ADAM THEODORE GERSTENBLITH MD
NPI 1265654875
Ophthalmology - Retina Specialist in Hagerstown, MD
Active since May 03, 2007PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
246 EASTERN BLVD N, SUITE 102, HAGERSTOWN, MD 21740(301) 671-2400(301) 671-2403 Get Directions Write a Review
About Adam Theodore Gerstenblith Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ADAM THEODORE GERSTENBLITH MD (NPI 1265654875) is an individual retina specialist in Hagerstown, Maryland, licensed in Maryland (D0075032) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Meritus Medical Center, and maintains a secondary practice location in Williamsport.
NPPES Registry Identity
NPI1265654875
Entity TypeIndividualMale
Primary Taxonomy207WX0107X
Provider Legal NameADAM THEODORE GERSTENBLITHCredential: MD
Location Address246 EASTERN BLVD N, SUITE 102Hagerstown, MD 21740
Mailing Address246 Eastern Blvd N, Suite 102Hagerstown, MD 21740-5965 · (301) 671-2400
Phone(301) 671-2400
Fax(301) 671-2403
Sole ProprietorNo
Medical School CMSJohns Hopkins University School Of MedicineGraduated 2007
Enumeration DateMay 3, 2007
Last NPPES UpdateDecember 6, 20214 updates tracked since enumeration
NPPES CertifiedDecember 6, 2021
✔ NPI 1265654875 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
Licenses✔ Licensed in MD · D0075032✔ Licensed in PA · MD442919
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedInternal MedicineTaxonomy 207R00000X · License 21124 (MD)
246 EASTERN BLVD N, Hagerstown, MD 21740
Secondary Practice Location 1
Location 110212 Governor Lane BlvdWilliamsport, MD 21795-4086 · Phone (301) 733-4200 · Fax (301) 223-7121
Accepted Insurance
The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield West Virginia.Insurance ›
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
✔
Enrolled in Medicare and accepts Medicare assignment
Adam Theodore Gerstenblith Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
PECOS PAC ID6204005028
PECOS Enrollment IDI20110812000384, I20130607000246
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.
Areas of Expertise CMS Part B claims 14
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
64,562 services346 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
3,302 services1,312 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
3,077 services1,255 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
2,344 services466 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
321 services321 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
140 services133 patients
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Meritus Medical Center
Acute Care Hospitals · Hagerstown, MDOwnershipVoluntary non-profit - Private
CMS Certification Number210001
Location11116 Medical Campus RoadHagerstown, MD 21742 · Washington County
Emergency services Birthing friendly
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 21740 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
New Patient
$133.05 typical visit price
range $57.99 – $175.57
Typical copayment $33.26 (range $14.49 – $43.89)
Most-billed visit code 99204
Established Patient
$72.23 typical visit price
range $18.66 – $143.02
Typical copayment $18.05 (range $4.66 – $35.75)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practiceQuality
100
Improvement Activities
40
Reported Quality Measures
Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…
98%653 patients4/55-star benchmark: 100%
Age-Related Macular Degeneration (AMD): Dilated Macular Examination
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…
100%653 patients5/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
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
46%78 patients2/55-star benchmark: 95%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%437 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
100%500 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during…
100%500 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
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.
100%5,892 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%175 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
63%1,444 patients3/55-star benchmark: 99%
Health Information Exchange
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…
37%147 patients2/55-star benchmark: 98%
Medication Reconciliation
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.
100%892 patients5/55-star benchmark: 100%
Patient-Specific Education
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.
91%2,797 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
46%515 patients3/55-star benchmark: 90%
Preventive Care and Screening: Influenza Immunization
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
41%561 patients2/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
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
Patients screenedForUse: 97% · 1,078 patients
Patients tobacco: 96% · 1,078 patients
89%113 patients4/55-star benchmark: 98%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
100%82 patients5/55-star benchmark: 100%
Provide Patient Access
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…
86%2,797 patients4/55-star benchmark: 100%
Secure Messaging
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…
13%2,797 patients1/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
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.
Lower rates are better for this measure.
Patients 2+: 0% · 1,430 patients
0%1,430 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Prosthetic/Orthotic Supplier
246 EASTERN BLVD N, SUITE 100
HAGERSTOWN, MD 21740
HAGERSTOWN, MD 21740
Ophthalmology (Retina Specialist)
246 EASTERN BLVD N, SUITE 102
HAGERSTOWN, MD 21740
HAGERSTOWN, MD 21740
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
246 EASTERN BLVD N, STE 104
HAGERSTOWN, MD 21740
HAGERSTOWN, MD 21740
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Adam Gerstenblith's NPI number?
The NPI number for Adam Gerstenblith is 1265654875. It was assigned to this individual provider in the NPPES registry on May 3, 2007.
Where is Adam Gerstenblith located?
Adam Gerstenblith practices at 246 Eastern Blvd N Suite 102, Hagerstown, MD 21740. The listed phone number is (301) 671-2400.
What is Adam Gerstenblith's specialty?
The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.
Is Adam Gerstenblith enrolled in Medicare?
Yes. Adam Gerstenblith is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
What insurance does Adam Gerstenblith accept?
Health plans from Highmark Blue Cross Blue Shield West Virginia list Adam Gerstenblith as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Adam Gerstenblith affiliated with any hospitals?
According to CMS data, Adam Gerstenblith is affiliated with Meritus Medical Center.
When was this NPI record last updated?
The NPPES record for Adam Gerstenblith was last updated on December 6, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.
