DR. HAROLD G. ASHCRAFT MD NPI 1114987401

Specialist in Johnstown, PA

NPI 1114987401 Individual Male Years of Experience 40 Specialist PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 97.1

NPI Profile for DR. HAROLD G. ASHCRAFT MD

Harold Ashcraft is a provider established in Johnstown, Pennsylvania and his medical specialization is specialist with more than 40 years of experience. He graduated from West Virginia University School Of Medicine in 1983. The NPI number of Harold Ashcraft is 1114987401 and was assigned on March 2006. The practitioner's primary taxonomy code is 174400000X with license number MD-045155-L (PA). The provider is registered as an individual and his NPI record was last updated 15 years ago.

Harold Ashcraft 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.

Harold Ashcraft is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Upmc Somerset.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 97.1, 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.

NPI

1114987401

Provider NameDR. HAROLD G. ASHCRAFT MD
Provider Location Address1086 FRANKLIN ST PATHOLOGY RM 205B JOHNSTOWN, PA 15905
Provider Mailing Address1086 FRANKLIN ST PATHOLOGY RM 205B JOHNSTOWN, PA 15905
GenderMale
NPI Entity TypeIndividual
Medical School NameWEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year1983
Is Sole Proprietor?N/A
Is Organization Subpart?N/A
Enumeration Date03-23-2006
Last Update Date07-08-2007


Primary Taxonomy

Taxonomy Code174400000X
ClassificationSpecialist
TypeOther Service Providers
License No.MD-045155-L
License StatePA
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Business Address

DR. HAROLD G. ASHCRAFT MD
1086 FRANKLIN ST
PATHOLOGY RM 205B
JOHNSTOWN, PA
ZIP 15905
Phone: (814) 534-9812
Fax: (814) 534-9372

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Mailing Address

DR. HAROLD G. ASHCRAFT MD
1086 FRANKLIN ST
PATHOLOGY RM 205B
JOHNSTOWN, PA
ZIP 15905
Phone: (814) 534-9812
Fax: (814) 534-9372



PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID7618142407
PECOS Enrollment IDI20111206000389
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 order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's 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.

MIPS Measure Score Weight Score
Quality 40% 100
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 (PI) 25% 78.3
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 15% 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 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 20% 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.
MIPS Final Score - 97.1
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.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 190Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)
  • 119Special stained specimen slides to examine tissue (HCPCS:88341)
  • 52Tissue or cell analysis by immunologic technique (HCPCS:88342)
  • 20Pathology examination of tissue using a microscope, moderately low complexity (HCPCS:88304)
  • 19Pathology examination of tissue using a microscope, moderately high complexity (HCPCS:88307)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Harold Ashcraft is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
UPMC SOMERSET225 SOUTH CENTER AVENUE
SOMERSET, PA 15501
(814) 443-5000Acute Care Hospitals390039

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
D42803MEDICARE UPIN (02)PA
522873MEDICARE ID-TYPE UNSPECIFIED (04)PA
0779958MEDICAID (05)PA

NPI Validation Check Digit Calculation


The following table explains step by step the 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.
1114987401
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
21241881440
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 2 + 4 + 1 + 8 + 8 + 1 + 4 + 4 + 0 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1114987401 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1669476149CONEMAUGH HEALTH INITIATIVES
Organization
Surgery (Trauma Surgery)1086 FRANKLIN ST GOOD SAMARITAN BLDG., GROUND FLOOR
JOHNSTOWN, PA 15905
(814) 534-9402
1629073069 WILLIAM FRITZ MD
Individual
Anesthesiology (Pain Medicine)1086 FRANKLIN ST STE A401
JOHNSTOWN, PA 15905
(814) 534-5138
1104822006DR. LIAN QIAN M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)1086 FRANKLIN ST RM 205B
JOHNSTOWN, PA 15905
(814) 534-9822
1841297389 STEPHEN LEE MILLER MD
Individual
Surgery (Surgical Critical Care)1086 FRANKLIN ST GOOD SAMARITAN BLDG., GROUND FLOOR
JOHNSTOWN, PA 15905
(814) 534-9402
1437143658 DANIEL R MEENAN MD
Individual
Anesthesiology1086 FRANKLIN ST SUITE A401
JOHNSTOWN, PA 15905
(814) 534-5138
1184618308 JASMAT N KANSAGRA MD
Individual
Anesthesiology1086 FRANKLIN ST SUITE A401
JOHNSTOWN, PA 15905
(814) 534-5138
1043204191CONEMAUGH HEALTH INITIATIVES
Organization
Internal Medicine1086 FRANKLIN ST
JOHNSTOWN, PA 15905
(814) 410-8300
1679556195DR. WAYNE LAWRENCE ROSEN DO
Individual
Radiology (Diagnostic Radiology)1086 FRANKLIN ST
JOHNSTOWN, PA 15905
(814) 539-5987
1568446946MR. RICHARD F SEIFERT DO
Individual
Anesthesiology1086 FRANKLIN ST SUITE A401
JOHNSTOWN, PA 15905
(814) 534-5138
1003894361 CHRISTINA DAVIS PA-C
Individual
Physician Assistant (Medical)1086 FRANKLIN ST E3
JOHNSTOWN, PA 15905
(814) 534-5592
1407826779 GEORGE B LEE CRNA
Individual
Specialist1086 FRANKLIN ST
JOHNSTOWN, PA 15905
(814) 534-9321
1730154733 SHEHUI JOHN ZHANG MD
Individual
Anesthesiology1086 FRANKLIN ST SUITE A401
JOHNSTOWN, PA 15905
(814) 534-5138
1700854221 MATTHEW W ELCHIN PA-C
Individual
Physician Assistant1086 FRANKLIN ST
JOHNSTOWN, PA 15905
(814) 539-5987
1932178894 LORETTA A OPILA MD
Individual
Emergency Medicine1086 FRANKLIN ST CONEMAUGH EMERGENCY PHYSICIANS GROUP
JOHNSTOWN, PA 15905
(814) 534-9600
1588633473 SUDHA BABRA MD
Individual
Emergency Medicine1086 FRANKLIN ST CONEMAUGH EMERGENCY PHYSICIANS GROUP
JOHNSTOWN, PA 15905
(814) 534-9600
1225007552 JONATHAN L BARNHART MD
Individual
Emergency Medicine1086 FRANKLIN ST CONEMAUGH EMERGENCY PHYSICIANS GROUP
JOHNSTOWN, PA 15905
(814) 534-9600
1417916578 MICHAEL H LEWITT MD
Individual
Emergency Medicine1086 FRANKLIN ST CONEMAUGH EMERGENCY PHYSICIANS GROUP
JOHNSTOWN, PA 15905
(814) 534-9600
1649230996DR. JOHN F. YERGER MD
Individual
Specialist1086 FRANKLIN ST PATHOLOGY RM 205B
JOHNSTOWN, PA 15905
(814) 534-9812
1841250818DR. WAHEEB M. RIZKALLA MD
Individual
Specialist1086 FRANKLIN ST PATHOLOGY RM 205B
JOHNSTOWN, PA 15905
(814) 534-9812
1407816382DR. MANJUNATH S. HEGGERE MD
Individual
Specialist1086 FRANKLIN ST PATHOLOGY RM 205B
JOHNSTOWN, PA 15905
(814) 534-9812

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Harold G. Ashcraft Md is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.