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JEFFREY C BARTON DPM
NPI 1013938737
Podiatrist in Dover, DE

Active since July 21, 2006PECOS EnrolledAccepts Medicare Assignment
90.48/100
CMS Quality Rating
200 BANNING ST, SUITE 360, DOVER, DE 19904(302) 735-9811(302) 735-9812 Get Directions Write a Review

NPPES record last updated: August 16, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jeffrey C Barton Dpm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFREY C BARTON DPM (NPI 1013938737) is an individual podiatrist in Dover, Delaware, licensed in Delaware (E10000125) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1013938737
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameJEFFREY C BARTONCredential: DPM
Location Address200 BANNING ST, SUITE 360Dover, DE 19904-3485
Mailing Address200 Banning St, Suite 360Dover, DE 19904-3485 · (302) 735-9811 · Fax (302) 735-9812
Phone(302) 735-9811
Fax(302) 735-9812
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateJuly 21, 2006
Last NPPES UpdateAugust 16, 2024
NPPES CertifiedAugust 16, 2024
✔ NPI 1013938737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in DE · E10000125
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
200 BANNING ST, Dover, DE 19904
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Other Identifiers 1

Medicaid0000802617DE

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jeffrey C Barton Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416918719
PECOS Enrollment IDI20041020000816
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
323 services158 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
159 services159 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
61 services26 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
33 services26 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
32 services27 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
26 services26 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19904 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.37 typical visit price
range $57.12 – $173.08
Typical copayment $22.09 (range $14.28 – $43.27)
Most-billed visit code 99203
Established Patient
$71.19 typical visit price
range $18.36 – $141.05
Typical copayment $17.79 (range $4.59 – $35.26)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.48/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality82.93
Promoting Interoperability100
Improvement Activities40
Cost85.33

Reported Quality Measures

Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
100%1,394 patients5/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
86%528 patients4/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
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.
69%5,637 patients1/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
96%1,579 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
92%254 patients5/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%1,394 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
Patients 1: 0% · 2,665 patients
0%26,265 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
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…
94%2,516 patients4/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 1,531 patients
Patients tobacco: 99% · 1,531 patients
29%207 patients2/55-star benchmark: 98%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
Patients 1: 3% · 2,665 patients
3%2,665 patients1/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…
Patients 1: 0% · 2,665 patients
0%2,665 patients1/55-star benchmark: 75%
Send a Summary of Care
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2)…
92%254 patients4/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
0%2,665 patients
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
0%2,665 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LYNDON B CAGAMPAN M.D.
Physical Medicine & Rehabilitation
200 BANNING ST, STE 350
DOVER, DE 19904
Kent County (302) 730-8848
MRS. SUSAN J BENEDETTO RPH
Pharmacist
200 BANNING ST, SUITE 100
DOVER, DE 19904
Kent County (302) 734-9303
ADVANCED SLEEP DISORDERS CENTER LLC
Clinical Medical Laboratory
200 BANNING ST, SUITE 210
DOVER, DE 19904
Kent County (302) 744-9645
TERESA A HARRIS NP
Nurse Practitioner (Women's Health)
200 BANNING ST, SUITE 320
DOVER, DE 19904
Kent County (302) 674-0223
SARA EL-BAFF RPH
Pharmacist
200 BANNING ST
DOVER, DE 19904
Kent County (302) 734-9303
DR. SANJEEV B PATEL MD
Internal Medicine (Interventional Cardiology)
200 BANNING ST, SUITE 340
DOVER, DE 19904
Kent County (302) 734-1414
MICHAEL RAFAEL ZARAGOZA MD
Urology
200 BANNING ST, SUITE 250
DOVER, DE 19904
Kent County (302) 736-1320
MR. DENNIS JAMES HORAN PA
Physician Assistant
200 BANNING ST, ST 210
DOVER, DE 19904
Kent County (302) 744-9645

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeffrey Barton's NPI number?

The NPI number for Jeffrey Barton is 1013938737. It was assigned to this individual provider in the NPPES registry on July 21, 2006.

Where is Jeffrey Barton located?

Jeffrey Barton practices at 200 Banning St Suite 360, Dover, DE 19904. The listed phone number is (302) 735-9811.

What is Jeffrey Barton's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Jeffrey Barton enrolled in Medicare?

Yes. Jeffrey Barton is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jeffrey Barton accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 2 other insurers list Jeffrey Barton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jeffrey Barton was last updated on August 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.