DR. JOHN M ROWLEY MD
NPI 1285601112
Surgery - Plastic and Reconstructive Surgery in Phoenix, AZ

Quality Rating: 0 out of 100 score

NPI Status: Active since February 28, 2006

Contact Information

15810 S 45TH ST
SUITE 140
PHOENIX, AZ
ZIP 85048
Phone: (480) 759-3001
Fax: (480) 759-1341

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Table of Contents

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Overall Quality Performance
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 31
Surgery
Plastic and Reconstructive Surgery
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About JOHN ROWLEY

This page provides the complete NPI Profile along with additional information for John Rowley, a provider established in Phoenix, Arizona with a medical specialization in Surgery, focusing in plastic and reconstructive surgery and more than 31 years of experience. He graduated from University Of Iowa, Rj & L Carver College Of Medicine in 1995. The healthcare provider is registered in the NPI registry with number 1285601112 assigned on February 2006. The practitioner's primary taxonomy code is 2086S0122X with license number 28662 (AZ). The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI: 1285601112
Provider Name: DR. JOHN M ROWLEY MD
Gender: Male
Entity Type: Individual
Location Address: 15810 S 45TH ST SUITE 140 PHOENIX, AZ 85048
Location Phone: (480) 759-3001
Location Fax: (480) 759-1341
Mailing Address: 4545 E CHANDLER BLVD STE 110 PHOENIX, AZ 85048
Mailing Phone: (480) 759-3001
Mailing Fax: (480) 759-1341
Medical School Name: UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Graduation Year: 1995
Is Sole Proprietor?: No
Enumeration Date: 02-28-2006
Last Update Date: 06-09-2020
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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: Surgery Plastic and Reconstructive Surgery
Taxonomy Code: 2086S0122X
Type: Allopathic & Osteopathic Physicians
License No.: 28662
License State: AZ
Taxonomy Description: A surgeon who specializes in plastic and reconstructive surgery.

Insurance Plans Accepted

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

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
UHC Bronze Standard - HMO
UHC Bronze Standard+ (Dental + Vision) - HMO
UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
UHC Gold Standard - HMO
UHC Silver Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
UHC Silver Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
UHC Silver Standard - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

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
691916	MEDICAID (05)	AZ

Medicare Participation & PECOS Enrollment Status

John Rowley is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

John Rowley 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
PECOS PAC ID: 1557321643
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20041013000669
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
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

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm
Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm
Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm
Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less
Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm
Complicated repair of wound of trunk, 2.6-7.5 cm
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 20-29 minutes
Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less
Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less
Mastectomy
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 15-29 minutes
Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm
Repair of wound by transferring skin, 30.1-60.0 sq cm
Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less
Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less
Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm
Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm
Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm

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 0, 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: 0 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: 0

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: N/A

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: 0

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: N/A

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: N/A

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.

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
Care Plan	68%	143
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
e-Prescribing	8%	71
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Medication Reconciliation	95%	56
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	14%	224
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.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	89%	560
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling	81%	58
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
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	8%	224
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.
Secure Messaging	7%	224
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.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. John Rowley is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
AURELIA OSBORN FOX MEMORIAL HOSPITAL	ONE NORTON AVENUE ONEONTA, NY 13820	(607) 432-2000	Acute Care Hospitals

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 1285601112, 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 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 16 → 1 + 6

Pos 4

Unchanged

Pos 5

Doubled → 12 → 1 + 2

Pos 6

Unchanged

Pos 7

Doubled → 2

Pos 8

Unchanged

Pos 9

Doubled → 2

Check

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 6 → 12 → 3 1 → 2 1 → 2

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 + 1 + 2 + 0 + 2 + 1 + 2 + 24 = 48

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

The next multiple of ten after 48 is 50. The difference is the calculated check digit.

50 - 48 = 2

This NPI is valid

The calculated check digit is 2, which matches the last digit of 1285601112.

Other Providers at the Same Location

The following 15 providers are registered at the same or a nearby location.

