PAUL A BISCHOFF M.D.
NPI 1285639328
Pediatrics in Johnson City, TN


Quality Rating: 97.9 out of 100 score

NPI Status: Active since June 16, 2005

Contact Information

301 MED TECH PKWY
STE 160
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 794-5560
Fax: (423) 975-0051

Get Directions Reviews

  • Individual
  • Male
  • Pediatrics
  • PECOS Enrolled

About PAUL BISCHOFF

Paul Bischoff is a pediatrician established in Johnson City, Tennessee and his medical specialization is Pediatrics. The healthcare provider is registered in the NPI registry with number 1285639328 assigned on June 2005. The practitioner's primary taxonomy code is 208000000X with license number 19570 (TN). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1285639328
Provider Name
PAUL A BISCHOFF M.D.
Gender
Male
Entity Type
Individual
Location Address
301 MED TECH PKWY STE 160 JOHNSON CITY, TN 37604
Location Phone
(423) 794-5560
Location Fax
(423) 975-0051
Mailing Address
301 MED TECH PKWY STE 160 JOHNSON CITY, TN 37604
Mailing Phone
(423) 794-5560
Mailing Fax
(423) 975-0051
Is Sole Proprietor?
No
Enumeration Date
06-16-2005
Last Update Date
03-05-2021
Code Navigator

A pediatrician like Paul Bischoff 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.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 97.9, 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.

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

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
License No.
19570
License State
TN
Taxonomy Description
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Insurance Plans Accepted

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

  • BlueCross BlueShield of Tennessee

    • BlueCross B07S HSA + $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross B08S $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross B10S $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross B15S $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross B16S $50 PCP Copay + $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross G06S $35 PCP Copay + $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross G07S $10 PCP Copay at Blue of TN + $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross G08S $30 PCP Copay + $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross S04S $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross S24S $35 PCP Copay + $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross S25S $55 PCP Copay + $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross S26S $40 PCP Copay + $0 Virtual Care for Medical & Mental Health - EPO
    • BlueCross S27S $60 PCP Copay + $0 Virtual Care for Medical & Mental Health - EPO
  • Cigna Healthcare

    • Connect Bronze 3500 Indiv Med Deductible Enhanced Diabetes Care - EPO
    • Connect Bronze 5500 Indiv Med Deductible - EPO
    • Connect Bronze 6500 Indiv Med Deductible - EPO
    • Connect Bronze 8500 Indiv Med Deductible - EPO
    • Connect Bronze CMS Standard - EPO
    • Connect Gold 500 Indiv Med Deductible - EPO
    • Connect Gold CMS Standard - EPO
    • Connect Silver 0 Indiv Med Deductible - EPO
    • Connect Silver 3000 Indiv Med Deductible - EPO
    • Connect Silver 4000 Indiv Med Deductible - EPO
    • Connect Silver 5000 Indiv Med Deductible - EPO
    • Connect Silver CMS Standard - EPO
  • 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
3080854MEDICAID (05)TN 

PECOS Enrollment and Medicare Participation Status

Paul Bischoff 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

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 37604 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $84.32
  • Minimum New Patient Price $54.58
  • Maximum New Patient Price $167.19
  • Average New Patient Copayment $21.08
  • Minimum New Patient Copayment $13.64
  • Maximum New Patient Copayment $41.79

Established Patients Visit Costs *

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

  • Average Established Patient Price $97.84
  • Minimum Established Patient Price $16.86
  • Maximum Established Patient Price $136.82
  • Average Established Patient Copayment $24.46
  • Minimum Established Patient Copayment $4.21
  • Maximum Established Patient Copayment $34.2

* 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: 97.9 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: 100

    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: 93

    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 PAUL A BISCHOFF M.D.

