ROLAND ZSOLT GERENCER MD
NPI 1144218892
Otolaryngology in Albuquerque, NM
Quality Rating: 84.14 out of 100 score
NPI Status: Active since October 06, 2005
Contact Information
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
Phone: (505) 842-8171
Fax: (505) 246-0684
- Individual
- Male
- Years of Experience 33
- Otolaryngology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About ROLAND GERENCER
This page provides the complete NPI Profile along with additional information for Roland Gerencer, a provider established in Albuquerque, New Mexico with a medical specialization in Otolaryngology and more than 33 years of experience. The healthcare provider is registered in the NPI registry with number 1144218892 assigned on October 2005. The practitioner's primary taxonomy code is 207Y00000X with license number 99-208 (NM). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1144218892
- Provider Name
- ROLAND ZSOLT GERENCER MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4901 LANG AVE NE ALBUQUERQUE, NM 87109
- Location Phone
- (505) 842-8171
- Location Fax
- (505) 246-0684
- Mailing Address
- 1020 TIJERAS AVE NE STE 22 ALBUQUERQUE, NM 87106
- Mailing Phone
- (505) 858-8503
- Mailing Fax
- (505) 246-0684
- Medical School Name
- OTHER
- Graduation Year
- 1993
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-06-2005
- Last Update Date
- 10-04-2021
- Code Navigator
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
Otolaryngology
- Taxonomy Code
- 207Y00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 99-208
- License State
- NM
- Taxonomy Description
- An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue ACA StandardHealth Silver with Health Choice - HMO
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.
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 |
|---|---|---|---|
| 040014203 | OTHER (01) | GBA PALMETTO - RAILROAD MEDICARE | |
| Z6104 | MEDICAID (05) | NM | |
| 201021487 | OTHER (01) | NM | PRESBYTERIAN HEALTH PLAN |
| NM024902 | OTHER (01) | NM | BCBS |
Medicare Participation & PECOS Enrollment Status
Roland Gerencer 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.
Roland Gerencer 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: 1456240050
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: I20040312000034
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
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Destruction of soft tissue of nasal passages
Diagnostic exam of nasal passages using an endoscope
Diagnostic exam of voice box using a flexible endoscope
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Evaluation of sleep-disordered breathing by examination of upper airway using an endoscope
Exam of the nose and throat using an endoscope
Insertion of hypoglossal nerve neurostimulator electrode and generator and breathing sensor electrode
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Removal of nasal air passage under lining tissue
Removal of nasal sinus tissue using an endoscope
Reshaping of nasal cartilage
Destruction of soft tissue in the nasal passages involves removing or reducing specific tissues in your nose that may be causing problems such as blockages or excessive snoring. The procedure is performed by a medical professional using specialized tools and techniques. It's typically safe and effective.
This service was performed 40 times for 18 patientsA diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
This service was performed 91 times for 64 patientsThis procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
This service was performed 126 times for 116 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 19 times for 13 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 89 times for 63 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 43 times for 40 patientsThis procedure examines your upper airway for sleep-related breathing issues. An endoscope, a thin tube with a light and camera, is gently inserted through your nose. This allows a detailed view of your airway to identify any abnormalities that could disrupt your sleep.
This service was performed 50 times for 49 patientsAn endoscopic examination of the nose and throat is a procedure where a thin, flexible tube with a light and camera attached (endoscope) is used to view these areas in detail. It helps identify any abnormalities or issues that may be causing symptoms like difficulty swallowing, persistent cough, or nasal congestion.
This service was performed 43 times for 39 patientsThis procedure involves placing a device that stimulates the hypoglossal nerve, which controls tongue movement. A generator powers the device and a sensor monitors your breathing. This helps keep the airway open during sleep, improving conditions like sleep apnea.
This service was performed 26 times for 26 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 26 times for 26 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 111 times for 111 patientsThis procedure, often done to improve breathing or address sinus issues, involves the removal of tissue from the lining of the nasal air passage. It's performed under anesthesia and recovery time varies based on individual health status.
This service was performed 27 times for 27 patientsThis procedure, known as endoscopic sinus surgery, involves using a thin, flexible tube with a light and camera to view and remove problematic nasal sinus tissue. It helps to alleviate sinus issues and improve breathing.
This service was performed 12 times for 12 patientsReshaping of nasal cartilage, also known as rhinoplasty, is a surgical procedure to modify the structure of the nose for aesthetic or functional purposes. It involves adjusting the cartilage and bone in the nose to achieve the desired shape or to improve breathing.
