MRS. ROBERTA G MCCAULEY NP
NPI 1245310952
Nurse Practitioner in Winchester, VA

NPI Status: Active since October 17, 2006

Contact Information

160 MERCHANT ST # 200
WINCHESTER, VA
ZIP 22603
Phone: (540) 536-5950
Fax: (540) 536-5955

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  • Individual
  • Female
  • Nurse Practitioner
  • PECOS Enrolled
  • Medicare Quality Reporting

About ROBERTA MCCAULEY

This page provides the complete NPI Profile along with additional information for Roberta Mccauley, a provider established in Winchester, Virginia with a medical specialization in Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1245310952 assigned on October 2006. The practitioner's primary taxonomy code is 363L00000X with license number 0024170803 (VA). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI
1245310952
Provider Name
MRS. ROBERTA G MCCAULEY NP
Gender
Female
Entity Type
Individual
Location Address
160 MERCHANT ST # 200 WINCHESTER, VA 22603
Location Phone
(540) 536-5950
Location Fax
(540) 536-5955
Mailing Address
220 CAMPUS BLVD STE 100 WINCHESTER, VA 22601
Mailing Phone
(154) 053-6510
Mailing Fax
(540) 536-5955
Is Sole Proprietor?
No
Enumeration Date
10-17-2006
Last Update Date
09-09-2021
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A nurse practitioner (NP) like Roberta Mccauley is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Secondary Locations

  • 607 E Jubal Early Dr
    Winchester, VA 22601
    (540) 536-2232
  • 33820 Old Valley Pike Ste 2
    Strasburg, VA 22657
    (540) 459-1310
  • 415A South St
    Front Royal, VA 22630
    (540) 656-0495
  • 65 Riverton Commons Dr
    Front Royal, VA 22630
    (540) 635-0700

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

Nurse Practitioner

Taxonomy Code
363L00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
0024170803
License State
VA
Taxonomy Description
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Medicare Participation & PECOS Enrollment Status

Roberta Mccauley 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

  • 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 22603 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $86.88
  • Minimum New Patient Price $56.19
  • Maximum New Patient Price $170.3
  • Average New Patient Copayment $21.72
  • Minimum New Patient Copayment $14.04
  • Maximum New Patient Copayment $42.57

Established Patients Visit Costs *

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

  • Average Established Patient Price $99.13
  • Minimum Established Patient Price $18.07
  • Maximum Established Patient Price $138.91
  • Average Established Patient Copayment $24.78
  • Minimum Established Patient Copayment $4.51
  • Maximum Established Patient Copayment $34.72

* 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.

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
e-Prescribing 96% 873
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Security Risk AnalysisYesN/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 ReportingYesN/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.

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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 1245310952, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

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.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
4
Doubled → 8
Pos 4
5
Unchanged
Pos 5
3
Doubled → 6
Pos 6
1
Unchanged
Pos 7
0
Doubled → 0
Pos 8
9
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
2
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 4 → 8 3 → 6 0 → 0 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 8 + 5 + 6 + 1 + 0 + 9 + 1 + 0 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1245310952.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Physician Assistant
160 MERCHANT ST # 200
WINCHESTER, VA 22603
Nurse Practitioner (Family)
160 MERCHANT ST # 200
WINCHESTER, VA 22603
Physician Assistant
160 MERCHANT ST # 200
WINCHESTER, VA 22603

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245310952, enumerated as an "individual" on October 17, 2006.

The provider is located at 160 MERCHANT ST # 200 WINCHESTER, VA 22603 and the phone number is (540) 536-5950.

Nurse Practitioner with taxonomy code 363L00000X.