ANDREW D VANDERHEYDEN M.D.
NPI 1093925679
Pathology - Anatomic Pathology & Clinical Pathology in Dubuque, IA
About Andrew D Vanderheyden M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREW D VANDERHEYDEN M.D. (NPI 1093925679) is an individual anatomic pathology & clinical pathology provider in Dubuque, Iowa, licensed in Iowa (38130) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Midwest Medical Center, and is a graduate of University Of Wisconsin School Of Medicine (2004).
NPPES Registry Identity
Specialties & Licenses
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Andrew D Vanderheyden M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
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.
Blood smear interpretation by physician with written report
Cell examination of specimen, concentration technique
Evaluation of fine needle aspirate
Evaluation of fine needle aspirate with interpretation and report
Microscopic genetic analysis of tumor, using computer-assisted technology
Pap test, evaluation of fine needle aspirate, immediate, each additional evaluation episode
Pathology examination of specimen during surgery, first tissue block
Pathology examination of tissue using a microscope, high complexity
Pathology examination of tissue using a microscope, intermediate complexity
Pathology examination of tissue using a microscope, moderately high complexity
Pathology examination of tissue using a microscope, moderately low complexity
Preparation of tissue for examination by removing any calcium present
Protein measurement, serum
Special stained specimen slides to examine tissue including interpretation and report
Special stained specimen slides to examine tissue, each additional procedure
Special stained specimen slides to examine tissue, initial procedure
Special stained specimen slides to identify organisms including interpretation and report
Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method
Blood smear interpretation is a lab test where your doctor examines a sample of your blood under a microscope. They look for abnormalities in your blood cells which can help diagnose various conditions. You'll receive a written report of the findings.
This service was performed 14 times for 14 patientsCell examination of a specimen using a concentration technique is a lab process that enhances the detection of cells in a sample. This method helps to focus on key areas of the sample, making it easier to spot abnormalities or changes. It's a crucial part of diagnosing and monitoring certain health conditions.
This service was performed 169 times for 134 patientsEvaluation of fine needle aspirate is a diagnostic procedure where a thin needle is used to collect cells from a lump or mass. This sample is then examined under a microscope to determine the nature of the lump, whether it's benign (non-cancerous) or malignant (cancerous).
This service was performed 87 times for 64 patientsThis procedure involves using a thin needle to collect a small sample from an abnormal area or lump. The sample is then examined under a microscope to identify any potential issues. A report of the findings is provided for further analysis.
This service was performed 91 times for 68 patientsMicroscopic genetic analysis of a tumor uses advanced computer technology to examine the genetic makeup of the tumor cells. This helps to understand the tumor better and tailor a treatment plan. It's a non-invasive procedure and provides valuable insights for your healthcare team.
This service was performed 111 times for 29 patientsA Pap test is a procedure that checks for abnormal cells in the body, which could indicate a serious condition. The evaluation of a fine needle aspirate is a process where a small sample is taken with a thin needle for examination. This can be done multiple times for a thorough analysis.
This service was performed 49 times for 17 patientsA pathology examination during surgery involves the immediate analysis of a removed tissue sample. This helps the surgeon make decisions during your operation. The "first tissue block" refers to the initial sample examined. It's a vital step to ensure your health.
This service was performed 176 times for 134 patientsA high complexity pathology examination involves studying body tissue under a microscope to identify any abnormalities. This intricate process helps in diagnosing various conditions and deciding on the best treatment plan.
This service was performed 12 times for 11 patientsA pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
This service was performed 2,643 times for 1,435 patientsA pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.
This service was performed 132 times for 95 patientsA pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.
This service was performed 126 times for 115 patientsThis procedure involves treating tissue samples to remove any calcium, which can interfere with the examination. The tissue is soaked in a special solution that safely dissolves the calcium, leaving the tissue intact for accurate analysis. This helps in making precise diagnoses.
This service was performed 53 times for 41 patientsA serum protein measurement is a blood test that determines the levels of proteins in your blood. It is used to evaluate your overall health, and diagnose nutritional problems, kidney disease, liver disease, or immune disorders.
This service was performed 11 times for 11 patientsSpecial stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.
