RYAN FITZGERALD M.D.
NPI 1205360476
Emergency Medicine in Houston, TX
Quality Rating: 76.42 out of 100 score
NPI Status: Active since April 14, 2017
Contact Information
6431 FANNIN ST
SUITE JJL 431
HOUSTON, TX
ZIP 77030
Phone: (713) 500-7878
Fax: (713) 500-0758
- Individual
- Male
- Years of Experience 7
- Emergency Medicine
- PECOS Enrolled
- Accepts Medicare Approved Payment
About RYAN FITZGERALD
Ryan Fitzgerald is a provider established in Houston, Texas and his medical specialization is Emergency Medicine with more than 7 years of experience. The healthcare provider is registered in the NPI registry with number 1205360476 assigned on April 2017. The practitioner's primary taxonomy code is 207P00000X with license number S0285 (TX). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1205360476
- Provider Name
- RYAN FITZGERALD M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 6431 FANNIN ST SUITE JJL 431 HOUSTON, TX 77030
- Location Phone
- (713) 500-7878
- Location Fax
- (713) 500-0758
- Mailing Address
- 7133 CHIMNEY ROAD RD HOUSTON, TX 77081
- Mailing Phone
- (049) 997-9784
- Mailing Fax
- (713) 500-0758
- Medical School Name
- OTHER
- Graduation Year
- 2017
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-14-2017
- Last Update Date
- 11-15-2021
- Code Navigator
Ryan Fitzgerald 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 under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 76.42, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $23.3 for a new patient copayment and $26.91 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
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- S0285
- License State
- TX
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Location Map
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 | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | 85529 (GA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Alliant Health Plans
- SoloCare Bronze No Referral HMO Chiro HDHP 7050 - HMO
- SoloCare Bronze No Referral HMO HDHP 7050 - HMO
- SoloCare Bronze PPO Chiro HDHP 7050 - PPO
- SoloCare Bronze PPO HDHP 7050 - PPO
- SoloCare Catastrophic No Referral HMO - HMO
- SoloCare Catastrophic No Referral HMO Chiro - HMO
- SoloCare Catastrophic PPO - PPO
- SoloCare Catastrophic PPO Chiro - PPO
- SoloCare Exp Bronze No Referral HMO 9450 - $0 Generic Rx - HMO
- SoloCare Exp Bronze No Referral HMO Chiro 9450 - $0 Generic Rx - HMO
Blue Cross and Blue Shield of Texas
- Blue Advantage Bronze HMO℠ 204 - HMO
- Blue Advantage Bronze HMO℠ 301 - HMO
- Blue Advantage Bronze HMO℠ 302 - HMO
- Blue Advantage Bronze HMO℠ 707 - HMO
- Blue Advantage Gold HMO℠ 206 - HMO
- Blue Advantage Gold HMO℠ 603 - HMO
- Blue Advantage Gold HMO℠ 706 - HMO
- Blue Advantage Plus Bronze℠ 303 - POS
- Blue Advantage Plus Bronze℠ 305 - POS
- Blue Advantage Plus Bronze℠ 707 - POS
Molina Healthcare
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 250 - HMO
- Silver 1 250 with Adult Vision Services - HMO
- Silver 12 250 with First 4 Primary Care Visits Free - HMO
- Silver 3 250 - HMO
- Silver 8 250 - HMO
Oscar Health Plan of Georgia
- Bronze Classic 4700 - HMO
- Bronze Classic PCP Saver Plus - HMO
- Bronze Classic Standard - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Simple 2 - HMO
- Gold Classic Standard - HMO
- Gold Elite Saver Plus - HMO
- Secure - HMO
- Silver Classic Standard - HMO
- Silver Elite Saver Plus - HMO
Oscar Health Plan, Inc.
- Bronze Classic (Choice) - HMO
- Bronze Classic 4700 (Choice) - HMO
- Bronze Classic 4700 (Select) - HMO
- Bronze Classic PCP Saver Plus Rx Copay (Choice) - HMO
- Bronze Classic PCP Saver Plus Rx Copay (Select) - HMO
- Bronze Classic Standard (Choice) - HMO
- Bronze Classic Standard (Select) - HMO
- Bronze Elite + PCP Saver Plus (Choice) - HMO
- Bronze Elite + PCP Saver Plus (Select) - HMO
- Gold Classic Standard (Choice) - HMO
Oscar Insurance Company
- Bronze Classic - EPO
- Bronze Classic | MercyOne - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic 4700 | MercyOne - EPO
- Bronze Classic PCP Saver Plus - EPO
- Bronze Classic PCP Saver Plus | MercyOne - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard | MercyOne - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus | MercyOne - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
PECOS Enrollment and Medicare Participation Status
Ryan Fitzgerald 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: 1052732807
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: I20200602002670, I20200818001942
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 77030 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $93.23
- Minimum New Patient Price $60.64
- Maximum New Patient Price $183.87
- Average New Patient Copayment $23.3
- Minimum New Patient Copayment $15.16
- Maximum New Patient Copayment $45.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $107.65
- Minimum Established Patient Price $18.93
- Maximum Established Patient Price $150.28
- Average Established Patient Copayment $26.91
- Minimum Established Patient Copayment $4.73
- Maximum Established Patient Copayment $37.57
* 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 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: 76.42 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: 72.26
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.
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.
