DR. JOSEPH DEAN SCHMOKER MD
NPI 1184645236
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Missoula, MT

Quality Rating: 85.43 out of 100 score

NPI Status: Active since July 22, 2006

Contact Information

500 W BROADWAY ST STE 320
MISSOULA, MT
ZIP 59802
Phone: (406) 329-5615
Fax: (406) 329-2791

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Table of Contents

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Overall Quality Performance
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 39
Thoracic Surgery (Cardiothoracic Vascula...
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About JOSEPH SCHMOKER

This page provides the complete NPI Profile along with additional information for Joseph Schmoker, a provider established in Missoula, Montana with a medical specialization in Thoracic Surgery (cardiothoracic Vascular Surgery) and more than 39 years of experience. He graduated from Saint Louis University School Of Medicine in 1987. The healthcare provider is registered in the NPI registry with number 1184645236 assigned on July 2006. The practitioner's primary taxonomy code is 208G00000X with license number 58333 (MT). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI: 1184645236
Provider Name: DR. JOSEPH DEAN SCHMOKER MD
Gender: Male
Entity Type: Individual
Location Address: 500 W BROADWAY ST STE 320 MISSOULA, MT 59802
Location Phone: (406) 329-5615
Location Fax: (406) 329-2791
Mailing Address: PO BOX 12 LIBERTY LAKE, WA 99019
Mailing Phone: (866) 747-2455
Medical School Name: SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year: 1987
Is Sole Proprietor?: No
Enumeration Date: 07-22-2006
Last Update Date: 07-16-2025
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Location Map

Secondary Locations

2979 Squalicum Pkwy Ste 201
Bellingham, WA 98225
(360) 788-6800
1300 28th St S Fl 2
Great Falls, MT 59405
(406) 455-4320

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: Thoracic Surgery (Cardiothoracic Vascular Surgery)
Taxonomy Code: 208G00000X
Type: Allopathic & Osteopathic Physicians
License No.: 58333
License State: MT
Taxonomy Description: A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	208G00000X	Allopathic & Osteopathic Physicians	Thoracic Surgery (Cardiothoracic Vascular Surgery)	042-0009731 (VT)
2	208G00000X	Allopathic & Osteopathic Physicians	Thoracic Surgery (Cardiothoracic Vascular Surgery)	MD61679267 (WA)

Insurance Plans Accepted

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

Blue Cross and Blue Shield of Montana

Blue Focus Bronze POS? 205 - POS
Blue Focus Bronze POS? 705 - POS
Blue Focus Bronze POS? Standard - POS
Blue Focus Gold POS? 207 - POS
Blue Focus Gold POS? 902 - POS
Blue Focus Gold POS? Standard - POS
Blue Focus Silver POS? 206 - POS
Blue Focus Silver POS? 903 - POS
Blue Focus Silver POS? Standard - POS
Blue Preferred Bronze PPO? 201 - PPO

Blue Cross Blue Shield of North Dakota

BlueCare Bronze HSA Eligible $50 PCP Copay ($5 Value Based Drug List) - PPO
BlueCare Gold $10 PCP Copay ($5 Value Based Drug List) - PPO
BlueCare Silver $20 PCP Copay ($5 Value Based Drug List) - PPO
BlueDirect Bronze 100 HSA Eligible ($8000 Deductible / $5 Preventive Drug List) - PPO
BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
BlueEssential Catastrophic 100 HSA Eligible $10600 Deductible - PPO
BlueValue Bronze HSA Eligible $50 PCP Copay (Standardized plan) - PPO
BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
BlueValue Silver $40 PCP Copay (Standardized plan) - PPO

Mountain Health CO-OP

Peak PPO Bronze HDHP - PPO
Peak PPO Bronze Standard - PPO
Peak PPO Catastrophic - PPO
Peak PPO Gold - PPO
Peak PPO Gold Standard - PPO
Peak PPO Silver - PPO
Peak PPO Silver Standard - PPO
Plus Bronze - PPO
Plus Bronze Standard - PPO
Plus Gold - PPO

PacificSource Health Plans

Core Bronze HSA 10600 - EPO
Core Bronze HSA 7500 - EPO
Core Bronze HSA 8300 - EPO
Core Gold 1500 - EPO
Core Gold 3000 - EPO
Core Silver 3500 - EPO
Core Silver 4500 - EPO
Core Silver 5000 - EPO
Core Silver 7500 - EPO
Core Standard Expanded Bronze HSA - EPO

