KENNETH LOMBARD M.D. NPI 1013946011

Pediatrics (Pediatric Gastroenterology) in Portland, ME

NPI 1013946011 Individual Male Pediatrics Pediatric Gastroenterology PECOS Enrolled MIPS Quality Score 95

NPI Profile for KENNETH LOMBARD M.D.

Kenneth Lombard is a pediatrician established in Portland, Maine and his medical specialization is pediatrics (pediatric gastroenterology) . The NPI number of Kenneth Lombard is 1013946011 and was assigned on July 2006. The practitioner's primary taxonomy code is 2080P0206X with license number 013678 (ME). The provider is registered as an individual and his NPI record was last updated 11 years ago.

A pediatrician like Kenneth Lombard M.d. is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Kenneth Lombard 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..

Kenneth Lombard is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

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, 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.

NPI

1013946011

Provider Name KENNETH LOMBARD M.D.
Provider Location Address887 CONGRESS ST SUITE 410B PORTLAND, ME 04102
Provider Mailing Address301 US ROUTE 1 BUILDING C SCARBOROUGH, ME 04074
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-02-2006
Last Update Date01-06-2011


Primary Taxonomy

Taxonomy Code2080P0206X
ClassificationPediatrics
TypeAllopathic & Osteopathic Physicians
SpecializationPediatric Gastroenterology
License No.013678
License StateME
Taxonomy DescriptionA pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.

Business Address

KENNETH LOMBARD M.D.
887 CONGRESS ST
SUITE 410B
PORTLAND, ME
ZIP 04102
Phone: (207) 662-5522
Fax: (207) 662-5526

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Mailing Address

KENNETH LOMBARD M.D.
301 US ROUTE 1
BUILDING C
SCARBOROUGH, ME
ZIP 04074
Phone: (207) 396-8600
Fax: (207) 396-8632



PECOS Enrollment and Medicare Participation

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
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% 71.8
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
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.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1208000000XAllopathic & Osteopathic PhysiciansPediatrics013678MENo

Taxonomy Description: a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

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
MM6620MEDICARE PIN (08)ME
MM662001MEDICARE PIN (08)ME
30006480MEDICAID (05)NH
A03360MEDICARE UPIN (02)ME
337220099MEDICAID (05)ME

NPI Validation Check Digit Calculation


The following table explains step by step the 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.
1013946011
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20231841202
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 1 + 8 + 4 + 1 + 2 + 0 + 2 + 24 = 49
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 49 = 11

The NPI number 1013946011 is valid because the calculated check digit 1 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
1548264054DR. MICHAEL ROBERT CURCI M.D.
Individual
Surgery (Pediatric Surgery)887 CONGRESS ST STE 410A
PORTLAND, ME 04102
(207) 772-4444
1942204466 BAIRD MALLORY MD
Individual
Surgery (Pediatric Surgery)887 CONGRESS ST SUITE 300
PORTLAND, ME 04102
(207) 662-5555
1700874104DR. GEORGES S ABOURJAILY MD
Individual
Surgery887 CONGRESS ST SUITE 400
PORTLAND, ME 04102
(207) 774-6368
1275524928MS. RENEE L. CHARD MSC; CGC
Individual
Genetic Counselor, MS887 CONGRESS ST SUITE 200
PORTLAND, ME 04102
(207) 771-5549
1487630265THE MAINE SURGICAL CARE GROUP
Organization
Surgery887 CONGRESS ST SUITE 400
PORTLAND, ME 04102
(207) 774-6368
1447239025 DAWNE MILLER FNP-C
Individual
Nurse Practitioner (Family)887 CONGRESS ST SUITE 210
PORTLAND, ME 04102
(207) 774-2544
1750360996 MARY R CARPENTER MS
Individual
Genetic Counselor, MS887 CONGRESS ST SUITE 200
PORTLAND, ME 04102
(207) 771-5549
1932171089 CHERYL L BLANK DO
Individual
Pediatrics (Pediatric Gastroenterology)887 CONGRESS ST SUITE 410B
PORTLAND, ME 04102
(207) 662-5522
1093781254DR. MICHAEL A DEDEKIAN MD
Individual
Pediatrics (Pediatric Endocrinology)887 CONGRESS ST SUITE 320
PORTLAND, ME 04102
(207) 662-5522
1952339178 JOHN D. BANCROFT MD
Individual
Pediatrics (Pediatric Gastroenterology)887 CONGRESS ST SUITE 410B
PORTLAND, ME 04102
(207) 523-3289
1477581361 ANNE MARIE CAIRNS DO
Individual
Pediatrics887 CONGRESS ST
PORTLAND, ME 04102
(207) 662-5522
1003846361DR. THOMAS MELLOW M.D.
Individual
Pediatrics (Pediatric Pulmonology)887 CONGRESS ST SUITE 320
PORTLAND, ME 04102
(207) 662-5522
1952332744MS. SARA A ELLINGWOOD M.S.
Individual
Genetic Counselor, MS887 CONGRESS ST SUITE 320
PORTLAND, ME 04102
(207) 662-5522
1790717312 MARK J INTEGLIA M.D.
Individual
Pediatrics (Pediatric Gastroenterology)887 CONGRESS ST SUITE 410B
PORTLAND, ME 04102
(207) 662-5522
1427080332 ALAN MORRIS M.D.
Individual
Pediatrics (Pediatric Endocrinology)887 CONGRESS ST SUITE 320
PORTLAND, ME 04102
(207) 662-5522
1356375950DR. CAROL MCCARTHY M.D
Individual
Pediatrics (Pediatric Infectious Diseases)887 CONGRESS ST SUITE 320
PORTLAND, ME 04102
(207) 662-5522
1790718716DR. ALBERT WILLIAM DIBBINS M.D.
Individual
Surgery (Pediatric Surgery)887 CONGRESS ST SUITE 410A
PORTLAND, ME 04102
(207) 772-4444
1689682809 ANNE I FREEDMAN LCSW
Individual
Social Worker (Clinical)887 CONGRESS ST SUITE 320
PORTLAND, ME 04102
(207) 662-5522
1750493417 MARY E CORRIGAN PNP
Individual
Nurse Practitioner (Pediatrics)887 CONGRESS ST SUITE 320
PORTLAND, ME 04102
(207) 662-5522
1225149313 MARY BUTEYN RD
Individual
Dietitian, Registered (Nutrition, Pediatric)887 CONGRESS ST SUITE 320
PORTLAND, ME 04102
(207) 662-5522

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
Kenneth Lombard M.d. is registered as an entity type code: 1. The entity type code describes 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.