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DR. RICHARD JAMES MISISCHIA SR. D.O.
NPI 1194810150
Internal Medicine - Rheumatology in Lorain, OH

Active since October 04, 2006PECOS EnrolledAccepts Medicare Assignment
83.2/100
CMS Quality Rating
3600 KOLBE RD STE 103, LORAIN, OH 44053(440) 222-4188(440) 222-4189 Get Directions Write a Review

NPPES record last updated: August 12, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 12, 2024, Nov 4, 2021, Sep 12, 2019 and 2 more (5 updates tracked since 2017).

About Dr. Richard James Misischia Sr. D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RICHARD JAMES MISISCHIA SR. D.O. (NPI 1194810150) is an individual rheumatology provider in Lorain, Ohio, licensed in Kentucky (05068) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Mercy Regional Medical Center, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1194810150
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NameDR. RICHARD JAMES MISISCHIA SR.Credential: D.O.
Location Address3600 KOLBE RD STE 103Lorain, OH 44053-1652
Mailing AddressPo Box 2379Ashland, KY 41105-2379
Phone(440) 222-4188
Fax(440) 222-4189
Sole ProprietorNo
Medical School CMSOtherGraduated 1993
Enumeration DateOctober 4, 2006
Last NPPES UpdateAugust 12, 20245 updates tracked since enumeration
NPPES CertifiedAugust 12, 2024
✔ NPI 1194810150 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
Licenses✔ Licensed in KY · 05068✔ Licensed in AL · DO.477
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
3600 KOLBE RD STE 103, Lorain, OH 44053
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc., Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Richard James Misischia Sr. D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406897446
PECOS Enrollment IDI20231102000174
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This 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.
27 services18 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This 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.
15 services15 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Regional Medical Center

Acute Care Hospitals · Lorain, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360172
Location3700 Kolbe RoadLorain, OH 44053 · Lorain County
Emergency services Birthing friendly

Mercy Allen Hospital

Critical Access Hospitals · Oberlin, OH
OwnershipVoluntary non-profit - Private
CMS Certification Number361306
Location200 West Lorain StreetOberlin, OH 44074 · Lorain County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44053 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.2/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.73
Promoting Interoperability82
Improvement Activities40
Cost71.28

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%1,690 patients4/55-star benchmark: 99%
Health Information Exchange
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…
13%214 patients1/55-star benchmark: 88%
Medication Reconciliation
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.
99%148 patients4/55-star benchmark: 100%
Patient-Specific Education
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.
56%732 patients3/55-star benchmark: 97%
Provide Patient Access
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…
100%732 patients5/55-star benchmark: 100%
Secure Messaging
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…
39%732 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
44%732 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MOHAMMAD FATHI SHARBEK MD
Specialist
3600 KOLBE RD STE 103
LORAIN, OH 44053
Lorain County (440) 960-7301

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Richard Misischia's NPI number?

The NPI number for Richard Misischia is 1194810150. It was assigned to this individual provider in the NPPES registry on October 4, 2006.

Where is Richard Misischia located?

Richard Misischia practices at 3600 Kolbe Rd Ste 103, Lorain, OH 44053. The listed phone number is (440) 222-4188.

What is Richard Misischia's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Richard Misischia enrolled in Medicare?

Yes. Richard Misischia is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Richard Misischia accept?

Health plans from Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc., Blue Cross Blue Shield of Arizona, CareSource and MedMutual and 2 other insurers list Richard Misischia as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Richard Misischia affiliated with any hospitals?

According to CMS data, Richard Misischia is affiliated with Mercy Regional Medical Center and Mercy Allen Hospital.

When was this NPI record last updated?

The NPPES record for Richard Misischia was last updated on August 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.