AGNES VIRGA M. D.
NPI 1184614414
Neuromusculoskeletal Medicine, Sports Medicine in Acton, MA

NPI Status: Active since October 27, 2005

Contact Information

411 MASS AVE
ACTON, MA
ZIP 01720
Phone: (978) 263-2898
Fax: (978) 263-3305

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  • Individual
  • Female
  • Years of Experience 46
  • Neuromusculoskeletal Medicine, Sports Me...
  • PECOS Enrolled
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About AGNES VIRGA

Agnes Virga is a provider established in Acton, Massachusetts and her medical specialization is Neuromusculoskeletal Medicine, Sports Medicine with more than 46 years of experience. The healthcare provider is registered in the NPI registry with number 1184614414 assigned on October 2005. The practitioner's primary taxonomy code is 204C00000X with license number 80633 (MA). The provider is registered as an individual and her NPI record was last updated 17 years ago.

NPI
1184614414
Provider Name
AGNES VIRGA M. D.
Gender
Female
Entity Type
Individual
Location Address
411 MASS AVE ACTON, MA 01720
Location Phone
(978) 263-2898
Location Fax
(978) 263-3305
Mailing Address
411 MASS AVE ACTON, MA 01720
Mailing Phone
(978) 263-2898
Mailing Fax
(978) 263-3305
Medical School Name
OTHER
Graduation Year
1978
Is Sole Proprietor?
No
Enumeration Date
10-27-2005
Last Update Date
07-08-2007
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Agnes Virga 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.

The provider participated in CMS Quality Payment Program and the following quality measures were reported: breast cancer screening, colorectal cancer screening, documentation of current medications in the medical record, e-prescribing, health information exchange, medication reconciliation, patient-specific education, pneumococcal vaccination status for older adults, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, provide patient access, secure messaging, security risk analysis and specialized registry reporting. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

The typical physician office visit costs for Medicare beneficiaries in this area are: $25.27 for a new patient copayment and $20.59 for an established patient copayment.

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

Neuromusculoskeletal Medicine, Sports Medicine

Taxonomy Code
204C00000X
Type
Allopathic & Osteopathic Physicians
License No.
80633
License State
MA
Taxonomy Description
A Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Source: American Osteopathic Association Additional Resources: AOA Osteopathic Board Certification in Neuromusculoskeletal Medicine; https://certification.osteopathic.org/sports-medicine/

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Blue Cross and Blue Shield

    • Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
    • Anthem Bronze Access Blue New England HMO 8500/50%/9450 - HMO
    • Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
    • Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
    • Anthem Gold Access Blue New England HMO 2000/10%/4725 w/HSA - HMO
    • Anthem Gold Access Blue New England HMO 2000/10%/8000 - HMO
    • Anthem Gold Access Blue New England HMO 2000/10%/8000 WH - HMO
    • Anthem Gold Access Blue New England HMO 2000/20%/4725 w/HSA - HMO
    • Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
    • Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
    • Anthem Platinum Access Blue New England HMO 250/10%/3000 - HMO
    • Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
    • Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
    • Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
    • Anthem Silver Access Blue New England HMO 3200/20%/7250 w/HSA - HMO
  • Medicare

  • Medicaid


*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
G27466MEDICARE UPIN (02)MA 
VIA21314MEDICARE ID-TYPE UNSPECIFIED (04)MA 
3155706MEDICAID (05)MA 

PECOS Enrollment and Medicare Participation Status

Agnes Virga 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: 6709912850

    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: I20100329000643

    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

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 01720 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $101.08
  • Minimum New Patient Price $66.28
  • Maximum New Patient Price $197.76
  • Average New Patient Copayment $25.27
  • Minimum New Patient Copayment $16.57
  • Maximum New Patient Copayment $49.44

Established Patients Visit Costs *

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

  • Average Established Patient Price $82.39
  • Minimum Established Patient Price $21.28
  • Maximum Established Patient Price $162.14
  • Average Established Patient Copayment $20.59
  • Minimum Established Patient Copayment $5.32
  • Maximum Established Patient Copayment $40.53

* 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 following quality measures meet Medicare's statistical reporting standards for the year 2018. 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
Breast Cancer Screening 27% 263
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Colorectal Cancer Screening 20% 417
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Documentation of Current Medications in the Medical Record 100% 1754
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 82% 2803
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange 44% 583
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Medication Reconciliation 95% 1484
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 55% 950
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 41% 368
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
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 80% 950
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 1% 950
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.
Specialized Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 49

    Needle measurement and recording of electrical activity of muscles of arm or leg complete study (HCPCS:95886)

  • 12

    Measurement and recording of brain wave (eeg) activity, awake and asleep (HCPCS:95819)

Hospital Affiliations

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. Agnes Virga is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
EMERSON HOSPITAL -133 OLD ROAD TO 9 ACRE CORNER
W CONCORD, MA 1742
(978) 369-1400Acute 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.
1184614414
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
21164121842
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 6 + 4 + 1 + 2 + 1 + 8 + 4 + 2 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 44

The NPI number 1184614414 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 9 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1912238882 DANIEL J BERTRAND DPT
Individual
Physical Therapist411 MASS AVE
ACTON, MA 01720
(978) 263-0007
1003000209KOPELMAN FAMILY CHIROPRACTIC INC
Organization
Chiropractor411 MASS AVE SUITE 102
ACTON, MA 01720
(978) 263-0008
1053385427MR. ROBERT E THOMAS MSPT, LATC
Individual
Physical Therapist411 MASS AVE SUITE 302
ACTON, MA 01720
(978) 263-0007
1669638524MISS SUUBI ALEXANDRA KASIRYE DPT
Individual
Physical Therapist411 MASS AVE SUITE 302
ACTON, MA 01720
(978) 263-0007
1285033241 BRETT MERRILL D.P.T.
Individual
Physical Therapist411 MASS AVE SUITE 302
ACTON, MA 01720
(978) 263-0007
1801345681 ROBERT EBERHARDT DPT
Individual
Physical Therapist411 MASS AVE SUITE 302
ACTON, MA 01720
(978) 263-0007
1518277995 DIANA PERKINS DPT
Individual
Physical Therapist411 MASS AVE SUITE 302
ACTON, MA 01720
(978) 263-0007
1891110094 COURTNEY CHAULK
Individual
Physical Therapist411 MASS AVE SUITE 302
ACTON, MA 01720
(978) 263-0007
1336579473MS. AMANDA JEAN LEONE DPT
Individual
Physical Therapist411 MASS AVE SUITE 302
ACTON, MA 01720
(978) 263-0007

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1184614414, enumerated in the NPI registry as an "individual" on October 27, 2005

The provider is located at 411 Mass Ave Acton, Ma 01720 and the phone number is (978) 263-2898

The provider's speciality is Neuromusculoskeletal Medicine, Sports Medicine with taxonomy code 204C00000X

The provider has more than 46 years of experience.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 17, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

Medicare beneficiaries should expect a typical cost of $101.08 with an average copayment of $25.27 for new patient appointments. Established patients should expect a typical charge of $82.39 and an average copayment of 20.59. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Needle measurement and recording of electrical activity of muscles of arm or leg complete study and Measurement and recording of brain wave (eeg) activity, awake and asleep.

The practitioner is affiliated to the following hospital(s): EMERSON HOSPITAL -. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on October 27, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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