many years of experience does Dr. Ross Berlin M.D. have?

The provider has more than 32 years of experience. He graduated from New York Medical College in 1991.

What insurance does Dr. Ross Berlin 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. Ross Berlin 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. Ross Berlin M.D.?

The most common procedures or services performed by this practitioner are: Needle measurement and recording of electrical activity of muscles of arm or leg complete study and Nerve transmission studies, 5-6 studies.

Is Dr. Ross Berlin M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: ATLANTICARE REGIONAL MEDICAL CENTER - CITY CAMPUS, SHORE MEDICAL CENTER and HOSPITAL OF UNIV OF PENNSYLVANIA. 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. Ross Berlin M.D. was last updated on November 13, 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]