JEFFREY P WINICK M.D.
NPI 1285637652
Ophthalmology in Fallbrook, CA

NPI Status: Active since May 31, 2005

Contact Information

1165 DALLAS RD
FALLBROOK, CA
ZIP 92028
Phone: (559) 573-2845

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  • Individual
  • Male
  • Ophthalmology
  • PECOS Enrolled
  • Medicare Quality Reporting

About JEFFREY WINICK

This page provides the complete NPI Profile along with additional information for Jeffrey Winick, a provider established in Fallbrook, California with a medical specialization in Ophthalmology. The healthcare provider is registered in the NPI registry with number 1285637652 assigned on May 2005. The practitioner's primary taxonomy code is 207W00000X with license number G46812 (CA). The provider is registered as an individual and his NPI record was last updated 10 years ago.

NPI
1285637652
Provider Name
JEFFREY P WINICK M.D.
Gender
Male
Entity Type
Individual
Location Address
1165 DALLAS RD FALLBROOK, CA 92028
Location Phone
(559) 573-2845
Mailing Address
1165 DALLAS RD FALLBROOK, CA 92028
Mailing Phone
(559) 573-2845
Is Sole Proprietor?
No
Enumeration Date
05-31-2005
Last Update Date
10-12-2016
Code Navigator

Ophthalmologists like Jeffrey Winick specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.

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

Ophthalmology

Taxonomy Code
207W00000X
Type
Allopathic & Osteopathic Physicians
License No.
G46812
License State
CA
Taxonomy Description
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

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)
1207W00000XAllopathic & Osteopathic Physicians

Ophthalmology

50258-020 (WI)
2207W00000XAllopathic & Osteopathic Physicians

Ophthalmology

036120884 (IL)
3207W00000XAllopathic & Osteopathic Physicians

Ophthalmology

2008014399 (MO)

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.

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
330191636OTHER (01)FEDERAL TAX ID NUMBER
A50505MEDICARE UPIN (02) 
WG46812AMEDICARE ID-TYPE UNSPECIFIED (04)CAPPIN OCEANSIDE
00G468120MEDICAID (05)CA 
K51911MEDICARE PIN (08)IL 
180001915MEDICARE ID-TYPE UNSPECIFIED (04)CARAILROAD MEDICARE
0821190001MEDICARE NSC (07)CA 

Medicare Participation & PECOS Enrollment Status

Jeffrey Winick 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: Durable Medical Equipment (DME) 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: No

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: Yes

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 92028 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $140.22
  • Minimum New Patient Price $62.1
  • Maximum New Patient Price $184.71
  • Average New Patient Copayment $35.05
  • Minimum New Patient Copayment $15.52
  • Maximum New Patient Copayment $46.17

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $76.87
  • Minimum Established Patient Price $20.62
  • Maximum Established Patient Price $151.42
  • Average Established Patient Copayment $19.21
  • Minimum Established Patient Copayment $5.15
  • Maximum Established Patient Copayment $37.85

* 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
Diabetes: Eye Exam 100% 238
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
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.

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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 1285637652, 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 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
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
5
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
3
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
6
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
2
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 7 → 14 → 5 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 + 1 + 2 + 3 + 1 + 4 + 6 + 1 + 0 + 24 = 58

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

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1285637652.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285637652, enumerated as an "individual" on May 31, 2005.

The provider is located at 1165 DALLAS RD FALLBROOK, CA 92028 and the phone number is (559) 573-2845.

Ophthalmology with taxonomy code 207W00000X.

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