DR. ALAN R. HALL M.D.
NPI 1093756645
Clinic/Center - Urgent Care in Hudson Oaks, TX

Quality Rating: 14.83 out of 100 score

NPI Status: Active since June 08, 2006

Contact Information

201 S OAKRIDGE DR
HUDSON OAKS, TX
ZIP 76087
Phone: (817) 599-5518
Fax: (817) 599-5538

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Table of Contents

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Overall Quality Performance
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 44
Clinic/Center
Urgent Care
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About ALAN HALL

This page provides the complete NPI Profile along with additional information for Alan Hall, a provider established in Hudson Oaks, Texas with a medical specialization in Clinic/center, focusing in urgent care and more than 44 years of experience. He graduated from University Of Texas Medical School At Houston in 1982. The healthcare provider is registered in the NPI registry with number 1093756645 assigned on June 2006. The practitioner's primary taxonomy code is 261QU0200X. The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI: 1093756645
Provider Name: DR. ALAN R. HALL M.D.
Gender: Male
Entity Type: Individual
Location Address: 201 S OAKRIDGE DR HUDSON OAKS, TX 76087
Location Phone: (817) 599-5518
Location Fax: (817) 599-5538
Mailing Address: 201 S OAKRIDGE DR HUDSON OAKS, TX 76087
Mailing Phone: (817) 599-5518
Mailing Fax: (817) 599-5538
Medical School Name: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduation Year: 1982
Is Sole Proprietor?: Yes
Enumeration Date: 06-08-2006
Last Update Date: 08-30-2023
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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: Clinic/Center Urgent Care
Taxonomy Code: 261QU0200X
Type: Ambulatory Health Care Facilities

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	207Q00000X	Allopathic & Osteopathic Physicians	Family Medicine	G3426 (TX)

Insurance Plans Accepted

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

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
UHC Bronze Standard - HMO
UHC Bronze Standard+ (Dental + Vision) - HMO
UHC Gold Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
UHC Gold Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
UHC Gold Standard - HMO
UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx) - HMO
UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision) - HMO
UHC Silver Standard - HMO
UHC Silver Value ($0 Virtual Urgent Care) - HMO
UHC Silver Value+ ($0 Virtual Urgent Care, Dental + Vision) - HMO

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

Medicare Participation & PECOS Enrollment Status

Alan Hall 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.

Alan Hall 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: 3577596998
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: I20050915001139
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.

Administration of vaccine
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg
Blood test, comprehensive group of blood chemicals
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
Detection test by immunoassay with direct visual observation for influenza virus
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)
Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)
Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique
Diphtheria and tetanus vaccine (7 years or older)
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
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r
Inhalation treatment for airway obstruction or sputum production
Injection of drug or substance under skin or into muscle
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
Injection, ceftriaxone sodium, per 250 mg
Injection, dexamethasone sodium phosphate, 1 mg
Injection, methylprednisolone acetate, 80 mg
Manual urinalysis test with examination using microscope, non-automated
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
Removal of foreign body from tissue, accessed beneath the skin, simple
Removal of impacted ear wax
Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
X-ray of chest, 2 views
X-ray of foot, minimum of 3 views
X-ray of hand, minimum of 3 views

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $41.72 for a new patient copayment and $24.26 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 76087 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99205

Average New Patient Price $166.88
Minimum New Patient Price $54.84
Maximum New Patient Price $166.88

Average New Patient Copayment $41.72
Minimum New Patient Copayment $13.71
Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $97.05
Minimum Established Patient Price $17.52
Maximum Established Patient Price $136.11

Average Established Patient Copayment $24.26
Minimum Established Patient Copayment $4.38
Maximum Established Patient Copayment $34.02

* 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 14.83, 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: 14.83 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: 0

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: 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: 0

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: 49.44

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: 49.44

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.

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
Annual registration in the Prescription Drug Monitoring Program	Yes	N/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Clinical Information Reconciliation	99%	4681
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.
Documentation of Current Medications in the Medical Record	100%	11142
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	84%	20869
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS).
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.
Improved Practices that Disseminate Appropriate Self-Management Materials	Yes	N/A
Provide self-management materials at an appropriate literacy level and in an appropriate language.
Patient-Specific Education	61%	9900
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.
Pneumococcal Vaccination Status for Older Adults	4%	1095
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Influenza Immunization	1%	5043
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
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	98%	198
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Provide Patient Access	84%	9900
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.
Secure Messaging	0%	9900
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 certified EHR technology to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative).
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.
Syndromic Surveillance Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit syndromic surveillance data from a urgent care ambulatory setting where the jurisdiction accepts syndromic data from such settings and the standards are clearly defined. 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_2_MULTI.
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.

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 1093756645, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

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 → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 14 → 1 + 4

Pos 6

Unchanged

Pos 7

Doubled → 12 → 1 + 2

Pos 8

Unchanged

Pos 9

Doubled → 8

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 9 → 18 → 9 7 → 14 → 5 6 → 12 → 3 4 → 8

Step 2: Add all digits plus the NPI constant

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

2 + 0 + 1 + 8 + 3 + 1 + 4 + 5 + 1 + 2 + 6 + 8 + 24 = 65

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

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5

This NPI is valid

The calculated check digit is 5, which matches the last digit of 1093756645.