MICHELLE ELIZABETH DOWNING M.D. NPI 1013172816

Anesthesiology in Durham, NC

NPI 1013172816 Individual Female Years of Experience 14 Anesthesiology PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About MICHELLE DOWNING

Michelle Downing is a provider established in Durham, North Carolina and her medical specialization is anesthesiology with more than 14 years of experience. She graduated from University Of Alabama School Of Medicine in 2008. The NPI number of Michelle Downing is 1013172816 and was assigned on July 2008. The practitioner's primary taxonomy code is 207L00000X with license number 29660 (AL). The provider is registered as an individual and her NPI record was last updated one year ago.

An anesthesiologist like Michelle Elizabeth Downing 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.

Michelle Downing is enrolled in PECOS and is eligible to order or refer healthcare 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

Michelle Downing 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 Brookwood Baptist Medical Center.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: pre-operative osa assessment, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, use of qcdr data for quality improvement such as comparative analysis reports across patient populations, use of qcdr for feedback reports that incorporate population health and use of qcdr to support clinical decision making. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

NPI

1013172816

Provider Name MICHELLE ELIZABETH DOWNING M.D.
Provider Location Address2301 ERWIN RD, ROOM 5688 HAFS BOX 3094 DUMC DURHAM, NC 27710
Provider Mailing Address3104 BLUE LAKE DR STE 110 VESTAVIA, AL 35243
GenderFemale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year2008
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-22-2008
Last Update Date05-24-2020


Primary Taxonomy

Taxonomy Code207L00000X
ClassificationAnesthesiology
TypeAllopathic & Osteopathic Physicians
License No.29660
License StateAL
Taxonomy DescriptionAn 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.

Business Address

MICHELLE ELIZABETH DOWNING M.D.
2301 ERWIN RD, ROOM 5688 HAFS
BOX 3094 DUMC
DURHAM, NC
ZIP 27710
Phone: (919) 681-6944

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Mailing Address

MICHELLE ELIZABETH DOWNING M.D.
3104 BLUE LAKE DR STE 110
VESTAVIA, AL
ZIP 35243
Phone: (205) 977-1949



Medicare Participation

Registered in PECOS? Yes 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.
PECOS PAC ID547409401
PECOS Enrollment IDI20130625000729
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

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.

  • 44Insertion of arterial catheter for blood sampling or infusion, accessed through the skin (HCPCS:36620)
  • 20Insertion of central venous catheter for infusion, patient 5 years or older (HCPCS:36556)
  • 18Ultrasonic guidance imaging supervision and interpretation for insertion of needle (HCPCS:76942)

Quality Reporting

The following quality measures meets 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 Rate Number of Patients
Pre-operative OSA assessment 100% 839
Percentage of patients who undergo a surgical procedure in the operating room/procedure room that have a pre-operative assessment for Obstructive Sleep Apnea (OSA)

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. Michelle Downing is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
BROOKWOOD BAPTIST MEDICAL CENTER2010 BROOKWOOD MEDICAL CENTER DRIVE
BIRMINGHAM, AL 35209
(205) 877-1000Acute Care Hospitals10139

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
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.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.