CHERYL A CUMMINGS PA-C NPI 1316049133

Physician Assistant in Elk Grove, CA

Individual Female Physician Assistant PECOS Enrolled MIPS Quality Score 90.9

About CHERYL A CUMMINGS PA-C

Cheryl Cummings is a primary care provider established in Elk Grove, California and her medical specialization is Physician Assistant. The NPI number of Cheryl Cummings is 1316049133 and was assigned on September 2006. The practitioner's primary taxonomy code is 363A00000X with license number PA14065 (CA). The provider is registered as an individual and her NPI record was last updated 7 years ago.

A primary care provider (PCP) like Cheryl A Cummings Pa-c sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

NPI

1316049133

Provider Name CHERYL A CUMMINGS PA-C
Provider Location Address8170 LAGUNA BLVD #114 ELK GROVE, CA 95758
Provider Mailing Address10470 OLD PLACERVILLE RD SUITE 100 SACRAMENTO, CA 95827
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Enumeration Date09-02-2006
Last Update Date07-27-2015



Cheryl Cummings 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..

Cheryl Cummings is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90.9, 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.



Primary Taxonomy

Taxonomy Code363A00000X
ClassificationPhysician Assistant
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.PA14065
License StateCA
Taxonomy DescriptionA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Business Address

CHERYL A CUMMINGS PA-C
8170 LAGUNA BLVD
#114
ELK GROVE, CA
ZIP 95758
Phone: (916) 691-5900
Fax: (916) 691-6736

Get Directions


Mailing Address

CHERYL A CUMMINGS PA-C
10470 OLD PLACERVILLE RD
SUITE 100
SACRAMENTO, CA
ZIP 95827
Phone: (800) 470-0071


PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
Eligible order / refer Part B Clinical Laboratory and ImagingNo
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)No
Eligible order / refer Power Mobility DevicesYes

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's 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.

MIPS Measure Score Weight Score
Quality 40% 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 (PI) 25% 72
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 15% 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 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 20% 69.6
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.
MIPS Final Score - 90.9
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.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 43Administration of influenza virus vaccine (HCPCS:G0008)
  • 41Administration of pneumococcal vaccine (HCPCS:G0009)
  • 37Pneumococcal vaccine for injection into muscle (HCPCS:90670)

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0PA140650MEDICARE ID-TYPE UNSPECIFIED (04)
OPA140651MEDICARE PIN (08)CA
0PA140650MEDICAID (05)CA
S62833MEDICARE UPIN (02)
S62833MEDICARE UPIN (02)CA

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.
1316049133
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2326041816
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 2 + 6 + 0 + 4 + 1 + 8 + 1 + 6 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1316049133 is valid because the calculated check digit 3 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
1033267422DR. MORTEZA BEHESHTIAN DDS
Individual
Dentist (General Practice)8170 LAGUNA BLVD #300
ELK GROVE, CA 95758
(916) 683-2000
1992011225MRS. SARAH WOLFE HOUSER NP
Individual
Nurse Practitioner (Adult Health)8170 LAGUNA BLVD SUITE 220
ELK GROVE, CA 95758
(916) 691-5900
1932373925 NYONNOWEH R. GREENE M.D.
Individual
Family Medicine8170 LAGUNA BLVD SUITE 220
SACRAMENTO, CA 95758
(916) 691-5919
1811952328DR. DUNG THI LE MD
Individual
Family Medicine8170 LAGUNA BLVD SUITE 113
ELK GROVE, CA 95758
(916) 691-5900
1689610388DR. TODD M FISHER M.D.
Individual
Internal Medicine8170 LAGUNA BLVD SUITE 101
SACRAMENTO, CA 95758
(916) 691-5915
1669583977 JAMES B GARRETT MD
Individual
Family Medicine8170 LAGUNA BLVD #215
ELK GROVE, CA 95758
(916) 691-5900
1609978352 GEORGE Y HISATOMI MD
Individual
Family Medicine8170 LAGUNA BLVD #114
ELK GROVE, CA 95758
(916) 691-5900
1629171400 PATRICIA R JAUREGUI MD
Individual
Family Medicine8170 LAGUNA BLVD SUITE 215
ELK GROVE, CA 95758
(916) 691-5900
1780781930 THERESE E ROSELLINI DO
Individual
Obstetrics & Gynecology8170 LAGUNA BLVD #304
ELK GROVE, CA 95758
(916) 691-5996
1932107646 MICHAEL PATRICK SOTAK M.D.
Individual
Emergency Medicine8170 LAGUNA BLVD SUITE 114
ELK GROVE, CA 95758
(916) 691-5900
1043221815 KATIE C ASKEW MD
Individual
Family Medicine8170 LAGUNA BLVD SUITE 114
ELK GROVE, CA 95758
(916) 691-5900
1740291574 RUENELL D ADAMS MD
Individual
Family Medicine8170 LAGUNA BLVD SUITE 220
ELK GROVE, CA 95758
(916) 691-5900
1093728776 THOMAS N ATKINS MD
Individual
Family Medicine8170 LAGUNA BLVD SUITE 215
ELK GROVE, CA 95758
(916) 691-5900
1043325707 SCOTT C CANNON MD
Individual
Family Medicine8170 LAGUNA BLVD SUITE 114
ELK GROVE, CA 95758
(916) 691-5900
1689772071 BHASKARA G REDDY MD
Individual
Family Medicine8170 LAGUNA BLVD #101
ELK GROVE, CA 95758
(916) 691-5915
1093911661 KARANBIR SINGH GILL M.D.
Individual
Pediatrics8170 LAGUNA BLVD SUITE 210
ELK GROVE, CA 95758
(916) 691-5999
1376525154DR. OMAR AHMED JR. M.D.
Individual
Pediatrics8170 LAGUNA BLVD SUITE 210
ELK GROVE, CA 95758
(916) 691-5999
1316929896 BETH GOODWILL NP
Individual
Nurse Practitioner (Pediatrics)8170 LAGUNA BLVD SUITE 210
ELK GROVE, CA 95758
(916) 691-5988
1417979949DR. ALISON L JUOZOKAS M.D.
Individual
Family Medicine8170 LAGUNA BLVD SUITE 220
ELK GROVE, CA 95758
(916) 691-5900
1396767786DR. ELIZABETH MARIE GONZALEZ M.D.
Individual
Obstetrics & Gynecology8170 LAGUNA BLVD SUITE 303
ELK GROVE, CA 95758
(916) 691-5996

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Cheryl A Cummings Pa-c is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.