MRS. COLLEEN A SMITH FNPC
NPI 1104904192
Obstetrics & Gynecology in Utica, NY

NPI Status: Active since November 01, 2006

Contact Information

3 PARKSIDE CT
UTICA, NY
ZIP 13501
Phone: (315) 724-6787
Fax: (315) 735-6624

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  • Individual
  • Female
  • Obstetrics & Gynecology
  • PECOS Enrolled
  • Medicare Quality Reporting

About COLLEEN SMITH

This page provides the complete NPI Profile along with additional information for Colleen Smith, a women's health care provider established in Utica, New York with a medical specialization in Obstetrics & Gynecology. The healthcare provider is registered in the NPI registry with number 1104904192 assigned on November 2006. The practitioner's primary taxonomy code is 207V00000X with license number F3318581 (NY). The provider is registered as an individual and her NPI record was last updated 19 years ago.

NPI
1104904192
Provider Name
MRS. COLLEEN A SMITH FNPC
Gender
Female
Entity Type
Individual
Location Address
3 PARKSIDE CT UTICA, NY 13501
Location Phone
(315) 724-6787
Location Fax
(315) 735-6624
Mailing Address
3 PARKSIDE CT UTICA, NY 13501
Mailing Phone
(315) 724-6787
Mailing Fax
(315) 735-6624
Is Sole Proprietor?
No
Enumeration Date
11-01-2006
Last Update Date
07-08-2007
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Women's health care providers like Colleen Smith treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

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

Obstetrics & Gynecology

Taxonomy Code
207V00000X
Type
Allopathic & Osteopathic Physicians
License No.
F3318581
License State
NY
Taxonomy Description
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Insurance Plans Accepted

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

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
G67061MEDICARE UPIN (02) 
CC8145MEDICARE ID-TYPE UNSPECIFIED (04) 

Medicare Participation & PECOS Enrollment Status

Colleen Smith 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

  • 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

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 13501 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
Breast Cancer Screening 83% 181
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Colorectal Cancer Screening 86% 259
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Diabetes: Foot Exam 82% 55
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
Documentation of Current Medications in the Medical Record 99% 739
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
Electronic submission of Patient Centered Medical Home accreditationYesN/A
I attest that I am a Patient Centered Medical Home (PCMH) or Comparable Specialty Practice that has achieved certification from a national program, regional or state program, private payer, or other body that administers patient-centered medical home accreditation and should receive full credit for the Improvement Activities performance category.
Implementation of formal quality improvement methods, practice changes, or other practice improvement processesYesN/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
Pneumococcal Vaccination Status for Older Adults 91% 136
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Population empanelmentYesN/A
Empanel (assign responsibility for) the total population, linking each patient to a MIPS eligible clinician or group or care team. Empanelment is a series of processes that assign each active patient to a MIPS eligible clinician or group and/or care team, confirm assignment with patients and clinicians, and use the resultant patient panels as a foundation for individual patient and population health management. Empanelment identifies the patients and population for whom the MIPS eligible clinician or group and/or care team is responsible and is the foundation for the relationship continuity between patient and MIPS eligible clinician or group /care team that is at the heart of comprehensive primary care. Effective empanelment requires identification of the “active population” of the practice: those patients who identify and use your practice as a source for primary care. There are many ways to define “active patients” operationally, but generally, the definition of “active patients” includes patients who have sought care within the last 24 to 36 months, allowing inclusion of younger patients who have minimal acute or preventive health care.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 94% 465
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Use evidence-based decision aids to support shared decision-making.YesN/A
Use evidence-based decision aids to support shared decision-making.

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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 1104904192, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

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
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
0
Unchanged
Pos 7
4
Doubled → 8
Pos 8
1
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
2
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 0 → 0 9 → 18 → 9 4 → 8 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 0 + 4 + 1 + 8 + 0 + 8 + 1 + 1 + 8 + 24 = 58

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

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1104904192.

Other Providers at the Same Location


The following 18 providers are registered at the same or a nearby location.

Obstetrics & Gynecology
3 PARKSIDE CT
UTICA, NY 13501
Obstetrics & Gynecology
3 PARKSIDE CT
UTICA, NY 13501
Urology
3 PARKSIDE CT
UTICA, NY 13501
Obstetrics & Gynecology
3 PARKSIDE CT
UTICA, NY 13501
Occupational Therapist
3 PARKSIDE CT
UTICA, NY 13501
Speech-Language Pathologist
3 PARKSIDE CT
UTICA, NY 13501
Physical Therapist
3 PARKSIDE CT
UTICA, NY 13501
Speech-Language Pathologist
3 PARKSIDE CT
UTICA, NY 13501
Physical Therapist
3 PARKSIDE CT
UTICA, NY 13501
Speech-Language Pathologist
3 PARKSIDE CT
UTICA, NY 13501
Occupational Therapist (Pediatrics)
3 PARKSIDE CT
UTICA, NY 13501
Speech-Language Pathologist
3 PARKSIDE CT
UTICA, NY 13501
Occupational Therapist
3 PARKSIDE CT
UTICA, NY 13501
Obstetrics & Gynecology
3 PARKSIDE CT
UTICA, NY 13501
Obstetrics & Gynecology
3 PARKSIDE CT
UTICA, NY 13501
Nurse Practitioner (Family)
3 PARKSIDE CT
UTICA, NY 13501
Dental Hygienist
3 PARKSIDE CT
UTICA, NY 13501
Dental Hygienist
3 PARKSIDE CT
UTICA, NY 13501

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104904192, enumerated as an "individual" on November 01, 2006.

The provider is located at 3 PARKSIDE CT UTICA, NY 13501 and the phone number is (315) 724-6787.

Obstetrics & Gynecology with taxonomy code 207V00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.