DR. CATHERINE JANE HUNTER M.D.
NPI 1295907665
Surgery - Pediatric Surgery in Chicago, IL


Quality Rating: 71.66 out of 100 score

NPI Status: Active since March 26, 2008

Contact Information

225 E CHICAGO AVE # 63
DIVISION OF PEDIATRIC SURGERY
CHICAGO, IL
ZIP 60611
Phone: (312) 227-9678

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  • Individual
  • Female
  • Surgery
  • Pediatric Surgery
  • Accepts Insurance
  • PECOS Enrolled

About CATHERINE HUNTER

This page provides the complete NPI Profile along with additional information for Catherine Hunter, a provider established in Chicago, Illinois with a medical specialization in Surgery, focusing in pediatric surgery . The healthcare provider is registered in the NPI registry with number 1295907665 assigned on March 2008. The practitioner's primary taxonomy code is 2086S0120X with license number 35283 (OK). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI
1295907665
Provider Name
DR. CATHERINE JANE HUNTER M.D.
Gender
Female
Entity Type
Individual
Location Address
225 E CHICAGO AVE # 63 DIVISION OF PEDIATRIC SURGERY CHICAGO, IL 60611
Location Phone
(312) 227-9678
Mailing Address
225 E CHICAGO AVE # 63 CHICAGO, IL 60611
Mailing Phone
(312) 227-4210
Is Sole Proprietor?
Yes
Enumeration Date
03-26-2008
Last Update Date
01-29-2021
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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 Pediatric Surgery

Taxonomy Code
2086S0120X
Type
Allopathic & Osteopathic Physicians
License No.
35283
License State
OK
Taxonomy Description
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

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)
1208600000XAllopathic & Osteopathic Physicians

Surgery

A91659 (CA)

Insurance Plans Accepted

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

  • Blue Advantage Bronze PPO? 202 - PPO
  • Blue Advantage Bronze PPO? 203 - PPO
  • Blue Advantage Bronze PPO? Standard - PPO
  • Blue Advantage Gold PPO? 309 - PPO
  • Blue Advantage Gold PPO? 604 - PPO
  • Blue Advantage Gold PPO? Standard - PPO
  • Blue Advantage Silver PPO? 204 - PPO
  • Blue Advantage Silver PPO? 501 - PPO
  • Blue Advantage Silver PPO? Standard - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • Balance by Medica Bronze $0 Copay PCP Visits - PPO
  • Balance by Medica Bronze Premier - PPO
  • Balance by Medica Expanded Bronze Standard - PPO
  • Balance by Medica Gold $0 Copay PCP Visits - PPO
  • Balance by Medica Gold Share - PPO
  • Balance by Medica Gold Standard - PPO
  • Balance by Medica Silver $0 Copay PCP Visits - PPO
  • Balance by Medica Silver Share - PPO
  • Balance by Medica Silver Standard - PPO
  • Harmony by Medica Bronze $0 Copay PCP Visits - PPO
  • Harmony by Medica Bronze $0 Copay PCP Visits + Adult Eye Exam - PPO
  • Harmony by Medica Bronze Premier - PPO
  • Harmony by Medica Bronze Premier + Adult Eye Exam - PPO
  • Harmony by Medica Expanded Bronze Standard - PPO
  • Harmony by Medica Expanded Bronze Standard + Adult Eye Exam - PPO
  • Harmony by Medica Gold $0 Copay PCP Visits - PPO
  • Harmony by Medica Gold $0 Copay PCP Visits + Adult Eye Exam - PPO
  • Harmony by Medica Gold Share - PPO
  • Harmony by Medica Gold Share + Adult Eye Exam - PPO
  • Harmony by Medica Gold Standard - PPO
  • MENDING Direct Primary Care Bronze 4950 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Gold $0 Ded ($0 DPC $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Silver 2300 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Standard Bronze (No Direct Primary Care, for DPC select DPC Bronze) - HMO
  • MENDING Standard Gold (No Direct Primary Care, for DPC select DPC Gold) - HMO
  • MENDING Standard Silver (No Direct Primary Care, for DPC select DPC Silver) - HMO

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
135639217OTHER (01)ILNPI (INSTITUTIONAL)

Medicare Participation & PECOS Enrollment Status

Catherine Hunter 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 71.66, 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: 71.66 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: 53.48

    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: 52.07

    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: 52.07

    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 DR. CATHERINE JANE HUNTER M.D.

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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 1295907665, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

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
9
Doubled → 18 → 1 + 8
Pos 4
5
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
0
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
6
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
5
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 9 → 18 → 9 9 → 18 → 9 7 → 14 → 5 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 8 + 5 + 1 + 8 + 0 + 1 + 4 + 6 + 1 + 2 + 24 = 65

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

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1295907665.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Clinic/Center (Ambulatory Surgical)
225 E CHICAGO AVE # 63
CHICAGO, IL 60611
Surgery (Plastic and Reconstructive Surgery)
225 E CHICAGO AVE # 63
CHICAGO, IL 60611
Surgery (Pediatric Surgery)
225 E CHICAGO AVE # 63
CHICAGO, IL 60611
Surgery
225 E CHICAGO AVE # 63
CHICAGO, IL 60611

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295907665, enumerated as an "individual" on March 26, 2008.

The provider is located at 225 E CHICAGO AVE # 63 DIVISION OF PEDIATRIC SURGERY CHICAGO, IL 60611 and the phone number is (312) 227-9678.

Surgery with taxonomy code 2086S0120X and a focus in Pediatric Surgery.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Oklahoma, Medica,. Please consult your insurance carrier or call the provider to verify.