DR. TRINA MARIE SETTLES DO
NPI 1104834712
Family Medicine in Bloomfield, IA


Quality Rating: 92.18 out of 100 score

NPI Status: Active since August 03, 2006

Contact Information

509 N MADISON ST
BLOOMFIELD, IA
ZIP 52537
Phone: (641) 664-2145
Fax: (641) 664-2058

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  • Individual
  • Female
  • Years of Experience 25
  • Family Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About TRINA SETTLES

Trina Settles is a primary care provider established in Bloomfield, Iowa and her medical specialization is Family Medicine with more than 25 years of experience. She graduated from At Still University Of Health Sciences, College Of Osteo Med, Kirksville in 2000. The healthcare provider is registered in the NPI registry with number 1104834712 assigned on August 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 2001014690 (MO). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1104834712
Provider Name
DR. TRINA MARIE SETTLES DO
Gender
Female
Entity Type
Individual
Location Address
509 N MADISON ST BLOOMFIELD, IA 52537
Location Phone
(641) 664-2145
Location Fax
(641) 664-2058
Mailing Address
509 N MADISON ST BLOOMFIELD, IA 52537
Mailing Phone
(641) 664-2145
Mailing Fax
(641) 664-2058
Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduation Year
2000
Is Sole Proprietor?
No
Enumeration Date
08-03-2006
Last Update Date
09-18-2020
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A primary care provider (PCP) like Trina Settles sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Trina Settles 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 under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.18, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $21.16 for a new patient copayment and $24.57 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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
2001014690
License State
MO
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

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

  • Ambetter from Arkansas Health & Wellness

    • Choice Bronze HSA (QualChoice) - POS
    • Complete Gold - PPO
    • Complete Gold + Vision + Adult Dental - PPO
    • Complete Silver - PPO
    • Complete Silver + Vision + Adult Dental - PPO
  • Ambetter from Home State Health

    • Choice Bronze HSA - EPO
    • Choice Bronze HSA + Vision + Adult Dental - EPO
    • Clear Gold - EPO
    • Clear Gold + Vision + Adult Dental - EPO
    • Clear Silver - EPO
  • Ambetter from Nebraska Total Care

    • Choice Bronze HSA - HMO
    • Choice Bronze HSA + Vision + Adult Dental - HMO
    • Clear Gold - HMO
    • Clear Gold + Vision + Adult Dental - HMO
    • Clear Silver - HMO
  • Ambetter from NH Healthy Families

    • Choice Bronze HSA - EPO
    • Choice Bronze HSA + Vision + Adult Dental - EPO
    • Complete Gold - EPO
    • Complete Gold + Vision + Adult Dental - EPO
    • Complete Silver - EPO
  • Ambetter from Sunflower Health Plan

    • Choice Bronze HSA - EPO
    • Choice Bronze HSA + Vision + Adult Dental - EPO
    • Clear Silver - EPO
    • Clear Silver + Vision + Adult Dental - EPO
    • Complete Gold - EPO
  • Ambetter Health of Delaware

    • Clear Gold - EPO
    • Clear Gold + Vision + Adult Dental - EPO
    • Clear Silver - EPO
    • Clear Silver + Vision + Adult Dental - EPO
    • Complete Gold - EPO
  • Ambetter of Illinois

    • Central Bronze - HMO
    • Central Bronze + Vision + Adult Dental - HMO
    • Central Gold - HMO
    • Central Gold + Vision + Adult Dental - HMO
    • Central Silver - HMO
  • Ambetter of Oklahoma

    • Clear Gold - PPO
    • Clear Gold + Vision + Adult Dental - PPO
    • Clear Silver - PPO
    • Clear Silver + Vision + Adult Dental - PPO
    • Complete Silver - PPO
  • Ambetter of Tennessee

    • Choice Bronze HSA - EPO
    • Choice Bronze HSA + Vision + Adult Dental - EPO
    • Clear Silver - EPO
    • Clear Silver + Vision + Adult Dental - EPO
    • Complete Gold - EPO
  • Medica

    • Medica Insure Bronze Copay - EPO
    • Medica Insure Bronze Copay $0 PCP - EPO
    • Medica Insure Bronze Copay $0 PCP Office Visits - EPO
    • Medica Insure Bronze Premier - EPO
    • Medica Insure Bronze Share Plus - EPO
  • Oscar Health Plan, Inc.

    • Bronze Classic (Choice) - HMO
    • Bronze Classic 4700 (Choice) - HMO
    • Bronze Classic 4700 (Select) - HMO
    • Bronze Classic PCP Saver Plus Rx Copay (Choice) - HMO
    • Bronze Classic PCP Saver Plus Rx Copay (Select) - HMO
  • Oscar Insurance Company

    • Bronze Classic - EPO
    • Bronze Classic | MercyOne - EPO
    • Bronze Classic 4700 - EPO
    • Bronze Classic 4700 | MercyOne - EPO
    • Bronze Classic PCP Saver Plus - EPO
  • Wellmark Health Plan of Iowa, Inc.

