DR. BARRY LEE GARDNER M.D.
NPI 1033197231
Radiology - Radiation Oncology in Colorado Springs, CO
NPI Status: Active since January 06, 2006
Contact Information
1644 MEDICAL CENTER PT
SUITE 100
COLORADO SPRINGS, CO
ZIP 80907
Phone: (719) 247-5500
Fax: (719) 247-5437
- Individual
- Male
- Years of Experience 37
- Radiology
- Radiation Oncology
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About BARRY GARDNER
This page provides the complete NPI Profile along with additional information for Barry Gardner, a provider established in Colorado Springs, Colorado with a medical specialization in Radiology, focusing in radiation oncology and more than 37 years of experience. He graduated from Uniformed Services Uhs Fe Hebert School Of Med in 1989. The healthcare provider is registered in the NPI registry with number 1033197231 assigned on January 2006. The practitioner's primary taxonomy code is 2085R0001X with license number 44618 (CO). The provider is registered as an individual and his NPI record was last updated 11 years ago.
- NPI
- 1033197231
- Provider Name
- DR. BARRY LEE GARDNER M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1644 MEDICAL CENTER PT SUITE 100 COLORADO SPRINGS, CO 80907
- Location Phone
- (719) 247-5500
- Location Fax
- (719) 247-5437
- Mailing Address
- 1644 MEDICAL CENTER PT SUITE 100 COLORADO SPRINGS, CO 80907
- Mailing Phone
- (719) 247-5500
- Mailing Fax
- (719) 247-5437
- Medical School Name
- UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED
- Graduation Year
- 1989
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-06-2006
- Last Update Date
- 11-16-2015
- Code Navigator
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
Radiology Radiation Oncology
- Taxonomy Code
- 2085R0001X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 44618
- License State
- CO
- Taxonomy Description
- A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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 |
|---|---|---|---|
| C806332 | MEDICARE PIN (08) | ||
| L62197 | MEDICARE UPIN (02) | ||
| 74632043 | MEDICAID (05) | CO |
Medicare Participation & PECOS Enrollment Status
Barry Gardner 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.
Barry Gardner 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: 4082619929
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: I20060927000112
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
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.
Calculation of radiation therapy dose
Complex radiation therapy planning
Continuing radiation therapy consultation per week
Ct guidance for insertion of radiation therapy fields
Design and construction of complex radiation treatment device
Design and construction of radiation treatment device for high precision radiation therapy
Established patient office or other outpatient visit, 30-39 minutes
High precision radiation therapy planning
Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or
Radiation treatment management, 5 treatment sessions
Radiation therapy dose calculation is a process to determine the exact amount of radiation needed to treat a specific area in the body. This calculation helps ensure the treatment is effective while minimizing harm to healthy tissues. It's a key part of planning your radiation therapy.
This service was performed 222 times for 63 patientsComplex radiation therapy planning is a process to determine the most effective way to deliver radiation to a specific area in your body. It involves detailed imaging to map your body's structure, allowing for precise targeting of cancer cells while sparing healthy tissue.
This service was performed 53 times for 53 patientsContinuing radiation therapy consultation per week involves regular meetings with your healthcare team. These sessions help monitor your progress, manage side effects, and adjust your treatment plan if necessary. It's a key part of ensuring the effectiveness of your radiation therapy.
This service was performed 473 times for 75 patientsCT guidance for insertion of radiation therapy fields involves using a CT scan to accurately map the area of your body where radiation will be applied. This ensures the radiation targets only the necessary area, minimizing impact to healthy tissues.
This service was performed 2,306 times for 75 patientsThe design and construction of a complex radiation treatment device is a process where a specialized instrument is created. This device targets harmful cells with high-energy rays to destroy or damage them, while minimizing impact on healthy cells. This aids in treating conditions like cancer.
This service was performed 64 times for 59 patientsA radiation treatment device is custom-made for each patient to target cancer cells with high precision. It's designed to focus radiation on the tumor, sparing healthy tissue. This process ensures effective therapy while minimizing side effects.
This service was performed 59 times for 58 patientsThis 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.
This service was performed 21 times for 21 patientsHigh precision radiation therapy planning involves detailed mapping of your body to target cancer cells accurately. Advanced imaging techniques help identify the exact location of the tumor, minimizing harm to healthy tissues. This personalized approach enhances effectiveness and reduces side effects.