Premera Blue Cross Blue Shield of Alaska

Premera Blue Cross Alaska One Gold - PPO
Premera Blue Cross Preferred Bronze 5800 HSA - PPO
Premera Blue Cross Preferred Bronze 6350 - PPO
Premera Blue Cross Preferred Gold 1500 - PPO
Premera Blue Cross Preferred Silver 4500 - PPO
Premera Blue Cross Standard Bronze II - PPO
Premera Blue Cross Standard Gold - PPO
Premera Blue Cross Standard Silver - PPO
Premera Blue Cross Family Dental - PPO
Premera Blue Cross Pediatric Dental - PPO

Providence Health Plan

HSA Qualified 7500 Bronze - Choice Network - EPO
HSA-E Qualified 7500 Bronze - Signature Network - EPO
Providence Oregon Standard Bronze Plan - Choice Network - EPO
Providence Oregon Standard Bronze Plan - Signature Network - EPO
Providence Oregon Standard Gold Plan - Choice Network - EPO
Providence Oregon Standard Gold Plan - Signature Network - EPO
Providence Oregon Standard Silver Plan - Choice Network - EPO
Providence Oregon Standard Silver Plan - Signature Network - EPO

Sanford Health Plan

Sanford Individual TRUE $1,750 - HMO
Sanford Individual TRUE $10,600 - HMO
Sanford Individual TRUE $3,500 - HMO
Sanford Individual TRUE $4,750 - HMO
Sanford Individual TRUE $6,500 - HMO
Sanford Individual TRUE $7,200 HSA Qualified - HMO
Sanford Individual TRUE Standardized $2,000 - HMO
Sanford Individual TRUE Standardized $6,000 - HMO
Sanford Individual TRUE Standardized $7,500 - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Joseph Schmoker 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.

Joseph Schmoker 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: 2961564398
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: I20250422001704, I20250612003508
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

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.

Coronary artery bypass graft (CABG)
Coronary artery bypass using artery graft, 1 graft
Coronary artery bypass using artery graft, 2 grafts
Coronary artery bypass using vein or artery graft, 1 graft
Coronary artery bypass using vein or artery graft, 2 grafts
Coronary artery bypass using vein or artery graft, 3 grafts
Established patient office or other outpatient visit, 10-19 minutes
Harvest of artery from arm for heart bypass graft using an endoscope
Harvest of vein using an endoscope
Initial hospital inpatient care per day, typically 70 minutes
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
Partial destruction and reconstruction of right upper heart chamber
Radical reconstruction of mitral valve on heart-lung machine
Repair of ascending aorta with graft on heart-lung machine with valve suspension for aortic disease
Replacement of aortic valve on heart-lung machine
Replacement of aortic valve through the skin and femoral artery

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $43.06 for a new patient copayment and $17.7 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 59802 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99205

Average New Patient Price $172.26
Minimum New Patient Price $56.81
Maximum New Patient Price $172.26

Average New Patient Copayment $43.06
Minimum New Patient Copayment $14.2
Maximum New Patient Copayment $43.06

Established Patients Visit Costs *

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

Average Established Patient Price $70.82
Minimum Established Patient Price $18.24
Maximum Established Patient Price $140.32

Average Established Patient Copayment $17.7
Minimum Established Patient Copayment $4.56
Maximum Established Patient Copayment $35.08

* 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.

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 85.43, 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 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: 85.43 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: 85.98

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: 100

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: 65.45

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: 65.45

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.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

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. Joseph Schmoker is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
SANFORD MEDICAL CENTER FARGO	801 BROADWAY NORTH FARGO, ND 58122	(701) 234-2000	Acute Care Hospitals
DEACONESS MEDICAL CENTER	W 800 FIFTH AVENUE SPOKANE, WA 99210	(509) 473-5800	Acute Care Hospitals

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 1184645236, we treat the final digit (6) 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 16 → 1 + 6

Pos 4

Unchanged

Pos 5

Doubled → 12 → 1 + 2

Pos 6

Unchanged

Pos 7

Doubled → 10 → 1 + 0

Pos 8

Unchanged

Pos 9

Doubled → 6

Check

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 8 → 16 → 7 6 → 12 → 3 5 → 10 → 1 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 6 + 4 + 1 + 2 + 4 + 1 + 0 + 2 + 6 + 24 = 54

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

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6

This NPI is valid

The calculated check digit is 6, which matches the last digit of 1184645236.