DR. DAVID FREDERICK SHIRLEY M.D.
NPI 1275560484
Family Medicine - Geriatric Medicine in Rocklin, CA

NPI Status: Active since June 26, 2006

Contact Information

3031 STANFORD RANCH RD
SUITE 2, #220
ROCKLIN, CA
ZIP 95765
Phone: (916) 677-7962
Fax: (916) 435-2964

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  • Individual
  • Male
  • Family Medicine
  • Geriatric Medicine
  • PECOS Enrolled
  • Medicare Quality Reporting

About DAVID SHIRLEY

This page provides the complete NPI Profile along with additional information for David Shirley, a primary care provider established in Rocklin, California with a medical specialization in Family Medicine, focusing in geriatric medicine . The healthcare provider is registered in the NPI registry with number 1275560484 assigned on June 2006. The practitioner's primary taxonomy code is 207QG0300X with license number G66004 (CA). The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI
1275560484
Provider Name
DR. DAVID FREDERICK SHIRLEY M.D.
Gender
Male
Entity Type
Individual
Location Address
3031 STANFORD RANCH RD SUITE 2, #220 ROCKLIN, CA 95765
Location Phone
(916) 677-7962
Location Fax
(916) 435-2964
Mailing Address
3031 STANFORD RANCH RD SUITE 2, #220 ROCKLIN, CA 95765
Mailing Phone
(916) 677-7962
Mailing Fax
(916) 435-2964
Is Sole Proprietor?
No
Enumeration Date
06-26-2006
Last Update Date
07-08-2007
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A primary care provider (PCP) like David Shirley sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

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

Family Medicine Geriatric Medicine

Taxonomy Code
207QG0300X
Type
Allopathic & Osteopathic Physicians
License No.
G66004
License State
CA
Taxonomy Description
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

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
ZZZ24568ZMEDICARE ID-TYPE UNSPECIFIED (04) 
E29236MEDICARE UPIN (02) 

Medicare Participation & PECOS Enrollment Status

David Shirley 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

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.

Unknown

  • Other-Enteral and Parenteral (OB006N)

    Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4035)

    1 DME suppliers used 13 Medicare Claims 403 Services Paid

  • Other-Enteral and Parenteral (OB006N)

    Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4150)

    1 DME suppliers used 13 Medicare Claims 5785 Services Paid

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 37 Medicare Claims 39 Services Paid

  • DME-Other DME (DE000N)

    Iv pole (HCPCS:E0776)

    1 DME suppliers used 12 Medicare Claims 12 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)

    3 DME suppliers used 53 Medicare Claims 54 Services Paid

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 95765 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $92.61
  • Minimum New Patient Price $60.44
  • Maximum New Patient Price $180.85
  • Average New Patient Copayment $23.15
  • Minimum New Patient Copayment $15.11
  • Maximum New Patient Copayment $45.21

Established Patients Visit Costs *

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

  • Average Established Patient Price $105.95
  • Minimum Established Patient Price $19.88
  • Maximum Established Patient Price $148.15
  • Average Established Patient Copayment $26.48
  • Minimum Established Patient Copayment $4.97
  • Maximum Established Patient Copayment $37.03

* 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
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Consultation of the Prescription Drug Monitoring ProgramYesN/A
Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance.
Documentation of Current Medications in the Medical Record 94% 703
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 New Medicaid Patients and Follow-upYesN/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
e-Prescribing 99% 2069
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Implementation of improvements that contribute to more timely communication of test resultsYesN/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral LoopYesN/A
Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology.
Medication Reconciliation 87% 213
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 5% 269
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 RecordYesN/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 1% 269
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.
Tobacco useYesN/A
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence.
Use of certified EHR to capture patient reported outcomesYesN/A
In support of improving patient access, performing additional activities that enable capture of patient reported outcomes (e.g., home blood pressure, blood glucose logs, food diaries, at-risk health factors such as tobacco or alcohol use, etc.) or patient activation measures through use of certified EHR technology, containing this data in a separate queue for clinician recognition and review.
Use of decision support and standardized treatment protocolsYesN/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 3% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
239
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 1275560484, we treat the final digit (4) 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 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

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
7
Doubled → 14 → 1 + 4
Pos 4
5
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
0
Doubled → 0
Pos 8
4
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
4
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 7 → 14 → 5 5 → 10 → 1 0 → 0 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

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

2 + 2 + 1 + 4 + 5 + 1 + 0 + 6 + 0 + 4 + 1 + 6 + 24 = 56

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

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1275560484.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Music Therapist
3031 STANFORD RANCH RD, SUITE 2, #230
ROCKLIN, CA 95765
Speech-Language Pathologist
3031 STANFORD RANCH RD, SUITE 134
ROCKLIN, CA 95765
Nurse Practitioner
3031 STANFORD RANCH RD, 2-448
ROCKLIN, CA 95765
Clinic/Center
3031 STANFORD RANCH RD, # 2-448
ROCKLIN, CA 95765
Skilled Nursing Facility
3031 STANFORD RANCH RD, SUITE 2, #220
ROCKLIN, CA 95765
Psychologist
3031 STANFORD RANCH RD, STE 2 #1065
ROCKLIN, CA 95765

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275560484, enumerated as an "individual" on June 26, 2006.

The provider is located at 3031 STANFORD RANCH RD SUITE 2, #220 ROCKLIN, CA 95765 and the phone number is (916) 677-7962.

Family Medicine with taxonomy code 207QG0300X and a focus in Geriatric Medicine.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.