This service was performed 56 times for 55 patientsIntensity-modulated radiation therapy (IMRT) is a type of cancer treatment. It uses advanced technology to manipulate photon beams of radiation to conform to the shape of a tumor. IMRT allows for the radiation dose to conform more precisely to the three-dimensional shape of the tumor by modulating—or controlling—the intensity of the radiation beam. This can result in better tumor control and less harm to healthy tissue.
This service was performed 2,352 times for 76 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 38 times for 38 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 47 times for 47 patientsThis service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
This service was performed 75 times for 27 patientsRadiation treatment management involves a series of 5 sessions where targeted radiation is used to destroy or shrink cancer cells in your body. Each session is carefully planned to maximize effectiveness while minimizing harm to healthy tissues. You may experience side effects which will be closely monitored and managed for your comfort.
This service was performed 472 times for 75 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $43.7 for a new patient copayment and $18.05 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 80907 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $174.82
- Minimum New Patient Price $58.06
- Maximum New Patient Price $174.82
- Average New Patient Copayment $43.7
- Minimum New Patient Copayment $14.51
- Maximum New Patient Copayment $43.7
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $72.2
- Minimum Established Patient Price $18.88
- Maximum Established Patient Price $142.79
- Average Established Patient Copayment $18.05
- Minimum Established Patient Copayment $4.72
- Maximum Established Patient Copayment $35.69
* 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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. 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 | Number of Patients |
|---|---|---|
| Clinical Data Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to a clinical data registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_PHCDRR_5_MULTI. | ||
| Clinical Information Reconciliation | 100% | 206 |
| 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. The MIPS eligible clinician must implement clinical information reconciliation for the following three clinical information sets: (1) Medication. Review of the patient's medication, including the name, dosage, frequency, and route of each medication. (2) Medication allergy. Review of the patient's known medication allergies. (3) Current Problem list. Review of the patient's current and active diagnoses. | ||
| Closing the Referral Loop: Receipt of Specialist Report | 100% | 119 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred | ||
| Collection and follow-up on patient experience and satisfaction data on beneficiary engagement | Yes | N/A |
| Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan. | ||
| Collection and use of patient experience and satisfaction data on access | Yes | N/A |
| Collection of patient experience and satisfaction data on access to care and development of an improvement plan, such as outlining steps for improving communications with patients to help understanding of urgent access needs. | ||
| Colorectal Cancer Screening | 31% | 222 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Documentation of Current Medications in the Medical Record | 6% | 315 |
| 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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Electronic Case Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to electronically submit case reporting of reportable conditions. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_PHCDRR_3_MULTI. | ||
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| e-Prescribing | 55% | 22 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Implementation of improvements that contribute to more timely communication of test results | Yes | N/A |
| Timely communication of test results defined as timely identification of abnormal test results with timely follow-up. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Oncology: Medical and Radiation - Pain Intensity Quantified | 95% | 1564 |
| Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified | ||
| Patient Navigator Program | Yes | N/A |
| Implement a Patient Navigator Program that offers evidence-based resources and tools to reduce avoidable hospital readmissions, utilizing a patient-centered and team-based approach, leveraging evidence-based best practices to improve care for patients by making hospitalizations less stressful, and the recovery period more supportive by implementing quality improvement strategies. | ||
| Patient-Specific Education | 4% | 283 |
| 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 clinician. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 49% | 292 |
| 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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Provide Patient Access | 63% | 283 |
| 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 ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology. | ||
| Public Health Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit data to public health registries. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_PHCDRR_4_MULTI. | ||
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | Yes | N/A |
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Tobacco use | Yes | N/A |
| Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. | ||
| Use of High-Risk Medications in the Elderly | 0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 25 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
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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 1033197231, we treat the final digit (1) 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 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
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 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 7 providers are registered at the same or a nearby location.
COLORADO SPRINGS, CO 80907
COLORADO SPRINGS, CO 80907
COLORADO SPRINGS, CO 80907
COLORADO SPRINGS, CO 80907
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1033197231, enumerated as an "individual" on January 06, 2006.
The provider is located at 1644 MEDICAL CENTER PT SUITE 100 COLORADO SPRINGS, CO 80907 and the phone number is (719) 247-5500.
Radiology with taxonomy code 2085R0001X and a focus in Radiation Oncology.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