This service was performed 26 times for 26 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.55 for a new patient copayment and $17 for an established patient copayment.
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 87109 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.21
- Minimum New Patient Price $54.26
- Maximum New Patient Price $166.8
- Average New Patient Copayment $31.55
- Minimum New Patient Copayment $13.56
- Maximum New Patient Copayment $41.7
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68
- Minimum Established Patient Price $17
- Maximum Established Patient Price $135.35
- Average Established Patient Copayment $17
- Minimum Established Patient Copayment $4.25
- Maximum Established Patient Copayment $33.83
* 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 provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 84.14, 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 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.
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Final Score: 84.14 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.
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Quality Score: 75.53
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.
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Promoting Interoperability Score: 90
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: 79.93
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: 79.93
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.
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 |
|---|---|---|
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 1% | 1631 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
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. Roland Gerencer is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| LOVELACE MEDICAL CENTER | 601 DR MARTIN LUTHER KING JR AVE NE ALBUQUERQUE, NM 87102 | (505) 727-8000 | 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 | 4 | 4 | 2 | 1 | 8 | 8 | 9 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 8 | 4 | 4 | 1 | 16 | 8 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 8 + 4 + 4 + 1 + 1 + 6 + 8 + 1 + 8 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1144218892 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 20 providers are registered at the same or nearby location.
MR. CHRISTOPHER LEON GRAY PA-C
Physician Assistant
(Medical)
4901 LANG AVE NE
SUITE 100
ALBUQUERQUE, NM
ZIP 87109
MS. ANGELA R MONTGOMERY PA-C
Physician Assistant
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
DR. BARBARA JOAN MCGUIRE MD
Internal Medicine
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
NAVITAS NEW MEXICO LLC
Clinic/Center
(Rehabilitation)
4901 LANG AVE NE
SUITE 100
ALBUQUERQUE, NM
ZIP 87109
MOBILE IMAGING ASSOCIATES LLC
Clinic/Center
(Magnetic Resonance Imaging (MRI))
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
ALICIA TAYLOR
Radiologic Technologist
(Radiation Therapy)
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
MRS. AMANDA L CANNADY PT, CLT
Community Health Worker
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
MRS. SAMANTHA FELDNER MARBURY PHARM D
Pharmacist
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
BREATHEAMERICA ALBUQUERQUE, INC.
Allergy & Immunology
(Allergy)
4901 LANG AVE NE
SUITE 100
ALBUQUERQUE, NM
ZIP 87109
JESSE RAEL MD
Radiology
(Diagnostic Radiology)
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
EDDIE G BENGE MD
Internal Medicine
(Rheumatology)
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
ANDREA KAY VERYSER MD
Internal Medicine
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
DR. MARY DICARLO
Internal Medicine
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
SURGICAL ONCOLOGY AND GASTROINTESTINAL SURGERY CONSULTANTS LLC
Surgery
4901 LANG AVE NE
SUITE 202
ALBUQUERQUE, NM
ZIP 87109
DR. EDWARD BENJAMIN CAZZOLA MD
Internal Medicine
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
GLENROY HEYWOOD MD
Surgery
4901 LANG AVE NE
SUITE 202
ALBUQUERQUE, NM
ZIP 87109
NEW MEXICO CENTER FOR MINIMALLY INVASIVE THERAPIES
Radiology
(Vascular & Interventional Radiology)
4901 LANG AVE NE
SUITE 202
ALBUQUERQUE, NM
ZIP 87109
TRUECARE LLC
Family Medicine
4901 LANG AVE NE
STE 202
ALBUQUERQUE, NM
ZIP 87109
DR. MARVIN ANTONIO PORFIRO SISON DUQUE M.D.
Internal Medicine
(Hematology & Oncology)
4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109
PAUL MICHAEL TAPIA PA-C
Physician Assistant
(Medical)
4901 LANG AVE NE
STE 100
ALBUQUERQUE, NM
ZIP 87109
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1144218892, enumerated as an "individual" on October 06, 2005.
The provider is located at 4901 LANG AVE NE ALBUQUERQUE, NM 87109 and the phone number is (505) 842-8171.
Otolaryngology with taxonomy code 207Y00000X.
The provider might be accepting Accepts: Blue Cross Blue Shield of Arizona, Railroad. Please consult your insurance carrier or call the provider to verify.
Roland Gerencer is affiliated with: LOVELACE MEDICAL CENTER.
