DR. DANIEL S ELY M.D.
NPI 1194744516
Specialist in Knoxville, TN
Quality Rating: 95.69 out of 100 score
NPI Status: Active since July 18, 2006
Contact Information
11440 PARKSIDE DR
SUITE 302
KNOXVILLE, TN
ZIP 37934
Phone: (865) 288-1548
Fax: (865) 377-1002
- Individual
- Male
- Years of Experience 43
- Specialist
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About DANIEL ELY
This page provides the complete NPI Profile along with additional information for Daniel Ely, a provider established in Knoxville, Tennessee with a medical specialization in Specialist and more than 43 years of experience. He graduated from University Of Utah School Of Medicine in 1983. The healthcare provider is registered in the NPI registry with number 1194744516 assigned on July 2006. The practitioner's primary taxonomy code is 174400000X with license number MD12755 (TN). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1194744516
- Provider Name
- DR. DANIEL S ELY M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 11440 PARKSIDE DR SUITE 302 KNOXVILLE, TN 37934
- Location Phone
- (865) 288-1548
- Location Fax
- (865) 377-1002
- Mailing Address
- 11440 PARKSIDE DR SUITE 302 KNOXVILLE, TN 37934
- Mailing Phone
- (865) 288-1548
- Mailing Fax
- (865) 377-1002
- Medical School Name
- UNIVERSITY OF UTAH SCHOOL OF MEDICINE
- Graduation Year
- 1983
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-18-2006
- Last Update Date
- 07-08-2007
- 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
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- MD12755
- License State
- TN
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Gold Advantage (Virtual Urgent Care, No Referrals) - EPO
- UHC Gold Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Advantage (Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Silver Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Standard (No Referrals) - EPO
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 |
|---|---|---|---|
| A98753 | MEDICARE UPIN (02) | TN | |
| 3024693 | MEDICARE ID-TYPE UNSPECIFIED (04) | TN |
Medicare Participation & PECOS Enrollment Status
Daniel Ely 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.
Daniel Ely 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: 9133027758
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: I20040102000674
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.
Follow-up hospital inpatient care per day, typically 25 minutes
Hospital discharge day management, 30 minutes or less
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 33 times for 18 patientsHospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
This service was performed 11 times for 11 patientsOverall 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 95.69, 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.
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Final Score: 95.69 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.
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Quality Score: 85.28
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.
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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: 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.
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 |
|---|---|---|
| Breast Cancer Screening | 96% | 239 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Clinical Information Reconciliation | 3% | 69 |
| For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation. The MIPS eligible clinician must implement clinical information reconciliation for the following three clinical information sets: (1) Medication. Review of the patient's medication, including the name, dosage, frequency, and route of each medication. (2) Medication allergy. Review of the patient's known medication allergies. (3) Current Problem list. Review of the patient's current and active diagnoses. | ||
| Closing the Referral Loop: Receipt of Specialist Report | 65% | 291 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred | ||
| Colorectal Cancer Screening | 100% | 228 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Diabetes: Medical Attention for Nephropathy | 86% | 141 |
| The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period | ||
| Documentation of Current Medications in the Medical Record | 97% | 2682 |
| 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 | ||
| Electronic submission of Patient Centered Medical Home accreditation | Yes | N/A |
| I attest that I am a Patient Centered Medical Home (PCMH) or Comparable Specialty Practice that has achieved certification from a national program, regional or state program, private payer, or other body that administers patient-centered medical home accreditation and should receive full credit for the Improvement Activities performance category. | ||
| e-Prescribing | 87% | 4980 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS). | ||
| Patient-Specific Education | 100% | 936 |
| The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 100% | 777 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 100% | 523 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Influenza Immunization | 83% | 784 |
| Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
| Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 40% | 1080 |
| Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 31% | 45 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide Patient Access | 65% | 936 |
| For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology. | ||
| Request/Accept Summary of Care | 1% | 178 |
| For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an electronic summary of care document. | ||
| Secure Messaging | 65% | 936 |
| 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 certified EHR technology to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative). | ||
| 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. | ||
| Send a Summary of Care | 1% | 178 |
| For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2) electronically exchanges the summary of care record. | ||
| Use of High-Risk Medications in the Elderly | 3% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 777 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
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. Daniel Ely is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| UNIVERSITY HEALTH SYSTEM, INC | 1924 ALCOA HIGHWAY KNOXVILLE, TN 37920 | (865) 544-9000 | Acute Care Hospitals |
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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 1194744516, 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 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 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.
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 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 13 providers are registered at the same or a nearby location.
KNOXVILLE, TN 37934
KNOXVILLE, TN 37934
KNOXVILLE, TN 37934
KNOXVILLE, TN 37934
KNOXVILLE, TN 37934
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194744516, enumerated as an "individual" on July 18, 2006.
The provider is located at 11440 PARKSIDE DR SUITE 302 KNOXVILLE, TN 37934 and the phone number is (865) 288-1548.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: BlueCross BlueShield of Tennessee,. Please consult your insurance carrier or call the provider to verify.
Daniel Ely is affiliated with: UNIVERSITY HEALTH SYSTEM, INC.
