MR. TODD PATRICK SHAFFETT C-FNP
NPI 1285639211
Nurse Practitioner - Family in Hammond, LA


Quality Rating: 96.1 out of 100 score

NPI Status: Active since June 16, 2005

Contact Information

16065 LAMONTE DR
HAMMOND, LA
ZIP 70403
Phone: (985) 892-7070
Fax: (985) 892-7017

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  • Individual
  • Male
  • Years of Experience 20
  • Nurse Practitioner
  • Family
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About TODD SHAFFETT

Todd Shaffett is a provider established in Hammond, Louisiana and his medical specialization is Nurse Practitioner with a focus in family with more than 20 years of experience. The healthcare provider is registered in the NPI registry with number 1285639211 assigned on June 2005. The practitioner's primary taxonomy code is 363LF0000X with license number RN093740 AP04689 (LA). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1285639211
Provider Name
MR. TODD PATRICK SHAFFETT C-FNP
Gender
Male
Entity Type
Individual
Location Address
16065 LAMONTE DR HAMMOND, LA 70403
Location Phone
(985) 892-7070
Location Fax
(985) 892-7017
Mailing Address
PO BOX 1089 HAMMOND, LA 70404
Mailing Phone
(985) 892-7070
Mailing Fax
(985) 892-7017
Medical School Name
OTHER
Graduation Year
2004
Is Sole Proprietor?
Yes
Enumeration Date
06-16-2005
Last Update Date
12-18-2017
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A nurse practitioner (NP) like Todd Shaffett is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Todd Shaffett 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.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 96.1, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $21.72 for a new patient copayment and $25.02 for an established patient copayment.

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

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
RN093740 AP04689
License State
LA

Insurance Plans Accepted

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

  • Ambetter from Arkansas Health & Wellness

    • Choice Bronze HSA (QualChoice) - POS
    • Complete Gold - PPO
    • Complete Gold + Vision + Adult Dental - PPO
    • Complete Silver - PPO
    • Complete Silver + Vision + Adult Dental - PPO
  • Ambetter from Louisiana Healthcare Connections

    • Clear Silver - EPO
    • Clear Silver + Vision + Adult Dental - EPO
    • Complete Gold - EPO
    • Complete Gold + Vision + Adult Dental - EPO
    • Elite Bronze - EPO
  • Ambetter from Magnolia Health

    • Ambetter Virtual Access Bronze (Virtual PCP selection required) - HMO
    • Ambetter Virtual Access Gold (Virtual PCP selection required) - HMO
    • Ambetter Virtual Access Silver (Virtual PCP selection required) - HMO
    • Choice Bronze HSA with Walgreens - HMO
    • Choice Bronze HSA with Walgreens + Vision + Adult Dental - HMO
  • Ambetter of Alabama

    • Choice Bronze HSA - EPO
    • Choice Bronze HSA + Vision + Adult Dental - EPO
    • Clear Silver - EPO
    • Clear Silver + Vision + Adult Dental - EPO
    • Elite Bronze - EPO
  • Ambetter of Tennessee

    • Choice Bronze HSA - EPO
    • Choice Bronze HSA + Vision + Adult Dental - EPO
    • Clear Silver - EPO
    • Clear Silver + Vision + Adult Dental - EPO
    • Complete Gold - EPO
  • Blue Cross and Blue Shield of Louisiana

    • Blue Max 100/100 $9450 - PPO
    • Blue Max 70/50 $6700 - PPO
    • Blue Max 90/70 $1500 - PPO
    • Blue Max Copay 50/50 $3300 - PPO
    • Blue Max Copay 50/50 $7500 Standardized Plan - PPO
  • Cigna Healthcare

    • Connect Bronze 5500 Enhanced Diabetes Care - EPO
    • Connect Bronze 6500 Indiv Med Deductible - EPO
    • Connect Bronze 8500 Indiv Med Deductible - EPO
    • Connect Bronze 9450 Indiv Med Deductible - EPO
    • Connect Bronze CMS Standard - EPO
  • HMO Louisiana

    • Blue POS 60/40 $6500 - POS
    • Blue POS 70/50 $4550 - POS
    • Blue POS 80/60 $3400 - POS
    • Blue POS Copay 50/50 $7500 Standardized Plan - POS
    • Blue POS Copay 60/40 $4300 - POS
  • Molina Healthcare

    • Bronze 4 - HMO
    • Bronze 8 - HMO
    • Gold 1 - HMO
    • Gold 1 with Adult Vision Services - HMO
    • Gold 8 - HMO
  • Primewell Health Services of Mississippi

    • Essential Bronze 6500 - POS
    • Essential Gold 1500 - POS
    • Freedom Silver 4000 - POS
    • Savings Bronze 5500 - POS
    • Savings Bronze 7400 - POS
  • Medicare

  • Medicaid


*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
1889458MEDICAID (05)LA 

PECOS Enrollment and Medicare Participation Status

Todd Shaffett 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: 5799796017

    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: I20060525000027

    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

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.

