DUNCAN FORBES WINTER M.D., F.A.C.S.
NPI 1093809683
Ophthalmology in Saranac Lake, NY
NPI Status: Active since October 03, 2006
Contact Information
86 MAIN STREET
SARANAC LAKE, NY
ZIP 12983
Phone: (518) 891-5189
Fax: (518) 891-1992
- Individual
- Male
- Ophthalmology
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About DUNCAN WINTER
This page provides the complete NPI Profile along with additional information for Duncan Winter, a provider established in Saranac Lake, New York with a medical specialization in Ophthalmology. The healthcare provider is registered in the NPI registry with number 1093809683 assigned on October 2006. The practitioner's primary taxonomy code is 207W00000X with license number 168303 (NY). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1093809683
- Provider Name
- DUNCAN FORBES WINTER M.D., F.A.C.S.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 86 MAIN STREET SARANAC LAKE, NY 12983
- Location Phone
- (518) 891-5189
- Location Fax
- (518) 891-1992
- Mailing Address
- 86 MAIN STREET SARANAC LAKE, NY 12983
- Mailing Phone
- (518) 891-5189
- Mailing Fax
- (518) 891-1992
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-03-2006
- Last Update Date
- 03-07-2023
- Code Navigator
Ophthalmologists like Duncan Winter specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
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
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 168303
- License State
- NY
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - 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.
*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 |
|---|---|---|---|
| 01221732 | MEDICAID (05) | NY | |
| 4155120001 | OTHER (01) | MEDICARE DME | |
| 180038045 | OTHER (01) | RR MEDICARE |
Medicare Participation & PECOS Enrollment Status
Duncan Winter 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: Durable Medical Equipment (DME) 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
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
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.
Established patient complete exam of visual system
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient problem focused exam of visual system
Exam of visual field with extended testing
Extended exam of the back part of the eye with optic nerve drawing
Imaging of front third of eye using a special microscope
Imaging of optic nerve
Imaging of retina
Injection of drug into eye
Injection, bevacizumab, 10 mg
Multiple measurements of eye fluid pressure over an extended time period
New patient complete exam of visual system
Removal of cataract with insertion of prosthetic lens
Removal of recurring cataract in lens capsule using a laser
Ultrasound scan to determine eye length and lens power
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
This service was performed 274 times for 269 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 75 times for 49 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 192 times for 166 patientsThis is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
This service was performed 58 times for 42 patientsAn extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
This service was performed 497 times for 312 patientsThis procedure involves a detailed examination of the back part of your eye, focusing on the optic nerve, a crucial component for vision. A drawing or map of the optic nerve is created to help track any changes over time. This can help detect eye diseases early.
This service was performed 575 times for 330 patientsThis procedure involves capturing detailed images of the front part of your eye using a specialized microscope. It helps in identifying any eye abnormalities or issues, improving the accuracy of diagnosis and treatment planning.
This service was performed 18 times for 17 patientsImaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
This service was performed 317 times for 215 patientsImaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
This service was performed 131 times for 73 patientsAn injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
This service was performed 24 times for 16 patientsBevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.
This service was performed 24 times for 16 patientsThis procedure involves recording the pressure inside your eyes at different times throughout the day. By tracking these changes, it can help detect conditions like glaucoma early, which can prevent vision loss. It's painless and non-invasive.
This service was performed 24 times for 17 patientsA new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
This service was performed 56 times for 56 patientsThis is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
This service was performed 36 times for 21 patientsThis procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
This service was performed 22 times for 18 patientsAn ultrasound scan for the eye is a safe, non-invasive procedure. It uses sound waves to create images of your eye's structure. This helps determine the length of your eye and the power of your lens, which is crucial for diagnosing eye conditions and planning surgeries.
This service was performed 19 times for 19 patientsPhysician Visit Costs
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 12983 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.4
- Minimum New Patient Price $54.87
- Maximum New Patient Price $166.88
- Average New Patient Copayment $31.6
- 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 99213
- Average Established Patient Price $68.57
- Minimum Established Patient Price $17.54
- Maximum Established Patient Price $136.14
- Average Established Patient Copayment $17.14
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.03
* 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 |
|---|---|---|
| Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 1% | 138 |
| Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for preventing progression of AMD | ||
| Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 31% | 126 |
| Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage AND the level of macular degeneration severity during one or more office visits within 12 months | ||
| Diabetes: Eye Exam | 100% | 91 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care | 54% | 50 |
| Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months | ||
| Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy | 56% | 55 |
| Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months | ||
| Documentation of Current Medications in the Medical Record | 48% | 1915 |
| 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 | 98% | 1811 |
| 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 | 24% | 240 |
| 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. | ||
| Medication Reconciliation | 91% | 1319 |
| 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 | 12% | 1129 |
| 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 | 86% | 320 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 97% | 581 |
| Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months | ||
| Provide Patient Access | 74% | 1129 |
| 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 | 3% | 400 |
| 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. | ||
| 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. | 670 |
| 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 | ||
| Use of QCDR for feedback reports that incorporate population health | Yes | N/A |
| Use of a QCDR to generate regular feedback reports that summarize local practice patterns and treatment outcomes, including for vulnerable populations. | ||
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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 1093809683, 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 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.
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 67 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093809683, enumerated as an "individual" on October 03, 2006.
The provider is located at 86 MAIN STREET SARANAC LAKE, NY 12983 and the phone number is (518) 891-5189.
Ophthalmology with taxonomy code 207W00000X.
The provider might be accepting Accepts: Providence Health Plan, Medicare, Medicaid and. Please consult your insurance carrier or call the provider to verify.
