MARK WALSH DO
NPI 1174513675
Physical Medicine & Rehabilitation in Reading, PA


Quality Rating: 100 out of 100 score

NPI Status: Active since October 26, 2005

Contact Information

1623 MORGANTOWN RD
READING, PA
ZIP 19607
Phone: (272) 228-0476

Get Directions Write a Review

  • Individual
  • Male
  • Physical Medicine & Rehabilitation
  • PECOS Enrolled
  • Medicare Quality Reporting

About MARK WALSH

This page provides the complete NPI Profile along with additional information for Mark Walsh, a provider established in Reading, Pennsylvania with a medical specialization in Physical Medicine & Rehabilitation. The healthcare provider is registered in the NPI registry with number 1174513675 assigned on October 2005. The practitioner's primary taxonomy code is 208100000X with license number OS007757L (PA). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1174513675
Provider Name
MARK WALSH DO
Gender
Male
Entity Type
Individual
Location Address
1623 MORGANTOWN RD READING, PA 19607
Location Phone
(272) 228-0476
Mailing Address
1623 MORGANTOWN RD READING, PA 19607
Mailing Phone
(226) 228-0476
Is Sole Proprietor?
No
Enumeration Date
10-26-2005
Last Update Date
07-24-2019
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

Physical Medicine & Rehabilitation

Taxonomy Code
208100000X
Type
Allopathic & Osteopathic Physicians
License No.
OS007757L
License State
PA
Taxonomy Description
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.

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.

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
50076569OTHER (01)PACAPITAL BLUE CROSS
001540071-0005MEDICAID (05)PA 
1775120OTHER (01)PABLUE CARE
20041481OTHER (01)PAAMERIHEALTH
819322OTHER (01)PABLUE CARE HMO (FPH)
001540071OTHER (01)PAMEDICAL ASSISTANCE
4407486OTHER (01)PAAETNA
P00292337OTHER (01)PARAILROAD MEDICARE
95285-1067OTHER (01)PAGEISINGER

Medicare Participation & PECOS Enrollment Status

Mark Walsh 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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE000N)

    Walker, folding, wheeled, adjustable or fixed height (HCPCS:E0143)

    1 DME suppliers used 22 Medicare Claims 22 Services Paid

  • DME-Other DME (DE000N)

    Walker, heavy duty, wheeled, rigid or folding, any type (HCPCS:E0149)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Other DME (DE000N)

    Commode chair, mobile or stationary, with fixed arms (HCPCS:E0163)

    2 DME suppliers used 23 Medicare Claims 23 Services Paid

  • DME-Other DME (DE000N)

    Commode chair, mobile or stationary, with detachable arms (HCPCS:E0165)

    2 DME suppliers used 25 Medicare Claims 25 Services Paid

  • DME-Hospital Beds (DB000N)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

    2 DME suppliers used 66 Medicare Claims 66 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    1 DME suppliers used 66 Medicare Claims 66 Services Paid

  • DME-Other DME (DE000N)

    Transfer device, any type, each (HCPCS:E0705)

    2 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Wheelchairs (DD021N)

    Manual wheelchair accessory, anti-tipping device, each (HCPCS:E0971)

    1 DME suppliers used 76 Medicare Claims 152 Services Paid

  • DME-Wheelchairs (DD021N)

    Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each (HCPCS:E0973)

    1 DME suppliers used 44 Medicare Claims 88 Services Paid

  • DME-Wheelchairs (DD021N)

    Wheelchair accessory, positioning belt/safety belt/pelvic strap, each (HCPCS:E0978)

    1 DME suppliers used 29 Medicare Claims 29 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    2 DME suppliers used 116 Medicare Claims 116 Services Paid

  • DME-Wheelchairs (DD021N)

    General use wheelchair seat cushion, width less than 22 inches, any depth (HCPCS:E2601)

    2 DME suppliers used 25 Medicare Claims 25 Services Paid

  • DME-Wheelchairs (DD000N)

    Standard wheelchair (HCPCS:K0001)

    3 DME suppliers used 107 Medicare Claims 107 Services Paid

  • DME-Wheelchairs (DD000N)

    Lightweight wheelchair (HCPCS:K0003)

    1 DME suppliers used 51 Medicare Claims 51 Services Paid

  • DME-Wheelchairs (DD000N)

    Heavy duty wheelchair (HCPCS:K0006)

    2 DME suppliers used 14 Medicare Claims 14 Services Paid

  • DME-Wheelchairs (DD021N)

    Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)

    1 DME suppliers used 83 Medicare Claims 83 Services Paid

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.

Follow-up hospital inpatient care per day, typically 15 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 303 times for 139 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 1,253 times for 237 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 110 times for 73 patients

Hospital discharge day management, 30 minutes or less

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

This service was performed 172 times for 163 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 265 times for 239 patients

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 100, 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 provider also has detailed performance information the following quality measures: .

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.

  • Final Score: 100 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.

  • Quality Score: 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 Score: 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 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: 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.

  • Cost Score: 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 Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Advance Care Plan 100% 302
Documentation of Current Medications in the Medical Record 100% 336

Reviews for MARK WALSH DO

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

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 1174513675, we treat the final digit (5) 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 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

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
7
Doubled → 14 → 1 + 4
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
1
Unchanged
Pos 7
3
Doubled → 6
Pos 8
6
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
5
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 7 → 14 → 5 5 → 10 → 1 3 → 6 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 + 4 + 4 + 1 + 0 + 1 + 6 + 6 + 1 + 4 + 24 = 55

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

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1174513675.

Other Providers at the Same Location


The following 19 providers are registered at the same or a nearby location.

Physical Medicine & Rehabilitation
1623 MORGANTOWN RD
READING, PA 19607
Physical Medicine & Rehabilitation
1623 MORGANTOWN RD
READING, PA 19607
Physical Medicine & Rehabilitation
1623 MORGANTOWN RD
READING, PA 19607
Occupational Therapist
1623 MORGANTOWN RD
READING, PA 19607
Physical Medicine & Rehabilitation
1623 MORGANTOWN RD
READING, PA 19607
Internal Medicine
1623 MORGANTOWN RD
READING, PA 19607
Clinical Neuropsychologist
1623 MORGANTOWN RD
READING, PA 19607
Family Medicine
1623 MORGANTOWN RD
READING, PA 19607
Clinic/Center (Rehabilitation)
1623 MORGANTOWN RD
READING, PA 19607
Physical Medicine & Rehabilitation
1623 MORGANTOWN RD
READING, PA 19607
Nurse Practitioner (Gerontology)
1623 MORGANTOWN RD
READING, PA 19607
Occupational Therapist
1623 MORGANTOWN RD
READING, PA 19607
Hospitalist
1623 MORGANTOWN RD
READING, PA 19607
Internal Medicine
1623 MORGANTOWN RD
READING, PA 19607
Physical Medicine & Rehabilitation
1623 MORGANTOWN RD
READING, PA 19607
Psychologist (Clinical)
1623 MORGANTOWN RD, HEALTHSOUTH READING REHABILITATION HOSPITAL
READING, PA 19607
Rehabilitation Hospital
1623 MORGANTOWN RD
READING, PA 19607
Internal Medicine
1623 MORGANTOWN RD
READING, PA 19607
Psychiatry & Neurology (Neurology)
1623 MORGANTOWN RD
READING, PA 19607

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174513675, enumerated as an "individual" on October 26, 2005.

The provider is located at 1623 MORGANTOWN RD READING, PA 19607 and the phone number is (272) 228-0476.

Physical Medicine & Rehabilitation with taxonomy code 208100000X.

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