Durable Medical Equipment

  • Other DME (D1E)

    Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories (HCPCS:A6550)

    2 DME suppliers used 13 Medicare Claims 65 Services Paid

  • Other DME (D1E)

    Canister, disposable, used with suction pump, each (HCPCS:A7000)

    2 DME suppliers used 12 Medicare Claims 56 Services Paid

  • Other DME (D1E)

    Negative pressure wound therapy electrical pump, stationary or portable (HCPCS:E2402)

    2 DME suppliers used 14 Medicare Claims 14 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 70403 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $86.88
  • Minimum New Patient Price $56.01
  • Maximum New Patient Price $172.78
  • Average New Patient Copayment $21.72
  • Minimum New Patient Copayment $14
  • Maximum New Patient Copayment $43.19

Established Patients Visit Costs *

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

  • Average Established Patient Price $100.08
  • Minimum Established Patient Price $16.83
  • Maximum Established Patient Price $140.34
  • Average Established Patient Copayment $25.02
  • Minimum Established Patient Copayment $4.2
  • Maximum Established Patient Copayment $35.08

* 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.

Overall MIPS Quality 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: 96.1 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: 92.91

    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: 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.

Reviews for MR. TODD PATRICK SHAFFETT C-FNP

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1285639211
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
221651231822
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 6 + 5 + 1 + 2 + 3 + 1 + 8 + 2 + 2 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1285639211 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


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

NPI Name / Type Taxonomy Address
1568983583 ALAINA JOURDAN APRN
Individual
Nurse Practitioner (Family)16065 LAMONTE DR
HAMMOND, LA 70403
(855) 432-5328
1457552424 AMANDA HERRICK ESTAPA ACNP
Individual
Nurse Practitioner16065 LAMONTE DR
HAMMOND, LA 70403
(985) 892-7070
1558989046 AMIE MICHELLE WILSON NP
Individual
Nurse Practitioner (Family)16065 LAMONTE DR
HAMMOND, LA 70403
(318) 239-7045
1568793750WOUND CARE ASSOCIATES LLC
Organization
Specialist16065 LAMONTE DR
HAMMOND, LA 70403
(985) 892-7070
1699293357PERFUSION VASCULAR HAMMOND LLC
Organization
Surgery (Vascular Surgery)16065 LAMONTE DR
HAMMOND, LA 70403
(985) 892-7070
1316332018 REBEKAH M STARNS APRN
Individual
Nurse Practitioner (Family)16065 LAMONTE DR
HAMMOND, LA 70403
(985) 892-7070
1376574921DR. SHAUN ROBERT CARPENTER M.D.
Individual
Emergency Medicine16065 LAMONTE DR
HAMMOND, LA 70403
(985) 892-7070
1396254330 KATIE SCHLOEGEL FNP-C
Individual
Nurse Practitioner (Family)16065 LAMONTE DR
HAMMOND, LA 70403
(985) 892-7070
1154690394MRS. MONIQUE LEONA CONSOER APRN
Individual
Nurse Practitioner (Adult Health)16065 LAMONTE DR
HAMMOND, LA 70403
(985) 982-7070
1184971673 KIMBERLY P. BROWN APRN
Individual
Nurse Practitioner (Family)16065 LAMONTE DR
HAMMOND, LA 70403
(985) 892-7070
1548824295 NATALIE DEAN APRN-CNP
Individual
Nurse Practitioner (Family)16065 LAMONTE DR
HAMMOND, LA 70403
(985) 892-7070
1598398703MR. BLANDON EDWARD SORRELL II NP
Individual
Nurse Practitioner (Family)16065 LAMONTE DR
HAMMOND, LA 70403
(985) 892-7070
1144911207 HOLLIE MICHELLE JOHNSON NP
Individual
Nurse Practitioner (Family)16065 LAMONTE DR
HAMMOND, LA 70403
(985) 956-7771
1578346086 LINDSEY RICHE ARCENEAUX FNP-C
Individual
Nurse Practitioner (Family)16065 LAMONTE DR
HAMMOND, LA 70403
(985) 956-7771
1124370838 BRITNI MCCONNELL MECHE FNP
Individual
Nurse Practitioner (Family)16065 LAMONTE DR
HAMMOND, LA 70403
(985) 892-7070

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285639211, enumerated in the NPI registry as an "individual" on June 16, 2005

The provider is located at 16065 Lamonte Dr Hammond, La 70403 and the phone number is (985) 892-7070

The provider's speciality is Nurse Practitioner with taxonomy code 363LF0000X with a focus in Family

The provider has more than 20 years of experience.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 11, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $86.88 with an average copayment of $21.72 for new patient appointments. Established patients should expect a typical charge of $100.08 and an average copayment of 25.02. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on June 16, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.