REGINA P QUINAIN M.D.
NPI 1174520373
Family Medicine in Leesburg, FL
NPI Status: Active since July 01, 2005
Contact Information
225 N 1ST ST
LEESBURG, FL
ZIP 34748
Phone: (407) 905-8827
Fax: (352) 360-2389
- Individual
- Female
- Years of Experience 35
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About REGINA QUINAIN
This page provides the complete NPI Profile along with additional information for Regina Quinain, a primary care provider established in Leesburg, Florida with a medical specialization in Family Medicine and more than 35 years of experience. The healthcare provider is registered in the NPI registry with number 1174520373 assigned on July 2005. The practitioner's primary taxonomy code is 207Q00000X with license number ME86261 (FL). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1174520373
- Provider Name
- REGINA P QUINAIN M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 225 N 1ST ST LEESBURG, FL 34748
- Location Phone
- (407) 905-8827
- Location Fax
- (352) 360-2389
- Mailing Address
- 110 S WOODLAND ST WINTER GARDEN, FL 34787
- Mailing Phone
- (407) 905-8827
- Mailing Fax
- (352) 360-2389
- Medical School Name
- OTHER
- Graduation Year
- 1991
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-01-2005
- Last Update Date
- 01-28-2021
- Code Navigator
A primary care provider (PCP) like Regina Quinain sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- ME86261
- License State
- FL
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete VALUE Gold - HMO
- Focused VALUE Silver - HMO
- Focused VALUE Silver + Vision + Adult Dental - HMO
- Standard Gold VALUE - HMO
- Standard Silver VALUE - HMO
- Standard Silver VALUE + Vision + Adult Dental - HMO
- Clarity Silver - HMO
- Clarity VALUE Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete VALUE Gold - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite VALUE Bronze - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Focused VALUE Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze VALUE - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
- BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-06 (Rewards) - PPO
- BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
- BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - PPO
- BlueOptions Silver 24J01-03 ($10 Labs / Rewards) - PPO
- BlueOptions Silver 24J01-07 ($50 PCP Visits / Rewards) - PPO
- BlueOptions Silver 24J01-19S ($40 PCP Visits / $80 Specialist Visits / Rewards) - PPO
- BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
- BlueSelect Bronze 1449 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - EPO
- BlueSelect Bronze 2139 ($50 PCP Visits / Rewards) - EPO
- BlueSelect Bronze 2139E ($50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
- BlueSelect Bronze 2139V ($50 PCP Visits / Adult Vision / Rewards) - EPO
- BlueSelect Bronze 2342S ($50 PCP Visits / Rewards) - EPO
- BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
- BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K01-05 (Rewards) - POS
- BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K02-18 (Rewards) - POS
- BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
- BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
- BlueCare Gold 24K01-10 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - POS
- BlueCare Gold 24K01-33S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
- BlueCare Gold 24K02-20 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
- BlueCare Gold 24K02-28S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-04 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-07 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K02-15 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
- BlueCare Silver 24K01-02 ($10 Labs / Rewards) - POS
- Bronze 1826 ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
- Bronze 1826 + Adult Dental + Adult Vision ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
- Bronze Savings 1820 (Primary Care Copay Visits 1-5, Open Access) - HMO
- Bronze Savings 1820 + Adult Dental + Adult Vision (Primary Care Copay Visits 1-5, Open Access) - HMO
- Bronze Standard 1828 - HMO
- Bronze Value 1814 (High Value Network Savings, Open Access) - HMO
- Bronze Value 1814 + Adult Dental + Adult Vision (High Value Network Savings, Open Access) - HMO
- Catastrophic 1746 (Primary Care Copay Visits 1-3, Open Access) - HMO
- Gold 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
- Gold 1742 + Adult Dental + Adult Vision (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
- Gold Savings 1825 ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
- Gold Savings 1825 + Adult Dental + Adult Vision ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
- Gold Standard 1833 - HMO
- Gold Value 1819 ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
- Gold Value 1819 + Adult Dental + Adult Vision ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
- Gold Value 1819 + Enhanced Diabetes Benefits ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
- Silver 1664 (Primary Care & Specialist Copays, Open Access) - HMO
- Silver 1664 + Adult Dental + Adult Vision (Primary Care & Specialist Copays, Open Access) - HMO
- Silver Savings 1821 (Primary Care Copay, Open Access) - HMO
- Silver Savings 1821 + Adult Dental + Adult Vision (Primary Care Copay, Open Access) - HMO
- Molina Bronze Enhanced 3500 - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Vision - HMO
- Molina Bronze Standard - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Core 1640 Plus with Adult Vision - HMO
- Molina Gold Enhanced 895 - HMO
- Molina Gold Enhanced 895 Plus with Adult Dental and Vision - HMO
- Molina Gold Enhanced 895 Plus with Adult Vision - HMO
- Molina Gold Standard - HMO
- Molina Silver Access - HMO
- Molina Silver Access Plus with Adult Dental and Vision - HMO
- Molina Silver Access Plus with Adult Vision - HMO
- Molina Silver Core - HMO
- Molina Silver Core Plus with Adult Dental and Vision - HMO
- Molina Silver Core Plus with Adult Vision - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 | with AdventHealth - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard | with AdventHealth - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Bronze Simple Diabetes - HMO
- Gold Classic Standard - HMO
- Gold Classic Standard | with AdventHealth - HMO
- Gold Elite Saver Plus | with AdventHealth - HMO
- Gold Simple - HMO
- Gold Simple | with AdventHealth - HMO
- Silver Classic Standard - HMO
- Silver Classic Standard | with AdventHealth - HMO
- Silver Elite - HMO
- Silver Elite | with AdventHealth - HMO
- Silver Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Silver Simple Chronic Care CKM - HMO
- Wellpoint Essential Bronze 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 5500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 7500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Catastrophic (+ Incentives) - HMO
- Wellpoint Essential Gold 1400 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 2000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 800 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - 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.
