MR. NAVEEN GNANABAKTHAN MD
NPI 1104267079
Hospitalist in Vernon, CT
NPI Status: Active since July 08, 2013
Contact Information
31 UNION STREET
ROCKVILLE GENERAL HOSPITAL
VERNON, CT
ZIP 06066
Phone: (860) 533-6595
Fax: (860) 533-6594
- Individual
- Male
- Years of Experience 11
- Hospitalist
- PECOS Enrolled
- Accepts Medicare Approved Payment
- Medicare Quality Reporting
About NAVEEN GNANABAKTHAN
Naveen Gnanabakthan is a provider established in Vernon, Connecticut and his medical specialization is Hospitalist with more than 11 years of experience. The healthcare provider is registered in the NPI registry with number 1104267079 assigned on July 2013. The practitioner's primary taxonomy code is 208M00000X with license number 54659 (CT). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1104267079
- Provider Name
- MR. NAVEEN GNANABAKTHAN MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 31 UNION STREET ROCKVILLE GENERAL HOSPITAL VERNON, CT 06066
- Location Phone
- (860) 533-6595
- Location Fax
- (860) 533-6594
- Mailing Address
- 1301 SOLANA BLVD BLDG. 2 SUITE 2200 SOUND PHYSICIANS WESTLAKE, TX 76262
- Mailing Phone
- (817) 767-6115
- Medical School Name
- OTHER
- Graduation Year
- 2013
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 07-08-2013
- Last Update Date
- 07-21-2022
- Code Navigator
Naveen Gnanabakthan 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.
The provider participated in CMS Quality Payment Program and the following quality measures were reported: care plan. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.
The typical physician office visit costs for Medicare beneficiaries in this area are: $36.17 for a new patient copayment and $28.02 for an established patient copayment.
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
Hospitalist
- Taxonomy Code
- 208M00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 54659
- License State
- CT
- Taxonomy Description
- Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
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 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
PECOS Enrollment and Medicare Participation Status
Naveen Gnanabakthan 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: 3072807882
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: I20210929001206
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.
Durable Medical Equipment
Oxygen and supplies (D1C)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
2 DME suppliers used 12 Medicare Claims 12 Services Paid
Oxygen and supplies (D1C)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 23 Medicare Claims 23 Services Paid
Physician 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 06066 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $144.69
- Minimum New Patient Price $63.47
- Maximum New Patient Price $190.87
- Average New Patient Copayment $36.17
- Minimum New Patient Copayment $15.86
- Maximum New Patient Copayment $47.71
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $112.09
- Minimum Established Patient Price $20.08
- Maximum Established Patient Price $156.18
- Average Established Patient Copayment $28.02
- Minimum Established Patient Copayment $5.02
- Maximum Established Patient Copayment $39.04
* 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 following quality measures meet Medicare's statistical reporting standards for the year 2018. 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 |
|---|---|---|
| Care Plan | 94% | 178 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
Hospital Affiliations
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. Naveen Gnanabakthan is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| ERIE COUNTY MEDICAL CENTER | 462 GRIDER STREET BUFFALO, NY 14215 | (716) 898-3936 | Acute Care Hospitals |
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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 | 1 | 0 | 4 | 2 | 6 | 7 | 0 | 7 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 0 | 4 | 4 | 6 | 14 | 0 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 0 + 4 + 4 + 6 + 1 + 4 + 0 + 1 + 4 + 24 = 51 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 51 = 9 | 9 | ||||||||
The NPI number 1104267079 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1821012238 | DR. ROBYN PEMBERTON MD Individual | Pediatrics | 31 UNION STREET ROCKVILLE GENERAL HOSPITAL ROCKVILLE, CT 06066 (860) 872-5152 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104267079, enumerated in the NPI registry as an "individual" on July 08, 2013
The provider is located at 31 Union Street Rockville General Hospital Vernon, Ct 06066 and the phone number is (860) 533-6595
The provider's speciality is Hospitalist with taxonomy code 208M00000X
The provider has more than 11 years of experience.
Yes, as of May 17, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
Medicare beneficiaries should expect a typical cost of $144.69 with an average copayment of $36.17 for new patient appointments. Established patients should expect a typical charge of $112.09 and an average copayment of 28.02. Please review your insurance plan or contact the provider directly to determine your specific costs.
The practitioner is affiliated to the following hospital(s): ERIE COUNTY MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on July 08, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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