CARL JONATHAN BEECROFT DPM

Podiatrist (Foot & Ankle Surgery)

15810 S 45TH ST
PHOENIX, AZ 85048

Maricopa County (480) 893-1090

DR. KELVIN S CREZEE DPM

Podiatrist (Foot & Ankle Surgery)

15810 S 45TH ST, ST #190
PHOENIX, AZ 85048

Maricopa County (480) 893-1090

IAN ALLEN MCLEOD PA-C, ATC, NCTMB

Physician Assistant

15810 S 45TH ST, SUITE 101
PHOENIX, AZ 85048

Maricopa County (480) 222-3384

DR. GREG ALAN HAUSER DC, FICPA

Chiropractor

15810 S 45TH ST, SUITE 160
PHOENIX, AZ 85048

Maricopa County (480) 704-6600

MRS. JULIE L TINDALL PT PHYSICAL THERAPIS

Physical Therapist

15810 S 45TH ST, SUITE 105
PHOENIX, AZ 85048

Maricopa County (480) 893-1321

MRS. KAREN B REIN PT

Physical Therapist

15810 S 45TH ST, SUITE 105
PHOENIX, AZ 85048

Maricopa County (480) 893-1321

PALO VERDE PLASTIC SURGERY PC

Surgery (Plastic and Reconstructive Surgery)

15810 S 45TH ST, SUITE 140
PHOENIX, AZ 85048

Maricopa County (480) 759-3001

AHWATUKEE FOOTHILLS PLASTIC SURGERY PC

Surgery (Plastic and Reconstructive Surgery)

15810 S 45TH ST, SUITE 140
PHOENIX, AZ 85048

Maricopa County (480) 759-3001

DR. ALEX MICHAEL STEWART DPM

Podiatrist (Foot & Ankle Surgery)

15810 S 45TH ST, SUITE 190
PHOENIX, AZ 85048

Maricopa County (480) 893-1090

PHOENIX DIAGNOSTIC IMAGING INC

Radiology (Diagnostic Radiology)

15810 S 45TH ST, SUITE 110
PHOENIX, AZ 85048

Maricopa County (480) 753-6161

SMI IMAGING, LLC

Radiology (Diagnostic Radiology)

15810 S 45TH ST, SUITE 110
PHOENIX, AZ 85048

Maricopa County (480) 753-6161

ANTHONY W HARDEN PHYSICAL THERAPY

Physical Therapist

15810 S 45TH ST, SUITE 105
PHOENIX, AZ 85048

Maricopa County (480) 893-1321

CUTTING EDGE RNFA, LLC

Registered Nurse (Registered Nurse First Assistant)

15810 S 45TH ST
PHOENIX, AZ 85048

Maricopa County (480) 292-4999

AHWATUKEE AMBULATORY SURGICAL CENTER, LLC

Clinic/Center (Ambulatory Surgical)

15810 S 45TH ST, SUITE 140
PHOENIX, AZ 85048

Maricopa County (480) 239-4799

TODD K FARNWORTH MD

Surgery (Plastic and Reconstructive Surgery)

15810 S 45TH ST, STE 140
PHOENIX, AZ 85048

Maricopa County (480) 759-3001

About JOHN ROWLEY

Location Map

Specialty - Primary Taxonomy

Surgery Plastic and Reconstructive Surgery

Insurance Plans Accepted

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 1557321643

PECOS Enrollment ID: I20041013000669

Accepts Medicare Assignment? 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

Areas of Expertise

Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm

Complicated repair of wound of trunk, 2.6-7.5 cm

Established patient office or other outpatient visit, 10-19 minutes

Established patient office or other outpatient visit, 20-29 minutes

Established patient office or other outpatient visit, 20-29 minutes

Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less

Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less

Mastectomy

Melanoma (skin cancer) excision

New patient office or other outpatient visit, 15-29 minutes

Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm

Repair of wound by transferring skin, 30.1-60.0 sq cm

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm

Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm

Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm

Overall MIPS Quality Performance

Final Score: 0 out of 100

Quality Score: 0

Promoting Interoperability Score: N/A

Improvement Activities Score: 0

Cost Score: N/A

Cost Score: N/A

Quality Reporting

Find Provider Hospital Affiliations - Privileges

Reviews for DR. JOHN M ROWLEY MD

NPI NPI Number Validation

How NPI Validation Works

Digit-by-digit view

Step 1: Double every other digit from the right

Step 2: Add all digits plus the NPI constant

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

Other Providers at the Same Location

Frequently Asked Questions