DR. JOSE MANUEL SILVA M.D.
NPI 1194045831
Internal Medicine - Clinical Cardiac Electrophysiology in Lynchburg, VA

Quality Rating: 89.26 out of 100 score

NPI Status: Active since June 04, 2010

Contact Information

2410 ATHERHOLT RD
LYNCHBURG, VA
ZIP 24501
Phone: (434) 200-5252

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Table of Contents

NPI Profile Information
Primary Taxonomy
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 16
Internal Medicine
Clinical Cardiac Electrophysiology
May Accept Medicare Approved Payment
PECOS Enrolled

About JOSE SILVA

This page provides the complete NPI Profile along with additional information for Jose Silva, an internist established in Lynchburg, Virginia with a medical specialization in Internal Medicine, focusing in clinical cardiac electrophysiology and more than 16 years of experience. He graduated from Columbia University College Of Physicians And Surgeons in 2010. The healthcare provider is registered in the NPI registry with number 1194045831 assigned on June 2010. The practitioner's primary taxonomy code is 207RC0001X with license number 0101266837 (VA). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI: 1194045831
Provider Name: DR. JOSE MANUEL SILVA M.D.
Gender: Male
Entity Type: Individual
Location Address: 2410 ATHERHOLT RD LYNCHBURG, VA 24501
Location Phone: (434) 200-5252
Mailing Address: 2410 ATHERHOLT RD LYNCHBURG, VA 24501
Mailing Phone: (434) 200-5252
Medical School Name: COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Graduation Year: 2010
Is Sole Proprietor?: No
Enumeration Date: 06-04-2010
Last Update Date: 05-12-2022
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An internist like Jose Silva is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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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: Internal Medicine Clinical Cardiac Electrophysiology
Taxonomy Code: 207RC0001X
Type: Allopathic & Osteopathic Physicians
License No.: 0101266837
License State: VA
Taxonomy Description: A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.

Medicare Participation & PECOS Enrollment Status

Jose Silva is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Jose Silva 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: 5395983027
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: I20190829001294
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? Maybe
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.

Blood test, clotting time
Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation
Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of lower chamber of heart causing ventricular tachycardia (rapid heart rate) or ventricular ectopy (irregular heartbeat)
Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of upper chamber of heart causing supraventricular tachycardia (rapid heart rate)
Destruction of heart conduction tissue to create heart block
Destruction of tissue of upper heart chamber through tube to treat abnormal heart rhythm
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Evaluation of cardiac rhythm monitor system
Evaluation of cardiac rhythm monitor system, remote up to 30 days
Evaluation of implantable heart and blood vessel monitoring system
Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days
Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days
Follow-up hospital inpatient care per day, typically 35 minutes
Heart rhythm review and interpretation of continous external ekg over 8-15 days
Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days
Hospital observation care on day of discharge
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
Insertion of catheters and destruction of tissue to treat abnormal heart rhythm
Insertion of implantable defibrillator system
Insertion of left lower heart electrode for pacemaker or defibrillator
Insertion of needle into vein for collection of blood sample
Insertion of pacemaker and upper and lower heart chamber electrode
Insertion of permanent leadless pacemaker using imaging guidance
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Pacemaker insertion or repair
Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent
Programming of dual lead implantable defibrillator system
Programming of dual lead pacemaker system
Programming of heart rhythm stimulation after drug infusion
Programming of multiple lead implantable defibrillator system
Programming of multiple lead pacemaker system
Programming of single lead implantable defibrillator system
Programming of single lead pacemaker system
Repair of left upper heart chamber with implant with review by radiologist
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Ultrasound evaluation of heart blood vessel with review by radiologist
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes

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 24501 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $129.04
Minimum New Patient Price $56.19
Maximum New Patient Price $170.3

Average New Patient Copayment $32.26
Minimum New Patient Copayment $14.04
Maximum New Patient Copayment $42.57

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $99.13
Minimum Established Patient Price $18.07
Maximum Established Patient Price $138.91

Average Established Patient Copayment $24.78
Minimum Established Patient Copayment $4.51
Maximum Established Patient Copayment $34.72

* 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 89.26, 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: 89.26 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: 87.37

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.

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. Jose Silva is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
CENTRA HEALTH - LYNCHBURG GEN HOSPITAL	1901 TATE SPRINGS ROAD LYNCHBURG, VA 24501	(434) 200-4789	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 1194045831, we treat the final digit (1) 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 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

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 → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 0

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 9 → 18 → 9 0 → 0 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 + 8 + 4 + 0 + 4 + 1 + 0 + 8 + 6 + 24 = 59

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

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1

This NPI is valid

The calculated check digit is 1, which matches the last digit of 1194045831.