- 76
Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report (HCPCS:93010)
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. Ryan Fitzgerald is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
EMORY DECATUR HOSPITAL | 2701 N DECATUR ROAD DECATUR, GA 30033 | (404) 501-1000 | Acute Care Hospitals | |
EMORY HILLANDALE HOSPITAL | 2801 DEKALB MEDICAL PARKWAY LITHONIA, GA 30058 | (404) 501-8040 | Acute Care Hospitals |
Reviews for RYAN FITZGERALD M.D.
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
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. | |||||||||
1 | 2 | 0 | 5 | 3 | 6 | 0 | 4 | 7 | 6 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 0 | 5 | 6 | 6 | 0 | 4 | 14 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 2 + 0 + 5 + 6 + 6 + 0 + 4 + 1 + 4 + 24 = 54 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 54 = 6 | 6 |
The NPI number 1205360476 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1619965878 | DR. CEDRIC DUPONT M.D. Individual | Anesthesiology | 6431 FANNIN ST MSB 5.020 HOUSTON, TX 77030 (713) 500-6222 |
1437148186 | MISS ANDREA ELLEN HARBISON M.S. Individual | Genetic Counselor, MS | 6431 FANNIN ST SUITE 3.148 HOUSTON, TX 77030 (713) 500-5766 |
1649258013 | MRS. JENNIFER MALONE HOSKOVEC M.S., C.G.C. Individual | Genetic Counselor, MS | 6431 FANNIN ST SUITE 3.604 HOUSTON, TX 77030 (713) 500-6383 |
1487628905 | DR. DANIEL L IVAN MD Individual | Pediatrics | 6431 FANNIN ST JJL 495 HOUSTON, TX 77030 (713) 500-5666 |
1659334100 | RODRIGO HASBUN M.D., M.P.H. Individual | Internal Medicine (Infectious Disease) | 6431 FANNIN ST 2.112 MSB HOUSTON, TX 77030 (713) 500-7140 |
1578528956 | MR. KHALID F ALMOOSA M.D. Individual | Internal Medicine (Pulmonary Disease) | 6431 FANNIN ST MSB 1.274 HOUSTON, TX 77030 (713) 500-6828 |
1942268255 | DR. ARLO WELTGE MD MPH Individual | Emergency Medicine | 6431 FANNIN ST JJL 417 HOUSTON, TX 77030 (713) 667-4113 |
1750329470 | MAJDI M RADAIDEH M.D. Individual | Radiology (Diagnostic Radiology) | 6431 FANNIN ST 2132 HOUSTON, TX 77030 (713) 500-7700 |
1396784708 | JEFFERY KATZ M.D. Individual | Anesthesiology | 6431 FANNIN ST 5020 HOUSTON, TX 77030 (713) 500-6200 |
1023057973 | EDWARD D COCCO P.A. Individual | Physician Assistant (Surgical) | 6431 FANNIN ST 7148 HOUSTON, TX 77030 (713) 500-6150 |
1043259567 | DR. SHERVIN ASSASSI M.D. Individual | Internal Medicine (Rheumatology) | 6431 FANNIN ST MSB 5.270 HOUSTON, TX 77030 (713) 500-6900 |
1164467569 | VIRGINIA A MOYER M.D. Individual | Pediatrics | 6431 FANNIN ST 3020 HOUSTON, TX 77030 (713) 500-5700 |
1558399774 | D'JUANNA WHITE-SATCHER M.D. Individual | Pediatrics | 6431 FANNIN ST 3020 HOUSTON, TX 77030 (713) 500-5700 |
1013948835 | DR. AMBER LUONG M.D., PH.D Individual | Otolaryngology | 6431 FANNIN ST MSB 5.036 HOUSTON, TX 77030 (713) 500-5421 |
1891710471 | DR. CHARLES LAWRENCE MADDOW M.D. Individual | Emergency Medicine | 6431 FANNIN ST EMERGENCY MEDICINE JJL 4TH FLOOR HOUSTON, TX 77030 (713) 500-7668 |
1003832320 | DR. DAVIDE CATTANO MD Individual | Anesthesiology | 6431 FANNIN ST MSB 5.020 HOUSTON, TX 77030 (713) 500-6235 |
1831118785 | DR. ERIC K CHAN M.D. Individual | Anesthesiology | 6431 FANNIN ST MSB. 5.020 HOUSTON, TX 77030 (713) 500-6200 |
1043223209 | MATTHEW TREVOR HARBISON MD Individual | Internal Medicine | 6431 FANNIN ST MSB 1.122 HOUSTON, TX 77030 (713) 500-6714 |
1639271869 | CLAIRE NARVAEZ SINGLETARY M.S., C.G.C. Individual | Genetic Counselor, MS | 6431 FANNIN ST MSB 3.144 HOUSTON, TX 77030 (713) 500-5195 |
1295827608 | CHRISTOPHER GREELEY MD Individual | Pediatrics | 6431 FANNIN ST HOUSTON, TX 77030 (713) 500-6064 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205360476, enumerated in the NPI registry as an "individual" on April 14, 2017
The provider is located at 6431 Fannin St Suite Jjl 431 Houston, Tx 77030 and the phone number is (713) 500-7878
The provider's speciality is Emergency Medicine with taxonomy code 207P00000X
The provider has more than 7 years of experience.
The provider might be accepting Accepts: Alliant Health Plans, Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 10, 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 $93.23 with an average copayment of $23.3 for new patient appointments. Established patients should expect a typical charge of $107.65 and an average copayment of 26.91. 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: Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report.
The practitioner is affiliated to the following hospital(s): EMORY DECATUR HOSPITAL and EMORY HILLANDALE 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 April 14, 2017. 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.