RENE S GOMEZ MD
NPI 1255316766
Specialist in Lawrenceville, NJ
NPI Status: Active since December 08, 2005
Contact Information
3131 PRINCETON PIKE
BLD 3 SUITE 202
LAWRENCEVILLE, NJ
ZIP 08648
Phone: (609) 896-1701
Fax: (609) 896-3737
- Individual
- Male
- Specialist
- PECOS Enrolled
- Medicare Quality Reporting
About RENE GOMEZ
This page provides the complete NPI Profile along with additional information for Rene Gomez, a provider established in Lawrenceville, New Jersey with a medical specialization in Specialist. The healthcare provider is registered in the NPI registry with number 1255316766 assigned on December 2005. The practitioner's primary taxonomy code is 174400000X with license number MA38588 (NJ). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1255316766
- Provider Name
- RENE S GOMEZ MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3131 PRINCETON PIKE BLD 3 SUITE 202 LAWRENCEVILLE, NJ 08648
- Location Phone
- (609) 896-1701
- Location Fax
- (609) 896-3737
- Mailing Address
- 3131 PRINCETON PIKE BLD 3 SUITE 202 LAWRENCEVILLE, NJ 08648
- Mailing Phone
- (609) 896-1701
- Mailing Fax
- (609) 896-3737
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 12-08-2005
- Last Update Date
- 07-08-2007
- Code Navigator
Location Map
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
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- MA38588
- License State
- NJ
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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.
*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 |
|---|---|---|---|
| D96488 | MEDICARE UPIN (02) | NJ | |
| 742422 | MEDICARE ID-TYPE UNSPECIFIED (04) | NJ |
Medicare Participation & PECOS Enrollment Status
Rene Gomez 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
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 |
|---|---|---|
| Advance Care Planning | Yes | N/A |
| Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning. | ||
| Care Plan | 98% | 555 |
| 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 | ||
| Closing the Referral Loop: Receipt of Specialist Report | 100% | 54 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred | ||
| Dementia: Caregiver Education and Support | 61% | 251 |
| Percentage of patients with dementia whose caregiver(s)* were provided with education** on dementia disease management and health behavior changes AND were referred to additional resources*** for support in the last 12 months | ||
| Dementia: Functional Status Assessment | 97% | 273 |
| Percentage of patients with dementia for whom an assessment of functional status* was performed at least once in the last 12 months | ||
| Documentation of Current Medications in the Medical Record | 100% | 2831 |
| 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, Family, and Caregivers in Developing a Plan of Care | Yes | N/A |
| Engage patients, family, and caregivers in developing a plan of care and prioritizing their goals for action, documented in the electronic health record (EHR) technology. | ||
| e-Prescribing | 100% | 2296 |
| 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: Plan of Care | 92% | 367 |
| Percentage of patients aged 65 years and older with a history of falls that had a plan of care for falls documented within 12 months | ||
| Falls: Risk Assessment | 90% | 365 |
| Percentage of patients aged 65 years and older with a history of falls that had a risk assessment for falls completed within 12 months | ||
| Falls: Screening for Future Fall Risk | 80% | 555 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Implementation of formal quality improvement methods, practice changes, or other practice improvement processes | Yes | N/A |
| Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/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. | ||
| MEDICATION PRESCRIBED FOR ACUTE MIGRAINE ATTACK | 70% | 378 |
| Percentage of patients age 12 years and older with a diagnosis of migraine who were prescribed a guideline recommended medication for acute migraine attacks within the 12 month measurement period. | ||
| Medication Reconciliation | 97% | 2946 |
| 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. | ||
| Participation in MOC Part IV | Yes | N/A |
| Participation in Maintenance of Certification (MOC) Part IV, such as the American Board of Internal Medicine (ABIM) Approved Quality Improvement (AQI) Program, National Cardiovascular Data Registry (NCDR) Clinical Quality Coach, Quality Practice Initiative Certification Program, American Board of Medical Specialties Practice Performance Improvement Module or ASA Simulation Education Network, for improving professional practice including participation in a local, regional or national outcomes registry or quality assessment program. Performance of monthly activities across practice to regularly assess performance in practice, by reviewing outcomes addressing identified areas for improvement and evaluating the results. | ||
| Patient-Specific Education | 45% | 1273 |
| 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. | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 96% | 1273 |
| 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. | ||
| Regular training in care coordination | Yes | N/A |
| Implementation of regular care coordination training. | ||
| Screening for Psychiatric or Behavioral Health Disorders | 94% | 288 |
| Percent of all visits for patients with a diagnosis of epilepsy where the patient was screened for psychiatric or behavioral disorders. | ||
| Secure Messaging | 7% | 1273 |
| 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. | ||
| TCPI Participation | Yes | N/A |
| Participation in the CMS Transforming Clinical Practice Initiative | ||
| 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. | ||
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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 1255316766, we treat the final digit (6) 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
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 54 is 60. 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.
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
LAWRENCEVILLE, NJ 08648
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255316766, enumerated as an "individual" on December 08, 2005.
The provider is located at 3131 PRINCETON PIKE BLD 3 SUITE 202 LAWRENCEVILLE, NJ 08648 and the phone number is (609) 896-1701.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
