DR. JUAN ANTONIO JIMENEZ M.D., PH.D.
NPI 1073836623
Urology in Cleveland, OH

NPI Status: Active since March 10, 2010

Contact Information

18099 LORAIN AVE STE 141
CLEVELAND, OH
ZIP 44111
Phone: (216) 941-0333
Fax: (216) 941-5257

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 16
Urology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About JUAN JIMENEZ

This page provides the complete NPI Profile along with additional information for Juan Jimenez, a provider established in Cleveland, Ohio with a medical specialization in Urology and more than 16 years of experience. He graduated from Indiana University School Of Medicine in 2010. The healthcare provider is registered in the NPI registry with number 1073836623 assigned on March 2010. The practitioner's primary taxonomy code is 208800000X with license number 35.129496 (OH). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI: 1073836623
Provider Name: DR. JUAN ANTONIO JIMENEZ M.D., PH.D.
Gender: Male
Entity Type: Individual
Location Address: 18099 LORAIN AVE STE 141 CLEVELAND, OH 44111
Location Phone: (216) 941-0333
Location Fax: (216) 941-5257
Mailing Address: 18099 LORAIN AVE STE 141 CLEVELAND, OH 44111
Mailing Phone: (216) 941-0333
Mailing Fax: (216) 941-5257
Medical School Name: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year: 2010
Is Sole Proprietor?: No
Enumeration Date: 03-10-2010
Last Update Date: 01-03-2022
Code Navigator

Location Map

Secondary Locations

5260 Smith Rd
Brookpark, OH 44142
(216) 941-0333
29101 Health Campus Dr Ste 310
Westlake, OH 44145
(440) 892-6600

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: Urology
Taxonomy Code: 208800000X
Type: Allopathic & Osteopathic Physicians
License No.: 35.129496
License State: OH
Taxonomy Description: A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

MedMutual

Bronze $8,300 w/ Adult Dental ON-EX - HMO
Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
Bronze HSA $7,300 ON-EX - HMO
Bronze Standard w/ Virtual & Wellness - HMO
Gold $1,000 w/ Adult Dental ON-EX - HMO
Gold $1,000 w/ Virtual & Wellness ON-EX - HMO
Gold $500 w/ Virtual & Wellness ON-EX - HMO
Gold Standard w/ Virtual & Wellness - HMO
Silver $5,000 w/ Adult Dental ON-EX - HMO
Silver $5,000 w/ Virtual & Wellness ON-EX - HMO
Silver $5,800 w/ Virtual & Wellness ON-EX - HMO
Silver Standard w/ Virtual & Wellness - HMO

Oscar Insurance Corporation of Ohio

Bronze Classic PCP Saver | Cleveland Clinic - HMO
Bronze Classic Standard | Cleveland Clinic - HMO
Bronze Simple Breathe Easy with Enhanced COPD Benefits | Cleveland Clinic - HMO
Bronze Simple Chronic Care CKM | Cleveland Clinic - HMO
Bronze Simple Diabetes | Cleveland Clinic - HMO
Bronze Simple HSA | Cleveland Clinic - HMO
Gold Classic Standard | Cleveland Clinic - HMO
Gold Elite | Cleveland Clinic - HMO
Gold Elite Saver Plus | Cleveland Clinic - HMO
Silver Classic Standard | Cleveland Clinic - HMO
Silver Elite Saver Plus | Cleveland Clinic - HMO
Silver Simple Breathe Easy with Enhanced COPD Benefits | Cleveland Clinic - HMO
Silver Simple Chronic Care CKM | Cleveland Clinic - HMO
Silver Simple Diabetes | Cleveland Clinic - HMO
Silver Simple PCP Saver | Cleveland Clinic - HMO
Silver Simple Women's Health with Menopause Benefits | Cleveland Clinic - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

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
0125785	MEDICAID (05)	OH

Medicare Participation & PECOS Enrollment Status

Juan Jimenez 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.

Juan Jimenez 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: 8820390826
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: I20160923000941
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.

Orthotic Devices

DME-Orthotic Devices (DF000N)
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each (HCPCS:A4357)
2 DME suppliers used 11 Medicare Claims 21 Services Paid
DME-Orthotic Devices (DF000N)
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each (HCPCS:A4358)
4 DME suppliers used 23 Medicare Claims 45 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.

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle
Automated urinalysis test
Complete laser vaporization of prostate including control of bleeding using an endoscope
Complex measurement of pressure of urine flow in bladder with voiding pressure studies
Complicated insertion of bladder tube
Crushing of stone of ureter with insertion of stent using an endoscope
Diagnostic exam of bladder and urethra using an endoscope
Electronic analysis of implanted neurostimulator generator with simple spinal cord or peripheral nerve stimulator programming
Electronic assessment of bladder emptying
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Follow-up hospital inpatient care per day, typically 15 minutes
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
Injection, garamycin, gentamicin, up to 80 mg
Leuprolide acetate (for depot suspension), 7.5 mg
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Prostate resection
Removal or manipulation of stone in ureter or kidney using an endoscope
Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope
Ultrasonic guidance for needle placement
Ultrasound measurement of bladder capacity after voiding

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.53 for a new patient copayment and $17.01 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 44111 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $126.12
Minimum New Patient Price $54.34
Maximum New Patient Price $166.65

