DR. RAYMOND ANNABLE PSY.D.
NPI 1093048241
Psychologist in Wilmington, NC

Quality Rating: 93.23 out of 100 score

NPI Status: Active since September 04, 2009

Contact Information

311 JUDGES RD STE 4E
WILMINGTON, NC
ZIP 28405
Phone: (910) 791-6767
Fax: (910) 791-6890

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Table of Contents

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Overall Quality Performance
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Psychologist
Accepts Insurance
Opted-Out Medicare

About RAYMOND ANNABLE

This page provides the complete NPI Profile along with additional information for Raymond Annable, a provider established in Wilmington, North Carolina with a medical specialization in Psychologist. The healthcare provider is registered in the NPI registry with number 1093048241 assigned on September 2009. The practitioner's primary taxonomy code is 103T00000X with license number 4382 (NC). The provider is registered as an individual and his NPI record was last updated 13 years ago.

NPI: 1093048241
Provider Name: DR. RAYMOND ANNABLE PSY.D.
Gender: Male
Entity Type: Individual
Location Address: 311 JUDGES RD STE 4E WILMINGTON, NC 28405
Location Phone: (910) 791-6767
Location Fax: (910) 791-6890
Mailing Address: 311 JUDGES RD STE 4E WILMINGTON, NC 28405
Mailing Phone: (910) 791-6767
Mailing Fax: (910) 791-6890
Is Sole Proprietor?: No
Enumeration Date: 09-04-2009
Last Update Date: 01-03-2013
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A psychologist like Raymond Annable studies cognitive, emotional, social processes and behavior by observing, interpreting, and recording how people relate to one another and to their environments. Psychologists gather information and evaluate behavior through controlled laboratory experiments, psychoanalysis, psychotherapy or through personality, performance, aptitude, or intelligence tests, and use this information when testing theories in their research or when treating patients.

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Raymond Annable opted out of Medicare effective on 04-01-2024 until 04-01-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.

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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: Psychologist
Taxonomy Code: 103T00000X
Type: Behavioral Health & Social Service Providers
License No.: 4382
License State: NC
Taxonomy Description: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	103TC0700X	Behavioral Health & Social Service Providers	Psychologist Clinical	2078 (OR)

Insurance Plans Accepted

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

Aetna CVS Health

Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision - HMO

AmeriHealth Caritas Next

AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
AmeriHealth Caritas Next Gold Deluxe + No Referrals - HMO
AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
AmeriHealth Caritas Next Silver Deluxe + No Referrals - HMO
AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
AmeriHealth Caritas Next Silver Signature + No Referrals - HMO

CareSource

Bronze First 7500 $25 Generic Drugs - HMO
Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
Core Gold 1500 $10 Generic Drugs - HMO
Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
Gold 1500 $15 Generic Drugs - HMO
Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
HDHP Preventive Silver 5500 $0 Select Drugs - HMO
Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
Low Premium Silver 6000 $3 Generic Drugs - HMO
Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
Silver 5000 $20 Generic Drugs - HMO
Silver 5000 $20 Generic Drugs Adult Vision & Fitness - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

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.

Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2024
Opt-Out End Date: 04-01-2026
Eligible to Order and Refer? No

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 93.23, 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.

Final Score: 93.23 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.
Quality Score: 84.59

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 Score: 98.27

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: 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 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: 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.
Cost Score: 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.

NPI Validation Check Digit Calculation

The following table explains the step by step 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.
1	0	9	3	0	4	8	2	4	1
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	0	18	3	0	4	16	2	8
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 8 + 3 + 0 + 4 + 1 + 6 + 2 + 8 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 1									1

The NPI number 1093048241 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.