MR. JOSE LUIS AGUSTI M.D.
NPI 1033192604
Internal Medicine in Winfield, IN
Quality Rating: 46.02 out of 100 score
NPI Status: Active since November 28, 2005
Contact Information
4900 E 107TH CT
WINFIELD, IN
ZIP 46307
Phone: (219) 386-5018
Fax: (219) 472-0089
- NPI Profile Information
- Primary Taxonomy
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Overall Quality Performance
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 33
- Internal Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About JOSE AGUSTI
This page provides the complete NPI Profile along with additional information for Jose Agusti, an internist established in Winfield, Indiana with a medical specialization in Internal Medicine and more than 33 years of experience. The healthcare provider is registered in the NPI registry with number 1033192604 assigned on November 2005. The practitioner's primary taxonomy code is 207R00000X with license number 01061624A (IN). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1033192604
- Provider Name
- MR. JOSE LUIS AGUSTI M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4900 E 107TH CT WINFIELD, IN 46307
- Location Phone
- (219) 386-5018
- Location Fax
- (219) 472-0089
- Mailing Address
- 4900 E 107TH CT WINFIELD, IN 46307
- Mailing Phone
- (219) 900-3990
- Medical School Name
- OTHER
- Graduation Year
- 1994
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-28-2005
- Last Update Date
- 12-03-2024
- Code Navigator
An internist like Jose Agusti 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.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 01061624A
- License State
- IN
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Bronze 7500 $25 Generic Drugs - HMO
- Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Gold 2000 $15 Generic Drugs - HMO
- Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
- Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Gold Value ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Value+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 036101129 / 05 | MEDICAID (05) | IL | |
| 000000488177 | OTHER (01) | IN | ANTHEM |
| 200832510 | MEDICAID (05) | IN | |
| 01621679 | OTHER (01) | IL | BCBS OF IL |
Medicare Participation & PECOS Enrollment Status
Jose Agusti is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Jose Agusti 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.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4688569122
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20060724000077
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
16 DME suppliers used 44 Medicare Claims 150 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
15 DME suppliers used 25 Medicare Claims 47 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Tape, waterproof, per 18 square inches (HCPCS:A4452)
1 DME suppliers used 14 Medicare Claims 1804 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing (HCPCS:A6196)
1 DME suppliers used 27 Medicare Claims 829 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing (HCPCS:A6197)
1 DME suppliers used 13 Medicare Claims 366 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6203)
1 DME suppliers used 43 Medicare Claims 1355 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6245)
1 DME suppliers used 12 Medicare Claims 198 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6446)
1 DME suppliers used 14 Medicare Claims 822 Services Paid
DME-Other DME (DE000N)
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories (HCPCS:A6550)
2 DME suppliers used 26 Medicare Claims 351 Services Paid
DME-Other DME (DE000N)
Canister, disposable, used with suction pump, each (HCPCS:A7000)
4 DME suppliers used 27 Medicare Claims 193 Services Paid
DME-Other DME (DE000N)
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)
3 DME suppliers used 67 Medicare Claims 116 Services Paid
DME-Other DME (DE000N)
Filter, disposable, used with aerosol compressor or ultrasonic generator (HCPCS:A7013)
2 DME suppliers used 20 Medicare Claims 20 Services Paid
DME-Other DME (DE000N)
Aerosol mask, used with dme nebulizer (HCPCS:A7015)
3 DME suppliers used 28 Medicare Claims 28 Services Paid
DME-Hospital Beds (DB000N)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)
6 DME suppliers used 74 Medicare Claims 76 Services Paid
DME-Hospital Beds (DB000N)
Powered pressure-reducing air mattress (HCPCS:E0277)
2 DME suppliers used 35 Medicare Claims 35 Services Paid
DME-Hospital Beds (DB000N)
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress (HCPCS:E0303)
2 DME suppliers used 24 Medicare Claims 24 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
2 DME suppliers used 68 Medicare Claims 69 Services Paid
DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
3 DME suppliers used 155 Medicare Claims 161 Services Paid
DME-Other DME (DE000N)
Respiratory suction pump, home model, portable or stationary, electric (HCPCS:E0600)
2 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Other DME (DE000N)
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) (HCPCS:E0630)
3 DME suppliers used 16 Medicare Claims 16 Services Paid
DME-Other DME (DE000N)
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar (HCPCS:E0910)
2 DME suppliers used 47 Medicare Claims 47 Services Paid
DME-Hospital Beds (DB000N)
Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar (HCPCS:E0912)
3 DME suppliers used 22 Medicare Claims 22 Services Paid
DME-Wheelchairs (DD021N)
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each (HCPCS:E0955)
2 DME suppliers used 17 Medicare Claims 17 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
5 DME suppliers used 159 Medicare Claims 163 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
4 DME suppliers used 58 Medicare Claims 58 Services Paid
DME-Other DME (DE000N)
Negative pressure wound therapy electrical pump, stationary or portable (HCPCS:E2402)
2 DME suppliers used 36 Medicare Claims 36 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary (HCPCS:G0333)
5 DME suppliers used 24 Medicare Claims 24 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
2 DME suppliers used 56 Medicare Claims 56 Services Paid
DME-Wheelchairs (DD000N)
Extra heavy duty wheelchair (HCPCS:K0007)
1 DME suppliers used 19 Medicare Claims 19 Services Paid
DME-Wheelchairs (DD021N)
Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)
2 DME suppliers used 88 Medicare Claims 88 Services Paid
DME-Wheelchairs (DD009N)
Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds (HCPCS:K0822)
1 DME suppliers used 16 Medicare Claims 16 Services Paid
DME-Wheelchairs (DD009N)
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds (HCPCS:K0823)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
9 DME suppliers used 128 Medicare Claims 128 Services Paid
Orthotic Devices
DME-Orthotic Devices (DF000N)
Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone (HCPCS:A4315)
1 DME suppliers used 19 Medicare Claims 19 Services Paid
DME-Orthotic Devices (DF000N)
Urinary catheter anchoring device, adhesive skin attachment, each (HCPCS:A4333)
2 DME suppliers used 31 Medicare Claims 364 Services Paid
DME-Orthotic Devices (DF000N)
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each (HCPCS:A4357)
3 DME suppliers used 32 Medicare Claims 43 Services Paid
DME-Orthotic Devices (DF010N)
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4407)
2 DME suppliers used 12 Medicare Claims 330 Services Paid
Unknown
Other-Enteral and Parenteral (OB006N)
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4034)
5 DME suppliers used 40 Medicare Claims 1128 Services Paid
Other-Enteral and Parenteral (OB006N)
