DR. MICHAEL L. COHEN M.D.
NPI 1205885779
Internal Medicine - Critical Care Medicine in Walnut Creek, CA
NPI Status: Active since May 10, 2006
Contact Information
130 LA CASA VIA
BLDG #2, SUITE 208
WALNUT CREEK, CA
ZIP 94598
Phone: (925) 944-0166
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Insurance Plans Accepted
- Secondary Locations
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Quality Reporting
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Internal Medicine
- Critical Care Medicine
- PECOS Enrolled
- Medicare Quality Reporting
About MICHAEL COHEN
This page provides the complete NPI Profile along with additional information for Michael Cohen, an internist established in Walnut Creek, California with a medical specialization in Internal Medicine, focusing in critical care medicine . The healthcare provider is registered in the NPI registry with number 1205885779 assigned on May 2006. The practitioner's primary taxonomy code is 207RC0200X with license number G28277 (CA). The provider is registered as an individual and his NPI record was last updated 8 years ago.
- NPI
- 1205885779
- Provider Name
- DR. MICHAEL L. COHEN M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 130 LA CASA VIA BLDG #2, SUITE 208 WALNUT CREEK, CA 94598
- Location Phone
- (925) 944-0166
- Mailing Address
- 2637 SHADELANDS DR WALNUT CREEK, CA 94598
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-10-2006
- Last Update Date
- 01-31-2018
- Code Navigator
An internist like Michael Cohen 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.
Location Map
Secondary Locations
- 130 La Casa Via Bldg #2, Suite 208
Walnut Creek, CA 94598
(925) 944-0166
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 Critical Care Medicine
- Taxonomy Code
- 207RC0200X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- G28277
- License State
- CA
- Taxonomy Description
- An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
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 | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | G282770 (CA) |
| 2 | 207RS0012X | Allopathic & Osteopathic Physicians | Internal Medicine | G28277 (CA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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.
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 |
|---|---|---|---|
| 00G282770 | MEDICAID (05) | CA | |
| 290004008 | OTHER (01) | CA | MEDICARE RAILROAD BOARD |
| A43677 | OTHER (01) | CA | MEDICARE UPIN |
Medicare Participation & PECOS Enrollment Status
Michael Cohen 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: Durable Medical Equipment (DME) 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
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
21 DME suppliers used 573 Medicare Claims 573 Services Paid
DME-Other DME (DE001N)
Full face mask used with positive airway pressure device, each (HCPCS:A7030)
16 DME suppliers used 231 Medicare Claims 231 Services Paid
DME-Other DME (DE001N)
Face mask interface, replacement for full face mask, each (HCPCS:A7031)
16 DME suppliers used 238 Medicare Claims 608 Services Paid
DME-Other DME (DE001N)
Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)
19 DME suppliers used 416 Medicare Claims 2156 Services Paid
DME-Other DME (DE001N)
Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)
19 DME suppliers used 145 Medicare Claims 782 Services Paid
DME-Other DME (DE001N)
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)
25 DME suppliers used 607 Medicare Claims 607 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
25 DME suppliers used 502 Medicare Claims 503 Services Paid
DME-Other DME (DE001N)
Chinstrap used with positive airway pressure device (HCPCS:A7036)
10 DME suppliers used 81 Medicare Claims 81 Services Paid
DME-Other DME (DE001N)
Tubing used with positive airway pressure device (HCPCS:A7037)
14 DME suppliers used 148 Medicare Claims 148 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
27 DME suppliers used 842 Medicare Claims 4644 Services Paid
DME-Other DME (DE001N)
Filter, non disposable, used with positive airway pressure device (HCPCS:A7039)
20 DME suppliers used 292 Medicare Claims 292 Services Paid
DME-Other DME (DE001N)
Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)
20 DME suppliers used 317 Medicare Claims 317 Services Paid
DME-Other DME (DE001N)
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0470)
5 DME suppliers used 56 Medicare Claims 56 Services Paid
DME-Other DME (DE001N)
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0471)
5 DME suppliers used 190 Medicare Claims 190 Services Paid
DME-Other DME (DE001N)
Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)
8 DME suppliers used 77 Medicare Claims 77 Services Paid
DME-Other DME (DE001N)
Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)
2 DME suppliers used 51 Medicare Claims 51 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
13 DME suppliers used 832 Medicare Claims 832 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 24 Medicare Claims 24 Services Paid
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.
Established patient office or other outpatient visit, 30-39 minutes
New patient office or other outpatient visit, 45-59 minutes
Sleep study in sleep lab (6 years or older)
Sleep study in sleep lab with continuous airway pressure (6 years or older)
Sleep study including heart rate, breathing, and sleep time
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.
This service was performed 564 times for 432 patientsThis 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.
This service was performed 133 times for 133 patientsA sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
This service was performed 128 times for 126 patientsA sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
This service was performed 323 times for 285 patientsA sleep study monitors your sleep patterns to evaluate your sleep quality. It records your heart rate, breathing, and actual sleep time. This information helps identify any sleep disorders, ensuring you get the rest you need for optimal health.
This service was performed 108 times for 107 patientsPhysician 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 94598 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $153.83
- Minimum New Patient Price $69
- Maximum New Patient Price $202.35
- Average New Patient Copayment $38.45
- Minimum New Patient Copayment $17.25
- Maximum New Patient Copayment $50.58
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $119.48
- Minimum Established Patient Price $23.44
- Maximum Established Patient Price $166.46
- Average Established Patient Copayment $29.87
- Minimum Established Patient Copayment $5.86
- Maximum Established Patient Copayment $41.61
* 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.
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 | 64% | 321 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Colorectal Cancer Screening | 52% | 998 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Diabetes: Medical Attention for Nephropathy | 90% | 221 |
| 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 | 100% | 2264 |
| 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 | ||
| Engagement of patients through implementation of improvements in patient portal | Yes | N/A |
| Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence. | ||
| e-Prescribing | 99% | 176 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Falls: Screening for Future Fall Risk | 45% | 675 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Health Information Exchange | 3% | 30 |
| 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 at least one transition of care or referral. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| Medication Reconciliation | 100% | 1965 |
| 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. | ||
| Patient-Specific Education | 98% | 1593 |
| 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. | ||
| Pneumococcal Vaccination Status for Older Adults | 70% | 677 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Practice Improvements for Bilateral Exchange of Patient Information | Yes | N/A |
| Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: • Participate in a Health Information Exchange if available; and/or • Use structured referral notes. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 80% | 1571 |
| 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 | 49% | 1336 |
| 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 | 27% | 1283 |
| 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 | 5% | 21 |
| 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 | 99% | 1593 |
| 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 certain information. | ||
| Secure Messaging | 47% | 1593 |
| 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 message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| 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. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Use evidence-based decision aids to support shared decision-making. | Yes | N/A |
| Use evidence-based decision aids to support shared decision-making. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
| Use of High-Risk Medications in the Elderly | 1% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 677 |
| 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 | ||
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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 1205885779, we treat the final digit (9) 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 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
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 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205885779, enumerated as an "individual" on May 10, 2006.
The provider is located at 130 LA CASA VIA BLDG #2, SUITE 208 WALNUT CREEK, CA 94598 and the phone number is (925) 944-0166.
Internal Medicine with taxonomy code 207RC0200X and a focus in Critical Care Medicine.
The provider might be accepting Accepts: Medicare, Medicaid and Railroad Medicare. Please consult your insurance carrier or call the provider to verify.