    • Wellmark Bronze HDHP HMO - HMO
    • Wellmark Bronze HDHP HMO | Farm Bureau - HMO
    • Wellmark Bronze Traditional HMO - HMO
    • Wellmark Gold Traditional HMO - HMO
    • Wellmark Gold Traditional HMO | Farm Bureau - HMO

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

PECOS Enrollment and Medicare Participation Status

Trina Settles 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: 9335284579

    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: I20100226000680

    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

  • Other DME (D1E)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    8 DME suppliers used 51 Medicare Claims 91 Services Paid

  • Other DME (D1E)

    Lancets, per box of 100 (HCPCS:A4259)

    5 DME suppliers used 22 Medicare Claims 26 Services Paid

  • Other DME (D1E)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    1 DME suppliers used 14 Medicare Claims 26 Services Paid

  • Oxygen and supplies (D1C)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Other DME (D1E)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    1 DME suppliers used 14 Medicare Claims 14 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 18 Medicare Claims 18 Services Paid

  • Wheelchairs (D1D)

    Standard wheelchair (HCPCS:K0001)

    1 DME suppliers used 14 Medicare Claims 14 Services Paid

Drugs and Nutritional Products

  • Other drugs (O1E)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    2 DME suppliers used 13 Medicare Claims 13 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 52537 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.67
  • Minimum New Patient Price $54.88
  • Maximum New Patient Price $167.71
  • Average New Patient Copayment $21.16
  • Minimum New Patient Copayment $13.72
  • Maximum New Patient Copayment $41.92

Established Patients Visit Costs *

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

  • Average Established Patient Price $98.29
  • Minimum Established Patient Price $17.04
  • Maximum Established Patient Price $137.36
  • Average Established Patient Copayment $24.57
  • Minimum Established Patient Copayment $4.26
  • Maximum Established Patient Copayment $34.34

* 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 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: 92.18 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: 97.77

    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: 77.65

    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.

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. Trina Settles is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
DAVIS COUNTY HOSPITAL509 NORTH MADISON STREET
BLOOMFIELD, IA 52537
(641) 664-2145Critical Access Hospitals

Reviews for DR. TRINA MARIE SETTLES DO

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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.
1104834712
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2104163872
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 0 + 4 + 1 + 6 + 3 + 8 + 7 + 2 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 22

The NPI number 1104834712 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 17 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1336221290 JOSEPH JEREMY KRUSER ARNP
Individual
Nurse Practitioner (Family)509 N MADISON ST
BLOOMFIELD, IA 52537
(515) 664-2145
1154644250MRS. LYNETTE SUE SMITH R.D., L.D.
Individual
Dietitian, Registered509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-2145
1477508190DAVIS COUNTY HOSPITAL
Organization
Medicare Defined Swing Bed Unit509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-2145
1942253570DAVIS COUNTY HOSPITAL
Organization
Home Health509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-3629
1437102068DAVIS COUNTY HOSPITAL
Organization
Skilled Nursing Facility509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-2145
1942255666DAVIS COUNTY HOSPITAL
Organization
General Acute Care Hospital (Critical Access)509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-2145
1487740486DAVIS COUNTY HOSPITAL
Organization
Specialist509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-2145
1821413667DAVIS COUNTY HOSPITAL
Organization
Clinic/Center (Rural Health)509 N MADISON ST STE 100
BLOOMFIELD, IA 52537
(641) 664-3832
1184234205 MEGAN WHISLER PNP
Individual
Nurse Practitioner (Pediatrics)509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-2145
1760482426MRS. DIANNE KAY KNAPP ARNP
Individual
Nurse Practitioner (Family)509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-3832
1023197704 BEVERLY JOYCE OLIVER
Individual
Nurse Practitioner (Family)509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-2145
1396738902 MARY L GRAEFF MD
Individual
Pediatrics509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-3832
1770590846DR. JOHN MARKUS DELEEUW DO
Individual
Internal Medicine509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-3832
1104532357 PAIGE MEREDITH HELTON
Individual
Nurse Practitioner (Family)509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-3832
1437526258 JESSICA CHRISTEN
Individual
Nurse Practitioner (Family)509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-3832
1740847045DR. SILAS HYUN SEOK SHIN DO
Individual
Family Medicine509 N MADISON ST
BLOOMFIELD, IA 52537
(434) 799-4488
1942793153 CATHERINE MARIE DURFLINGER ARNP
Individual
Nurse Practitioner509 N MADISON ST
BLOOMFIELD, IA 52537
(641) 664-3840

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104834712, enumerated in the NPI registry as an "individual" on August 03, 2006

The provider is located at 509 N Madison St Bloomfield, Ia 52537 and the phone number is (641) 664-2145

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 25 years of experience. She graduated from At Still University Of Health Sciences, College Of Osteo Med, Kirksville in 2000.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of July 02, 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.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.

Medicare beneficiaries should expect a typical cost of $84.67 with an average copayment of $21.16 for new patient appointments. Established patients should expect a typical charge of $98.29 and an average copayment of 24.57. Please review your insurance plan or contact the provider directly to determine your specific costs.

The practitioner is affiliated to the following hospital(s): DAVIS COUNTY HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on August 03, 2006. 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.