MICHAEL DONALD MCDOWELL JR. DO
NPI 1285165357
Pediatrics - Pediatric Pulmonology in Houston, TX


Quality Rating: 82.38 out of 100 score

NPI Status: Active since March 21, 2017

Contact Information

6410 FANNIN ST
HOUSTON, TX
ZIP 77030
Phone: (832) 325-6516

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  • Individual
  • Male
  • Pediatrics
  • Pediatric Pulmonology
  • Accepts Insurance
  • PECOS Enrolled

About MICHAEL MCDOWELL

This page provides the complete NPI Profile along with additional information for Michael Mcdowell, a pediatrician established in Houston, Texas with a medical specialization in Pediatrics, focusing in pediatric pulmonology . The healthcare provider is registered in the NPI registry with number 1285165357 assigned on March 2017. The practitioner's primary taxonomy code is 2080P0214X with license number S5700 (TX). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1285165357
Provider Name
MICHAEL DONALD MCDOWELL JR. DO
Gender
Male
Entity Type
Individual
Location Address
6410 FANNIN ST HOUSTON, TX 77030
Location Phone
(832) 325-6516
Mailing Address
6431 FANNIN ST HOUSTON, TX 77030
Mailing Phone
(713) 500-5650
Is Sole Proprietor?
Yes
Enumeration Date
03-21-2017
Last Update Date
04-22-2024
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A pediatrician like Michael Mcdowell is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, 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

Pediatrics Pediatric Pulmonology

Taxonomy Code
2080P0214X
Type
Allopathic & Osteopathic Physicians
License No.
S5700
License State
TX
Taxonomy Description
A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.

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)
1208000000XAllopathic & Osteopathic Physicians

Pediatrics

2017017626 (MO)
2208000000XAllopathic & Osteopathic Physicians

Pediatrics

S5700 (TX)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BSW Diabetes Care Gold HMO 014 - HMO
  • BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Elite Gold HMO 004 - HMO
  • BSW Elite Gold HMO 012 - HMO
  • BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Prime Silver HMO 008 - HMO
  • BSW Prime Silver HMO 005 - HMO
  • BSW Savers Bronze HMO H S A 006 - HMO
  • BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Savers Bronze HMO H S A 009 - HMO
  • MyBlue Health Bronze? 402 - HMO
  • MyBlue Health Bronze? Standard - HMO
  • MyBlue Health Gold? 403 - HMO
  • MyBlue Health Gold? Standard - HMO
  • MyBlue Health Silver? 405 - HMO
  • MyBlue Health Silver? Standard - HMO
  • Community Premier Bronze 003 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Premier Bronze 018 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Premier Gold 005 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Premier Gold 021 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Premier Silver 012 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Premier Silver 020 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Select Bronze 016 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Select Silver 019 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - EPO
  • Bronze Simple Chronic Care CKM - EPO
  • Bronze Simple Diabetes - EPO
  • Gold Classic - EPO
  • Gold Classic Guided Care - HMO
  • Gold Classic Standard - EPO
  • Gold Classic Standard Guided Care - HMO
  • Gold Elite - EPO
  • Gold Simple Diabetes Guided Care - HMO
  • Gold Simple Guided Care - HMO
  • Silver Classic - EPO
  • Silver Classic Standard - EPO
  • Silver Classic Standard Guided Care - HMO
  • Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care - HMO
  • Silver Simple Chronic Care CKM Guided Care - HMO
  • Silver Simple Diabetes Guided Care - HMO
  • Silver Simple Guided Care - HMO
  • Wellpoint Essential Bronze 4000 HSA (+ Incentives) - HMO
  • Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze 6000 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs) - HMO
  • Wellpoint Essential Bronze 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze POS 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Bronze POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Bronze POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Catastrophic (+ Incentives) - HMO
  • Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold POS 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Gold POS 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Gold POS 700 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver POS 2500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Silver POS 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Michael Mcdowell 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

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 82.38, 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: 82.38 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: 79.23

    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: 58.5

    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: 58.5

    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.

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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 1285165357, we treat the final digit (7) 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

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
8
Doubled → 16 → 1 + 6
Pos 4
5
Unchanged
Pos 5
1
Doubled → 2
Pos 6
6
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
3
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
7
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 8 → 16 → 7 1 → 2 5 → 10 → 1 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 + 1 + 6 + 5 + 2 + 6 + 1 + 0 + 3 + 1 + 0 + 24 = 53

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

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1285165357.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Legal Medicine
6410 FANNIN ST, STE 225
HOUSTON, TX 77030
Obstetrics & Gynecology (Gynecology)
6410 FANNIN ST, 350
HOUSTON, TX 77030
Psychiatry & Neurology (Neurology)
6410 FANNIN ST, SUITE 1014
HOUSTON, TX 77030
Internal Medicine
6410 FANNIN ST, 600
HOUSTON, TX 77030
Psychiatry & Neurology (Neurology)
6410 FANNIN ST, SUITE 1460
HOUSTON, TX 77030
Surgery (Plastic and Reconstructive Surgery)
6410 FANNIN ST, SUITE 950
HOUSTON, TX 77030
Psychiatry & Neurology (Neurology)
6410 FANNIN ST, 1014
HOUSTON, TX 77030
Pediatrics
6410 FANNIN ST, 500
HOUSTON, TX 77030
Nurse Practitioner (Acute Care)
6410 FANNIN ST, 1020
HOUSTON, TX 77030
Internal Medicine (Critical Care Medicine)
6410 FANNIN ST, 1020
HOUSTON, TX 77030
Pediatrics
6410 FANNIN ST, 500
HOUSTON, TX 77030
Physician Assistant (Surgical)
6410 FANNIN ST, 1020
HOUSTON, TX 77030
Transplant Surgery
6410 FANNIN ST, 370
HOUSTON, TX 77030
Pediatrics (Pediatric Critical Care Medicine)
6410 FANNIN ST, 500
HOUSTON, TX 77030
Anesthesiology (Pain Medicine)
6410 FANNIN ST, 1115
HOUSTON, TX 77030
Pediatrics
6410 FANNIN ST, 500
HOUSTON, TX 77030
Pediatrics (Adolescent Medicine)
6410 FANNIN ST, 500
HOUSTON, TX 77030
Obstetrics & Gynecology (Maternal & Fetal Medicine)
6410 FANNIN ST, 350
HOUSTON, TX 77030
Pediatrics
6410 FANNIN ST, 500
HOUSTON, TX 77030
Physician Assistant (Surgical)
6410 FANNIN ST, 1020
HOUSTON, TX 77030

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285165357, enumerated as an "individual" on March 21, 2017.

The provider is located at 6410 FANNIN ST HOUSTON, TX 77030 and the phone number is (832) 325-6516.

Pediatrics with taxonomy code 2080P0214X and a focus in Pediatric Pulmonology.

The provider might be accepting Accepts: Baylor Scott and White Health Plan, Blue Cross and. Please consult your insurance carrier or call the provider to verify.