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

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.
1285639328
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
221651231834
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 + 3 + 4 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 88

The NPI number 1285639328 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


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

NPI Name / Type Taxonomy Address
1417952656 DAVID P ROE M.D.
Individual
Obstetrics & Gynecology301 MED TECH PKWY
JOHNSON CITY, TN 37604
(423) 794-5500
1063417194 BRIAN H DUNKELBERGER M.D.
Individual
Obstetrics & Gynecology301 MED TECH PKWY STE. 200
JOHNSON CITY, TN 37604
(423) 794-1300
1740285881 WILLIAM A BRIDGFORTH M.D.
Individual
Pediatrics301 MED TECH PKWY STE. 180
JOHNSON CITY, TN 37604
(423) 794-5540
1992700041 BOYCE M BERRY M.D.
Individual
Pediatrics301 MED TECH PKWY SUITE 180
JOHNSON CITY, TN 37604
(423) 794-5540
1235134073 TREVOR J GAGE M.D.
Individual
Pediatrics301 MED TECH PKWY STE. 180
JOHNSON CITY, TN 37604
(423) 794-5540
1366440307DR. SHOKO HANSEN M.D.
Individual
Internal Medicine301 MED TECH PKWY STE. 240
JOHNSON CITY, TN 37604
(423) 794-5520
1851392153 LINDSAY MESSINGER M.D.
Individual
Radiology (Diagnostic Radiology)301 MED TECH PKWY STE 100
JOHNSON CITY, TN 37604
(423) 794-5580
1093041865 MIRANDA G WORLEY PA-C
Individual
Physician Assistant (Medical)301 MED TECH PKWY STE 240
JOHNSON CITY, TN 37604
(423) 794-5520
1487983003MOUNTAIN STATES HEALTH ALLIANCE
Organization
Clinic/Center (Radiology)301 MED TECH PKWY SUITE 100
JOHNSON CITY, TN 37604
(423) 610-6226
1417952250 MARK L DONOVAN M.D.
Individual
Pediatrics301 MED TECH PKWY STE. 160
JOHNSON CITY, TN 37604
(423) 794-5560
1730184524 TEDFORD TAYLOR M.D.
Individual
Pediatrics301 MED TECH PKWY STE 160
JOHNSON CITY, TN 37604
(423) 794-5560
1073960381 ERIN MCPHERSON
Individual
Registered Nurse (Lactation Consultant)301 MED TECH PKWY SUITE 160
JOHNSON CITY, TN 37604
(423) 794-5560
1508021718 UNNATI M KIRAN MD
Individual
Internal Medicine301 MED TECH PKWY SUITE 240
JOHNSON CITY, TN 37604
(423) 794-5520
1386649119 SAMUEL V LEWIS M.D.
Individual
Obstetrics & Gynecology301 MED TECH PKWY STE 200
JOHNSON CITY, TN 37604
(423) 794-1300
1477558690 JILL R TALLEY-HORNE M.D.
Individual
Obstetrics & Gynecology301 MED TECH PKWY STE 200
JOHNSON CITY, TN 37604
(423) 794-1300
1497750657 GROVER E MAY M.D.
Individual
Obstetrics & Gynecology301 MED TECH PKWY SUITE 200
JOHNSON CITY, TN 37604
(423) 794-1300
1376548511 JAMES M PEARSON M.D.
Individual
Pediatrics301 MED TECH PKWY STE 160
JOHNSON CITY, TN 37604
(423) 794-5560
1629073861 BRYAN K NERREN M.D.
Individual
Internal Medicine301 MED TECH PKWY STE. 240
JOHNSON CITY, TN 37604
(423) 794-5520
1578582607MRS. AMY BROCK FLEMING APN
Individual
Nurse Practitioner301 MED TECH PKWY SUITE 280
JOHNSON CITY, TN 37604
(423) 794-5550
1699900670MRS. MELISSA CAROL SNYDER M.D.
Individual
Pediatrics301 MED TECH PKWY SUITE 160
JOHNSON CITY, TN 37604
(423) 794-5560

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285639328, enumerated in the NPI registry as an "individual" on June 16, 2005

The provider is located at 301 Med Tech Pkwy Ste 160 Johnson City, Tn 37604 and the phone number is (423) 794-5560

The provider's speciality is Pediatrics with taxonomy code 208000000X

The provider might be accepting Accepts: BlueCross BlueShield of Tennessee, Cigna. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 10, 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 $84.32 with an average copayment of $21.08 for new patient appointments. Established patients should expect a typical charge of $97.84 and an average copayment of 24.46. 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.