*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 |
|---|---|---|---|
| ME86261 | OTHER (01) | FL | MEDICAL LICENSE |
Medicare Participation & PECOS Enrollment Status
Regina Quinain 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.
Regina Quinain 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: 8729068234
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: I20040724000102
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
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 (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
6 DME suppliers used 11 Medicare Claims 37 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
1 DME suppliers used 13 Medicare Claims 13 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.
Established patient custodial care facility, group care, or assisted living visit, typically 1 hour
Insertion of needle into vein for collection of blood sample
This service involves a healthcare professional visiting an established patient in a group care facility or assisted living for about an hour. The visit may include health checks, medication management, and addressing any health concerns to maintain the patient's well-being.
This service was performed 232 times for 30 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 91 times for 48 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.9 for a new patient copayment and $24.79 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 34748 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $87.62
- Minimum New Patient Price $56
- Maximum New Patient Price $171.84
- Average New Patient Copayment $21.9
- Minimum New Patient Copayment $14
- Maximum New Patient Copayment $42.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $99.16
- Minimum Established Patient Price $17.57
- Maximum Established Patient Price $139.16
- Average Established Patient Copayment $24.79
- Minimum Established Patient Copayment $4.39
- Maximum Established Patient Copayment $34.79
* 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 |
|---|---|---|
| Annual registration in the Prescription Drug Monitoring Program | Yes | N/A |
| Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months. | ||
| Anticoagulant Management Improvements | Yes | N/A |
| Individual MIPS eligible clinicians and groups who prescribe oral Vitamin K antagonist therapy (warfarin) must attest that, for 60 percent of practice patients in the transition year and 75 percent of practice patients in Quality Payment Program Year 2 and future years, their ambulatory care patients receiving warfarin are being managed by one or more of the following improvement activities: • Patients are being managed by an anticoagulant management service, that involves systematic and coordinated care, incorporating comprehensive patient education, systematic prothrombin time (PT-INR) testing, tracking, follow-up, and patient communication of results and dosing decisions; • Patients are being managed according to validated electronic decision support and clinical management tools that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; • For rural or remote patients, patients are managed using remote monitoring or telehealth options that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; and/or • For patients who demonstrate motivation, competency, and adherence, patients are managed using either a patient self-testing (PST) or patient-self-management (PSM) program. | ||
| Care coordination agreements that promote improvements in patient tracking across settings | Yes | N/A |
| Establish effective care coordination and active referral management that could include one or more of the following: Establish care coordination agreements with frequently used consultants that set expectations for documented flow of information and MIPS eligible clinician or MIPS eligible clinician group expectations between settings. Provide patients with information that sets their expectations consistently with the care coordination agreements; Track patients referred to specialist through the entire process; and/or Systematically integrate information from referrals into the plan of care. | ||
| Consultation of the Prescription Drug Monitoring Program | Yes | N/A |
| Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance. | ||
| Depression screening | Yes | N/A |
| Depression screening and follow-up plan: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including depression screening and follow-up plan (refer to NQF #0418) for patients with co-occurring conditions of behavioral or mental health conditions. | ||
| Diabetes screening | Yes | N/A |
| Diabetes screening for people with schizophrenia or bipolar disease who are using antipsychotic medication. | ||
| Documentation of Current Medications in the Medical Record | 91% | 23 |
| 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 | 100% | 1362 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Glycemic management services | Yes | N/A |
| For outpatient Medicare beneficiaries with diabetes and who are prescribed antidiabetic agents (e.g., insulin, sulfonylureas), MIPS eligible clinicians and groups must attest to having: For the first performance year, at least 60 percent of medical records with documentation of an individualized glycemic treatment goal that: a) Takes into account patient-specific factors, including, at least 1) age, 2) comorbidities, and 3) risk for hypoglycemia, and b) Is reassessed at least annually. The performance threshold will increase to 75 percent for the second performance year and onward. Clinician would attest that, 60 percent for first year, or 75 percent for the second year, of their medical records that document individualized glycemic treatment represent patients who are being treated for at least 90 days during the performance period. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| Implementation of improvements that contribute to more timely communication of test results | Yes | N/A |
| Timely communication of test results defined as timely identification of abnormal test results with timely follow-up. | ||
| Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop | Yes | N/A |
| Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology. | ||
| Patient-Specific Education | 96% | 24 |
| 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. | ||
| Provide Patient Access | 8% | 24 |
| 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. | ||
| Secure Messaging | 8% | 24 |
| 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 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. | ||
| Tobacco use | Yes | N/A |
| Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. | ||
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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 1174520373, we treat the final digit (3) 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 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 47 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 17 providers are registered at the same or a nearby location.
LEESBURG, FL 34748
LEESBURG, FL 34748
LEESBURG, FL 34748
LEESBURG, FL 34748
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174520373, enumerated as an "individual" on July 01, 2005.
The provider is located at 225 N 1ST ST LEESBURG, FL 34748 and the phone number is (407) 905-8827.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Ambetter from Superior HealthPlan, Ambetter. Please consult your insurance carrier or call the provider to verify.
