DR. ALI DELBAKHSH M.D.
NPI 1154365872
Internal Medicine - Cardiovascular Disease in El Cajon, CA

NPI Status: Active since June 15, 2006

Contact Information

300 S PIERCE ST
SUITE 102
EL CAJON, CA
ZIP 92020
Phone: (619) 668-4700
Fax: (619) 668-0049

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  • Individual
  • Male
  • Internal Medicine
  • Cardiovascular Disease
  • PECOS Enrolled
  • Medicare Quality Reporting

About ALI DELBAKHSH

This page provides the complete NPI Profile along with additional information for Ali Delbakhsh, an internist established in El Cajon, California with a medical specialization in Internal Medicine, focusing in cardiovascular disease . The healthcare provider is registered in the NPI registry with number 1154365872 assigned on June 2006. The practitioner's primary taxonomy code is 207RC0000X with license number C10007278 (DE). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1154365872
Provider Name
DR. ALI DELBAKHSH M.D.
Gender
Male
Entity Type
Individual
Location Address
300 S PIERCE ST SUITE 102 EL CAJON, CA 92020
Location Phone
(619) 668-4700
Location Fax
(619) 668-0049
Mailing Address
300 S PIERCE ST SUITE 102 EL CAJON, CA 92020
Mailing Phone
(619) 668-4700
Mailing Fax
(619) 668-0049
Is Sole Proprietor?
No
Enumeration Date
06-15-2006
Last Update Date
09-29-2014
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An internist like Ali Delbakhsh is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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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

Internal Medicine Cardiovascular Disease

Taxonomy Code
207RC0000X
Type
Allopathic & Osteopathic Physicians
License No.
C10007278
License State
DE
Taxonomy Description
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

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
I121141MEDICARE UPIN (02) 
015220C16MEDICARE ID-TYPE UNSPECIFIED (04)DE 
1154365872MEDICAID (05)DE 
BN688ZMEDICARE PIN (08)CA 

Medicare Participation & PECOS Enrollment Status

Ali Delbakhsh 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 92020 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $140.22
  • Minimum New Patient Price $62.1
  • Maximum New Patient Price $184.71
  • Average New Patient Copayment $35.05
  • Minimum New Patient Copayment $15.52
  • Maximum New Patient Copayment $46.17

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $76.87
  • Minimum Established Patient Price $20.62
  • Maximum Established Patient Price $151.42
  • Average Established Patient Copayment $19.21
  • Minimum Established Patient Copayment $5.15
  • Maximum Established Patient Copayment $37.85

* 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
Diabetes: Medical Attention for Nephropathy 95% 453
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Documentation of Current Medications in the Medical Record 93% 3899
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
e-Prescribing 99% 3547
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Falls: Screening for Future Fall Risk 55% 1180
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Medication Reconciliation 95% 101
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 23% 1797
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Pneumococcal Vaccination Status for Older Adults 30% 1182
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 35% 2042
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
Preventive Care and Screening: Screening for Depression and Follow-Up Plan 18% 1752
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 85% 181
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical RecordYesN/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 82% 1797
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.
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.YesN/A
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.
Secure Messaging 5% 1797
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/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.

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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 1154365872, 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
5
Doubled → 10 → 1 + 0
Pos 4
4
Unchanged
Pos 5
3
Doubled → 6
Pos 6
6
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
8
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
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 5 → 10 → 1 3 → 6 5 → 10 → 1 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 0 + 4 + 6 + 6 + 1 + 0 + 8 + 1 + 4 + 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 1154365872.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Physician Assistant (Medical)
300 S PIERCE ST, SUITE 102
EL CAJON, CA 92020
Orthopaedic Surgery
300 S PIERCE ST, SUITE 202
EL CAJON, CA 92020
Physician Assistant
300 S PIERCE ST
EL CAJON, CA 92020
Internal Medicine (Cardiovascular Disease)
300 S PIERCE ST, #102
EL CAJON, CA 92020
Internal Medicine (Interventional Cardiology)
300 S PIERCE ST, SUITE 102
EL CAJON, CA 92020
Internal Medicine (Rheumatology)
300 S PIERCE ST
EL CAJON, CA 92020

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154365872, enumerated as an "individual" on June 15, 2006.

The provider is located at 300 S PIERCE ST SUITE 102 EL CAJON, CA 92020 and the phone number is (619) 668-4700.

Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.

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