This service was performed 37 times for 22 patientsSpecial stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.
This service was performed 544 times for 129 patientsThis procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.
This service was performed 276 times for 194 patientsThis service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.
This service was performed 77 times for 48 patientsThis procedure involves taking a small tissue sample from your gland located beneath your bladder. The sample is then examined under a microscope by a pathologist to check for any abnormalities or diseases. This is a standard method to ensure your well-being.
This service was performed 42 times for 42 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $30.55 for a new patient copayment and $23.51 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 52001 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $122.23
- Minimum New Patient Price $52.96
- Maximum New Patient Price $161.4
- Average New Patient Copayment $30.55
- Minimum New Patient Copayment $13.24
- Maximum New Patient Copayment $40.35
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $94.05
- Minimum Established Patient Price $16.91
- Maximum Established Patient Price $131.98
- Average Established Patient Copayment $23.51
- Minimum Established Patient Copayment $4.22
- Maximum Established Patient Copayment $32.99
* 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 92.85, 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.
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Final Score: 92.85 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.
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Quality Score: 85.71
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 comprises 40% of a provider's final MIPS score.
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.
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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 comprises 25% of a provider's final MIPS score.
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 comprises 15% of a provider's final MIPS score.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score. -
Cost Score: N/A
The Cost performance category assesses 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 comprises 20% of a provider's final MIPS score.
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 |
|---|---|---|
| Completion of an Accredited Safety or Quality Improvement Program | Yes | N/A |
| Completion of an accredited performance improvement continuing medical education program that addresses performance or quality improvement according to the following criteria: • The activity must address a quality or safety gap that is supported by a needs assessment or problem analysis, or must support the completion of such a needs assessment as part of the activity; • The activity must have specific, measurable aim(s) for improvement; • The activity must include interventions intended to result in improvement; • The activity must include data collection and analysis of performance data to assess the impact of the interventions; and The accredited program must define meaningful clinician participation in their activity, describe the mechanism for identifying clinicians who meet the requirements, and provide participant completion information. | ||
| Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop | Yes | N/A |
| Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology. | ||
| Participation in MOC Part IV | Yes | N/A |
| Participation in Maintenance of Certification (MOC) Part IV, such as the American Board of Internal Medicine (ABIM) Approved Quality Improvement (AQI) Program, National Cardiovascular Data Registry (NCDR) Clinical Quality Coach, Quality Practice Initiative Certification Program, American Board of Medical Specialties Practice Performance Improvement Module or ASA Simulation Education Network, for improving professional practice including participation in a local, regional or national outcomes registry or quality assessment program. Performance of monthly activities across practice to regularly assess performance in practice, by reviewing outcomes addressing identified areas for improvement and evaluating the results. | ||
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. Andrew Vanderheyden is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| MIDWEST MEDICAL CENTER | 1 MEDICAL CENTER DRIVE GALENA, IL 61036 | (815) 777-1340 | Critical Access Hospitals | |
| ST LUKES HOSPITAL | 1026 A AVE NE CEDAR RAPIDS, IA 52402 | (319) 369-7211 | Acute Care Hospitals | |
| FINLEY HOSPITAL | 350 NORTH GRANDVIEW AVENUE DUBUQUE, IA 52001 | (563) 582-1881 | Acute Care Hospitals | |
| GRANT REGIONAL HEALTH CENTER | 507 S MONROE ST LANCASTER, WI 53813 | (608) 723-2143 | Critical Access Hospitals |
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
DUBUQUE, IA 52001
DUBUQUE, IA 52001
DUBUQUE, IA 52001
DUBUQUE, IA 52001
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093925679, enumerated as an "individual" on May 23, 2007.
The provider is located at 350 N GRANDVIEW AVE DUBUQUE, IA 52001 and the phone number is (563) 589-2431.
Pathology with taxonomy code 207ZP0102X and a focus in Anatomic Pathology & Clinical Pathology.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from NH. Please consult your insurance carrier or call the provider to verify.
Andrew Vanderheyden is affiliated with: MIDWEST MEDICAL CENTER, ST LUKES HOSPITAL, FINLEY HOSPITAL and GRANT REGIONAL HEALTH CENTER.
