DR. THEODROS H. GEBREMESKEL MD
NPI 1215367008
Internal Medicine in Alexandria, VA


Quality Rating: 80.61 out of 100 score

NPI Status: Active since November 15, 2013

Contact Information

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306
Phone: (703) 664-7000
Fax: (703) 664-7666

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  • Individual
  • Male
  • Years of Experience 22
  • Internal Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About THEODROS GEBREMESKEL

This page provides the complete NPI Profile along with additional information for Theodros Gebremeskel, an internist established in Alexandria, Virginia with a medical specialization in Internal Medicine and more than 22 years of experience. The healthcare provider is registered in the NPI registry with number 1215367008 assigned on November 2013. The practitioner's primary taxonomy code is 207R00000X with license number 0101260734 (VA). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI
1215367008
Provider Name
DR. THEODROS H. GEBREMESKEL MD
Gender
Male
Entity Type
Individual
Location Address
2501 PARKERS LN ALEXANDRIA, VA 22306
Location Phone
(703) 664-7000
Location Fax
(703) 664-7666
Mailing Address
PO BOX 37174 BALTIMORE, MD 21297
Mailing Phone
(571) 423-5699
Mailing Fax
(703) 664-7666
Medical School Name
OTHER
Graduation Year
2004
Is Sole Proprietor?
No
Enumeration Date
11-15-2013
Last Update Date
08-30-2021
Code Navigator

An internist like Theodros Gebremeskel 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

  • 1840 Amherst St
    Winchester, VA 22601
    (540) 536-2270
  • 3300 Gallows Rd
    Falls Church, VA 22042
    (703) 776-4001
  • 44045 Riverside Pkwy
    Leesburg, VA 20176
    (703) 858-6000

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

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
0101260734
License State
VA
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

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)
1208M00000XAllopathic & Osteopathic Physicians

Hospitalist

0101260734 (VA)
2390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

(NY)

Medicare Participation & PECOS Enrollment Status

Theodros Gebremeskel 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.

Theodros Gebremeskel 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: 6305127440

    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: I20191003002717

    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

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-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    2 DME suppliers used 16 Medicare Claims 16 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 17 Medicare Claims 17 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

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 14 times for 11 patients

Follow-up hospital inpatient care per day, typically 15 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 107 times for 68 patients

Follow-up hospital inpatient care per day, typically 25 minutes

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 391 times for 180 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 299 times for 144 patients

Hospital discharge day management, more than 30 minutes

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

This service was performed 101 times for 99 patients

Hospital observation care on day of discharge

Hospital observation care on the day of discharge involves monitoring your health status to ensure stability before you leave. This includes assessing vital signs, response to treatment, and readiness for home care or rehabilitation.

This service was performed 13 times for 13 patients

Initial hospital inpatient care per day, typically 30 minutes

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

This service was performed 23 times for 23 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 25 times for 25 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 44 times for 43 patients

Initial hospital observation care per day, typically 70 minutes

This service involves a healthcare professional closely monitoring your health condition during your hospital stay. It typically lasts for about 70 minutes each day. This helps in timely detection of any changes in your health, allowing for immediate response and treatment.

This service was performed 11 times for 11 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $36.96 for a new patient copayment and $28.43 for an established patient copayment.

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 22306 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $147.85
  • Minimum New Patient Price $65.18
  • Maximum New Patient Price $194.86
  • Average New Patient Copayment $36.96
  • Minimum New Patient Copayment $16.29
  • Maximum New Patient Copayment $48.71

Established Patients Visit Costs *

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

  • Average Established Patient Price $113.72
  • Minimum Established Patient Price $21.4
  • Maximum Established Patient Price $158.88
  • Average Established Patient Copayment $28.43
  • Minimum Established Patient Copayment $5.35
  • Maximum Established Patient Copayment $39.72

* 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 80.61, 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: 80.61 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: 71.98

    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: 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: 63.38

    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: 63.38

    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
Care Plan 82% 125
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan

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. Theodros Gebremeskel is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
INOVA MOUNT VERNON HOSPITAL2501 PARKERS LANE
ALEXANDRIA, VA 22306
(703) 664-7000Acute Care Hospitals

Reviews for DR. THEODROS H. GEBREMESKEL MD

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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.
1215367008
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2225661400
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 2 + 5 + 6 + 6 + 1 + 4 + 0 + 0 + 24 = 52
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 52 = 88

The NPI number 1215367008 is valid because the calculated check digit 8 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.

ARTI O TANGEDA CRNA

Nurse Anesthetist, Certified Registered

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 295-9360

DR. GINNY GUJRAL KHANNA D.O.

Emergency Medicine

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7000

MR. WILLIAM RUSSELL BARTOW JR

Physician Assistant

(Medical)

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7218

DR. ERIC DESMAN

Plastic Surgery

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7218

DR. ALFRED J KIRKWOOD D.O.

Preventive Medicine

(Undersea and Hyperbaric Medicine)

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7218

DR. JONATHAN TITUS M.D.

Preventive Medicine

(Undersea and Hyperbaric Medicine)

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7218

DR. EVERETT CLAYTON EMBREY III MD

Emergency Medicine

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7112

ROGER VICTOR GISOLFI M.D.

Physical Medicine & Rehabilitation

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7189

WILLIAM GEORGE HAMILTON M.D.

Orthopaedic Surgery

(Adult Reconstructive Orthopaedic Surgery)

2501 PARKERS LN
SUITE 200
ALEXANDRIA, VA
ZIP 22306

(703) 892-6500

WILLIAM G. PALACE MD

Emergency Medicine

2501 PARKERS LN
INOVA MOUNT VERNON HOSPITAL EMER DEPT
ALEXANDRIA, VA
ZIP 22306

(703) 664-7112

DONNA LYNN LACKORE SWANSON PA-C

Physician Assistant

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7264

DR. REBECCA L FREESE M.D.

Anesthesiology

(Pain Medicine)

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7049

MS. MARY JANE KEARNEY CRNA

Nurse Anesthetist, Certified Registered

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 295-9360

DR. PATRICK S GASPAR M.D.

Anesthesiology

(Pain Medicine)

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7049

DR. DEBORAH S BROWN M.D.

Anesthesiology

(Pain Medicine)

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 295-9360

MRS. KRISTIN LEIGH LUPTON PA-C

Physician Assistant

(Surgical)

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7264

MICHAEL JOEL SHUSTER M.D.

Emergency Medicine

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7112

DR. MARYIDA KLIMOWICZ MD

Emergency Medicine

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7112

DR. VAL CHAPMAN MD

Emergency Medicine

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7112

VIRGINIA EM-1 MEDICAL SERVICES, PC

Emergency Medicine

2501 PARKERS LN
ALEXANDRIA, VA
ZIP 22306

(703) 664-7112

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215367008, enumerated as an "individual" on November 15, 2013.

The provider is located at 2501 PARKERS LN ALEXANDRIA, VA 22306 and the phone number is (703) 664-7000.

Internal Medicine with taxonomy code 207R00000X.

Theodros Gebremeskel is affiliated with: INOVA MOUNT VERNON HOSPITAL.