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4035)
2 DME suppliers used 22 Medicare Claims 606 Services Paid
Other-Enteral and Parenteral (OB006N)
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4150)
5 DME suppliers used 42 Medicare Claims 14901 Services Paid
Other-Enteral and Parenteral (OB006N)
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4152)
1 DME suppliers used 12 Medicare Claims 4177 Services Paid
Other-Enteral and Parenteral (OB006N)
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4154)
2 DME suppliers used 11 Medicare Claims 6487 Services Paid
Drugs Administered Through DME
DME-Drugs Administered Through DME (DG006N)
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms (HCPCS:J7605)
1 DME suppliers used 15 Medicare Claims 900 Services Paid
DME-Drugs Administered Through DME (DG006N)
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)
10 DME suppliers used 58 Medicare Claims 11634 Services Paid
DME-Drugs Administered Through DME (DG006N)
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)
8 DME suppliers used 105 Medicare Claims 11160 Services Paid
DME-Drugs Administered Through DME (DG000N)
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)
3 DME suppliers used 19 Medicare Claims 1320 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Advance care planning, first 30 minutes
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month
Injection of drug or substance under skin or into muscle
Injection, ceftriaxone sodium, per 250 mg
Injection, dexamethasone sodium phosphate, 1 mg
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a
Removal of fingernails or toenails, 6 or more nails
Removal of tissue from wound, 20.0 sq cm or less
Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes
Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes
Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes
Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes
Simple or single drainage of skin abscess
Smoking and tobacco use intensive counseling, 4-10 minutes
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes
Transitional care management services for problem of at least moderate complexity
Transitional care management services for problem of high complexity
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
This service was performed 59 times for 53 patientsChronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
This service was performed 208 times for 106 patientsChronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
This service was performed 412 times for 221 patientsThis procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
This service was performed 59 times for 33 patientsCeftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.
This service was performed 45 times for 18 patientsDexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
This service was performed 220 times for 16 patientsThis is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
This service was performed 108 times for 104 patientsThis procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.
This service was performed 346 times for 151 patientsThis procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
This service was performed 15 times for 14 patientsThis procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.
This service was performed 20 times for 12 patientsAn established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.
This service was performed 49 times for 35 patientsAn established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.
This service was performed 358 times for 195 patientsAn established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
This service was performed 764 times for 237 patientsA new patient home visit is a comprehensive 75-minute appointment conducted at your home. The healthcare professional will assess your health, discuss any concerns, and create a personalized care plan. It's convenient, comfortable, and tailored to your specific needs.
This service was performed 15 times for 15 patientsA new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.
This service was performed 48 times for 48 patientsA simple or single drainage of skin abscess is a procedure to remove pus from a skin infection. A small cut is made on the abscess, the pus is drained out, and the area is cleaned. This helps to reduce pain, speed up recovery, and prevent the spread of infection.
This service was performed 16 times for 12 patientsThis service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.
This service was performed 31 times for 16 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 29 times for 20 patientsTransitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
This service was performed 11 times for 11 patientsTransitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
This service was performed 23 times for 20 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $30.62 for a new patient copayment and $23.55 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 46307 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $122.49
- Minimum New Patient Price $53.07
- Maximum New Patient Price $161.76
- Average New Patient Copayment $30.62
- Minimum New Patient Copayment $13.26
- Maximum New Patient Copayment $40.44
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $94.22
- Minimum Established Patient Price $16.93
- Maximum Established Patient Price $132.22
- Average Established Patient Copayment $23.55
- Minimum Established Patient Copayment $4.23
- Maximum Established Patient Copayment $33.05
* The physician office visit costs information is generated by 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 provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 46.02, 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 Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS 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.
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Final Score: 46.02 out of 100
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.
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Quality Score: 28.05
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.
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Promoting Interoperability Score: N/A
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 Score: 20
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 activities measure category compromises 15% providers final MPIS scores.
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 Score: 32.66
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. -
Cost Score: 32.66
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.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Jose Agusti is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL | 25 NORTH WINFIELD ROAD WINFIELD, IL 60190 | (630) 682-1600 | Acute Care Hospitals | |
| ST MARY MEDICAL CENTER INC | 1500 S LAKE PARK AVE HOBART, IN 46342 | (219) 942-0551 | Acute Care Hospitals | |
| COMMUNITY HOSPITAL | 901 MACARTHUR BLVD MUNSTER, IN 46321 | (219) 836-1600 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1033192604, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1033192604, enumerated as an "individual" on November 28, 2005.
The provider is located at 4900 E 107TH CT WINFIELD, IN 46307 and the phone number is (219) 386-5018.
Internal Medicine with taxonomy code 207R00000X.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.
Jose Agusti is affiliated with: NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL, ST MARY MEDICAL CENTER INC and COMMUNITY HOSPITAL.