EDWARD E BARTON MD
NPI 1174539167
Urology in Novi, MI
NPI Status: Active since July 31, 2006
Contact Information
26850 PROVIDENCE PARKWAY
STE 470
NOVI, MI
ZIP 48374
Phone: (248) 319-3000
Fax: (248) 319-3001
- Individual
- Male
- Urology
- PECOS Enrolled
- Medicare Quality Reporting
About EDWARD BARTON
This page provides the complete NPI Profile along with additional information for Edward Barton, a provider established in Novi, Michigan with a medical specialization in Urology. The healthcare provider is registered in the NPI registry with number 1174539167 assigned on July 2006. The practitioner's primary taxonomy code is 208800000X with license number 4301043346 (MI). The provider is registered as an individual and his NPI record was last updated 14 years ago.
- NPI
- 1174539167
- Provider Name
- EDWARD E BARTON MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 26850 PROVIDENCE PARKWAY STE 470 NOVI, MI 48374
- Location Phone
- (248) 319-3000
- Location Fax
- (248) 319-3001
- Mailing Address
- 26850 PROVIDENCE PARKWAY STE 470 NOVI, MI 48374
- Mailing Phone
- (248) 319-3000
- Mailing Fax
- (248) 319-3001
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-31-2006
- Last Update Date
- 09-19-2012
- 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
Urology
- Taxonomy Code
- 208800000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 4301043346
- License State
- MI
- Taxonomy Description
- A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
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 |
|---|---|---|---|
| B47412 | MEDICARE UPIN (02) | ||
| 0630378 | MEDICARE ID-TYPE UNSPECIFIED (04) |
Medicare Participation & PECOS Enrollment Status
Edward Barton 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
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.
Diagnostic exam of bladder and urethra using an 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
Manual urinalysis test with examination using microscope, non-automated
New patient office or other outpatient visit, 45-59 minutes
This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.
This service was performed 21 times for 15 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 65 times for 19 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 94 times for 77 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 21 times for 21 patientsA manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.
This service was performed 74 times for 43 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 18 times for 18 patientsPhysician 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 48374 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $134.28
- Minimum New Patient Price $58.04
- Maximum New Patient Price $177.36
- Average New Patient Copayment $33.57
- Minimum New Patient Copayment $14.51
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $72.38
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $143.49
- Average Established Patient Copayment $18.09
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $35.87
* 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 |
|---|---|---|
| Implementation of formal quality improvement methods, practice changes, or other practice improvement processes | Yes | N/A |
| Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive. | Yes | N/A |
| Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive. | ||
| Participation in a QCDR, that promotes use of patient engagement tools. | Yes | N/A |
| Participation in a QCDR, that promotes use of patient engagement tools. | ||
| Participation in a QCDR, that promotes use of processes and tools that engage patients for adherence to treatment plan. | Yes | N/A |
| Participation in a QCDR, that promotes use of processes and tools that engage patients for adherence to treatment plan. | ||
| Participation in MOC Part IV | Yes | N/A |
| Participation in Maintenance of Certification (MOC) Part IV, such as the American Board of Internal Medicine (ABIM) Approved Quality Improvement (AQI) Program, National Cardiovascular Data Registry (NCDR) Clinical Quality Coach, Quality Practice Initiative Certification Program, American Board of Medical Specialties Practice Performance Improvement Module or ASA Simulation Education Network, for improving professional practice including participation in a local, regional or national outcomes registry or quality assessment program. Performance of monthly activities across practice to regularly assess performance in practice, by reviewing outcomes addressing identified areas for improvement and evaluating the results. | ||
| Participation in Population Health Research | Yes | N/A |
| Participation in federally and/or privately funded research that identifies interventions, tools, or processes that can improve a targeted patient population. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
| Use of QCDR data for ongoing practice assessment and improvements | Yes | N/A |
| Use of QCDR data, for ongoing practice assessment and improvements in patient safety. | ||
| Use of QCDR to support clinical decision making | Yes | N/A |
| Participation in a QCDR, demonstrating performance of activities that promote implementation of shared clinical decision making capabilities. | ||
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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 1174539167, we treat the final digit (7) 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
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 53 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 9 providers are registered at the same or a nearby location.
NOVI, MI 48374
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174539167, enumerated as an "individual" on July 31, 2006.
The provider is located at 26850 PROVIDENCE PARKWAY STE 470 NOVI, MI 48374 and the phone number is (248) 319-3000.
Urology with taxonomy code 208800000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
