EDUS HOUSTON WARREN III NPI 1013092840
Internal Medicine - Hematology & Oncology in Seattle, WA

About EDUS HOUSTON WARREN III

Edus Warren is an internist established in Seattle, Washington and his medical specialization is Internal Medicine with a focus in hematology & oncology with more than 32 years of experience. He graduated from Harvard Medical School in 1991. The NPI number of Edus Warren is 1013092840 and was assigned on October 2006. The practitioner's primary taxonomy code is 207RH0003X with license number MD00031024 (WA). The provider is registered as an individual and his NPI record was last updated 10 years ago.

NPI
1013092840
Provider Name EDUS HOUSTON WARREN III
Location AddressUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST SEATTLE, WA 98195
Location Phone(206) 288-1000
Mailing AddressPO BOX 50095 SEATTLE, WA 98145
GenderMale
NPI Entity TypeIndividual
Medical School NameHARVARD MEDICAL SCHOOL
Graduation Year1991
Is Sole Proprietor?No
Enumeration Date10-27-2006
Last Update Date01-28-2013

An internist like Edus Houston Warren Iii 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.Edus Warren 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.

Edus Warren 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 .

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 82.5, 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: $48.81 for a new patient copayment and $28.8 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 Code207RH0003X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationHematology & Oncology
License No.MD00031024
License StateWA
Taxonomy DescriptionAn internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

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

EDUS HOUSTON WARREN III
UNIVERSITY OF WASHINGTON MEDICAL CTR
1959 NE PACIFIC ST
SEATTLE, WA
ZIP 98195
Phone: (206) 288-1000

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Mailing Address

EDUS HOUSTON WARREN III
PO BOX 50095
SEATTLE, WA
ZIP 98145
Phone: (206) 543-6420


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 ID840482618
PECOS Enrollment IDI20101012000604
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 98195 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99205
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$65.5 $195.25 $195.25
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$16.37 $48.81 $48.81
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
$21.08 $160.18 $115.21
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.27 $40.04 $28.8

* 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% 84.3
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% 68
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% 67
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 - 82.5
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.

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
0232145OTHER (01)WAL&I
2876OTHER (01)INTERNAL ID-MOTOR VEHICLE ID
G61180MEDICARE UPIN (02)
AB00239MEDICARE PIN (08)WA
1013092840MEDICAID (05)WA

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.
1013092840
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
202309488
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 9 + 4 + 8 + 8 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1013092840 is valid because the calculated check digit 0 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
1578653424 MICHAEL L ASTION
Individual
Pathology (Clinical Pathology/Laboratory Medicine)UNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-6131
1477643328 JAY WALTER HEINECKE
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)UNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4333
1558451401 MICHELLE MENTZER DEINER
Individual
Physician AssistantUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 288-1000
1467542316 CARINA GERRIT KNOWLTON MORAVEC
Individual
Nurse PractitionerUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 288-1000
1144310004 PETER JAMES KUDENCHUK
Individual
Internal Medicine (Clinical Cardiac Electrophysiology)UNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4300
1053401919 LYLE WILBUR LARSON
Individual
Physician AssistantUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4300
1962592824 GERARD BASHEIN
Individual
AnesthesiologyUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4260
1770673634 WAYNE L CHANDLER
Individual
Pathology (Clinical Pathology/Laboratory Medicine)UNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-6131
1457441313 GEORGE ERNEST LARAMORE
Individual
Radiology (Radiation Oncology)UNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4100
1992895858 WILLIAM JOHN ELLIS
Individual
UrologyUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4294
1740370600 HANS-PETER KIEM
Individual
Internal Medicine (Hematology & Oncology)UNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 288-1000
1912097874 DAVID K MADTES
Individual
Internal Medicine (Pulmonary Disease)UNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 288-1000
1649360504 MARK R TONELLI
Individual
Internal Medicine (Pulmonary Disease)UNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4615
1700976644 HEATHCLIFF S CHADWICK
Individual
AnesthesiologyUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4260
1528158466 MARYANN LEHMKUHLE HAWN O'HARA
Individual
Family MedicineUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 543-3101
1396835245 CHRISTOPHER DONALD KENT
Individual
AnesthesiologyUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4260
1205926151 STEFAN ANDRE LOMBAARD
Individual
AnesthesiologyUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4260
1902996853 DAVID ANDREW MARTIN
Individual
Internal Medicine (Rheumatology)UNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4615
1780774646 JORG DZIERSK
Individual
AnesthesiologyUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE, WA 98195
(206) 598-4260
1598855454 JOHN H LECKY
Individual
AnesthesiologyUNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC STREET
SEATTLE, WA 98195
(206) 598-4260

Frequently Asked Questions

What is Edus Warren III NPI number?

The NPI number assigned to Edus Warren III is 1013092840, registered as an "individual" on October 27, 2006

Where is Edus Warren III located?

The provider is located at University Of Washington Medical Ctr 1959 Ne Pacific St Seattle, Wa 98195 and the phone number is (206) 288-1000

Which is Edus Warren III specialty?

The provider's speciality is Internal Medicine with a focus in Hematology & Oncology

How many years of experience does Edus Warren III have?

The provider has more than 32 years of experience. He graduated from Harvard Medical School in 1991.

What insurance does Edus Warren III 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 Edus Warren III 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 Edus Warren III ?

Medicare beneficiaries should expect a typical cost of $195.25 with an average copayment of $48.81 for new patient appointments. Established patients should expect a typical charge of $115.21 and an average copayment of 28.8. Please review your insurance plan or contact the provider directly to determine your specific costs.

How do I update my NPI information?

The NPI record of Edus Warren III was last updated on October 27, 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]