Average New Patient Copayment $31.53
Minimum New Patient Copayment $13.58
Maximum New Patient Copayment $41.66

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $68.07
Minimum Established Patient Price $17.1
Maximum Established Patient Price $135.4

Average Established Patient Copayment $17.01
Minimum Established Patient Copayment $4.27
Maximum Established Patient Copayment $33.85

* 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
Breast Cancer Screening	99%	151
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Colorectal Cancer Screening	99%	576
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Diabetes: Medical Attention for Nephropathy	93%	152
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Documentation of Current Medications in the Medical Record	95%	1823
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
e-Prescribing	80%	824
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange	19%	174
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 at least one transition of care or referral.
Implementation of documentation improvements for practice/process improvements	Yes	N/A
Implementation of practices/processes that document care coordination activities (e.g., a documented care coordination encounter that tracks all clinical staff involved and communications from date patient is scheduled for outpatient procedure through day of procedure).
Medication Reconciliation	97%	584
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.
Patient-Specific Education	99%	1145
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Pneumococcal Vaccination Status for Older Adults	99%	498
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	36%	1097
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
Preventive Care and Screening: Influenza Immunization	100%	449
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access	52%	1145
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	13%	1145
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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
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.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized 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_TRANS_PHCDRR_3_MULTI.
Syndromic Surveillance Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit syndromic surveillance data. 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_TRANS_PHCDRR_2_MULTI.
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.	498
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

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. Juan Jimenez is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type
FAIRVIEW HOSPITAL	18101 LORAIN AVENUE CLEVELAND, OH 44111	(216) 476-7000	Acute Care Hospitals
MARYMOUNT HOSPITAL	12300 MCCRACKEN ROAD GARFIELD HEIGHTS, OH 44125	(216) 587-8149	Acute Care Hospitals
CLEVELAND CLINIC	9500 EUCLID AVENUE CLEVELAND, OH 44195	(216) 952-9829	Acute Care Hospitals
HILLCREST HOSPITAL	6780 MAYFIELD ROAD MAYFIELD HEIGHTS, OH 44124	(440) 312-4500	Acute Care Hospitals
CLEVELAND CLINIC AVON HOSPITAL	33300 CLEVELAND CLINIC BLVD AVON, OH 44011	(440) 695-5000	Acute Care Hospitals

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 1073836623, we treat the final digit (3) 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 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

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.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 14 → 1 + 4

Pos 4

Unchanged

Pos 5

Doubled → 16 → 1 + 6

Pos 6

Unchanged

Pos 7

Doubled → 12 → 1 + 2

Pos 8

Unchanged

Pos 9

Doubled → 4

Check

Target digit

Regular digit Doubled digit Check digit

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.

1 → 2 7 → 14 → 5 8 → 16 → 7 6 → 12 → 3 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 4 + 3 + 1 + 6 + 3 + 1 + 2 + 6 + 4 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3

This NPI is valid

The calculated check digit is 3, which matches the last digit of 1073836623.

Other Providers at the Same Location

The following 2 providers are registered at the same or a nearby location.

PATRICK MICHAEL IRWIN

Urology

18099 LORAIN AVE STE 141
CLEVELAND, OH 44111

Cuyahoga County (216) 941-0333

SOUTHWEST UROLOGY, LLC

Non-Pharmacy Dispensing Site

18099 LORAIN AVE STE 141
CLEVELAND, OH 44111

Cuyahoga County (216) 941-0333

About JUAN JIMENEZ

Location Map

Secondary Locations

Specialty - Primary Taxonomy

Urology

Insurance Plans Accepted

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 8820390826

PECOS Enrollment ID: I20160923000941

Accepts Medicare Assignment? Yes

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

Orthotic Devices

Areas of Expertise

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle

Automated urinalysis test

Complete laser vaporization of prostate including control of bleeding using an endoscope

Complex measurement of pressure of urine flow in bladder with voiding pressure studies

Complicated insertion of bladder tube

Crushing of stone of ureter with insertion of stent using an endoscope

Diagnostic exam of bladder and urethra using an endoscope

Electronic analysis of implanted neurostimulator generator with simple spinal cord or peripheral nerve stimulator programming

Electronic assessment of bladder emptying

Established patient office or other outpatient visit, 20-29 minutes

Established patient office or other outpatient visit, 30-39 minutes

Established patient office or other outpatient visit, 40-54 minutes

Follow-up hospital inpatient care per day, typically 15 minutes

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care per day, typically 70 minutes

Injection, garamycin, gentamicin, up to 80 mg

Leuprolide acetate (for depot suspension), 7.5 mg

New patient office or other outpatient visit, 30-44 minutes

New patient office or other outpatient visit, 45-59 minutes

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

Prostate resection

Removal or manipulation of stone in ureter or kidney using an endoscope

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope

Ultrasonic guidance for needle placement

Ultrasound measurement of bladder capacity after voiding

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Quality Reporting

Find Provider Hospital Affiliations - Privileges

Reviews for DR. JUAN ANTONIO JIMENEZ M.D., PH.D.

NPI NPI Number Validation

How NPI Validation Works

Digit-by-digit view

Step 1: Double every other digit from the right

Step 2: Add all digits plus the NPI constant

Step 3: Find the amount needed to reach the next multiple of 10

Other Providers at the Same Location

Frequently Asked Questions