STEPHANIE M RINALDI OT, MS NPI 1124326087
Occupational Therapist in Westfield, NJ

Individual Female Years of Experience 13 Occupational Therapist Accepts Medicare Approved Payment MIPS Quality Score 78.6

About STEPHANIE M RINALDI OT, MS

Stephanie Rinaldi is a provider established in Westfield, New Jersey and her medical specialization is Occupational Therapist with more than 13 years of experience. The NPI number of Stephanie Rinaldi is 1124326087 and was assigned on March 2011. The practitioner's primary taxonomy code is 225X00000X with license number 46TR00541700 (NJ). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI
1124326087
Provider Name STEPHANIE M RINALDI OT, MS
Provider Location Address1124 SOUTH AVE W WESTFIELD, NJ 07090
Provider Mailing AddressPO BOX 1014 CLARK, NJ 07066
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2010
Is Sole Proprietor?No
Enumeration Date03-02-2011
Last Update Date01-15-2018

Stephanie Rinaldi 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.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 78.6, 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.



Primary Taxonomy

Taxonomy Code225X00000X
ClassificationOccupational Therapist
TypeRespiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.46TR00541700
License StateNJ
Taxonomy DescriptionAn occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

Business Address

STEPHANIE M RINALDI OT, MS
1124 SOUTH AVE W
WESTFIELD, NJ
ZIP 07090
Phone: (908) 233-1222

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Mailing Address

STEPHANIE M RINALDI OT, MS
PO BOX 1014
CLARK, NJ
ZIP 07066
Phone: (732) 855-9751
Fax: (732) 855-9755


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.

PECOS PAC ID8022295005
PECOS Enrollment IDI20110531000036
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.

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% 73.4
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% 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 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 - 78.6
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.

  • 789Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes (HCPCS:97530)
  • 588Manual (physical) therapy techniques to 1 or more regions, each 15 minutes (HCPCS:97140)
  • 36Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes (HCPCS:97112)
  • 34Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes (HCPCS:97110)
  • 33Occupational therapy evaluation (HCPCS:97003)

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.
1124326087
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
21446212016
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 4 + 4 + 6 + 2 + 1 + 2 + 0 + 1 + 6 + 24 = 53
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 53 = 77

The NPI number 1124326087 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 11 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1194820191 MICHAEL B BAUMER PT
Individual
Physical Therapist1124 SOUTH AVE W
WESTFIELD, NJ 07090
(908) 233-1222
1225538432TWIN BORO PHYSICAL THERAPY ASSOCIATES PA
Organization
Occupational Therapist1124 SOUTH AVE W
WESTFIELD, NJ 07090
(908) 233-1222
1497770846 HEIDI ACKERMAN PT
Individual
Physical Therapist1124 SOUTH AVE W
WESTFIELD, NJ 07090
(908) 233-1222
1417236753 JESSICA GARRY KLASKIN PT, DPT
Individual
Physical Therapist1124 SOUTH AVE W
WESTFIELD, NJ 07090
(908) 233-1222
1801396627 THOMAS V. NAPATANO PT, DPT
Individual
Physical Therapist1124 SOUTH AVE W
WESTFIELD, NJ 07090
(908) 233-1222
1487679379 NANCY A. PIDANE PT
Individual
Physical Therapist1124 SOUTH AVE W
WESTFIELD, NJ 07090
(908) 233-1222
1033625942 JESSICA RAMIREZ OTR
Individual
Occupational Therapist1124 SOUTH AVE W
WESTFIELD, NJ 07090
(908) 233-1222
1275004095 CLAIRE MARIE PERFETTI DPT
Individual
Physical Therapist1124 SOUTH AVE W
WESTFIELD, NJ 07090
(908) 233-1222
1003011156 MAHALIA ELAINE S ONG OTR/L, CHT, CLT
Individual
Occupational Therapist1124 SOUTH AVE W
WESTFIELD, NJ 07090
(908) 233-1222
1154091221 OLIVIA GRACE WILKERSON DPT
Individual
Physical Therapist1124 SOUTH AVE W
WESTFIELD, NJ 07090
(908) 233-1222
1649926924DR. RYAN ROBERT VRINDTEN PT, DPT
Individual
Physical Therapist (Orthopedic)1124 SOUTH AVE W
WESTFIELD, NJ 07090
(908) 233-1222

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
Stephanie M Rinaldi Ot, Ms 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.