DR. JEFFREY ROBERT REES LYMAN MD
NPI 1316945876
Orthopaedic Surgery in Coeur D Alene, ID

NPI Status: Active since July 08, 2005

Contact Information

1233 N NORTHWOOD CENTER CT STE 101
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 457-4211
Fax: (208) 773-1473

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
Quality Measures
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Orthopaedic Surgery
Accepts Insurance
PECOS Enrolled
Opted-Out Medicare
Medicare Quality Reporting

About JEFFREY LYMAN

This page provides the complete NPI Profile along with additional information for Jeffrey Lyman, a provider established in Coeur D Alene, Idaho with a medical specialization in Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1316945876 assigned on July 2005. The practitioner's primary taxonomy code is 207X00000X with license number M-10680 (ID). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI: 1316945876
Provider Name: DR. JEFFREY ROBERT REES LYMAN MD
Gender: Male
Entity Type: Individual
Location Address: 1233 N NORTHWOOD CENTER CT STE 101 COEUR D ALENE, ID 83814
Location Phone: (208) 457-4211
Location Fax: (208) 773-1473
Mailing Address: 1233 N NORTHWOOD CENTER CT STE 101 COEUR D ALENE, ID 83814
Mailing Phone: (208) 457-4211
Mailing Fax: (208) 773-1473
Is Sole Proprietor?: No
Enumeration Date: 07-08-2005
Last Update Date: 12-22-2023
Code Navigator

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jeffrey Lyman opted out of Medicare effective on 04-01-2022 until 04-01-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.

Location Map

Secondary Locations

8552 N Government Way
Hayden, ID 83835
(208) 457-4211

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: Orthopaedic Surgery
Taxonomy Code: 207X00000X
Type: Allopathic & Osteopathic Physicians
License No.: M-10680
License State: ID
Taxonomy Description: An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

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)
1	207XS0114X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery	M-10680 (ID)
2	207XX0005X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery Sports Medicine	M-10680 (ID)
3	207XX0801X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery Orthopaedic Trauma	M-10680 (ID)

Insurance Plans Accepted

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

Moda Health Plan, Inc.

Moda Select Alaska Bronze 6500 - PPO
Moda Select Alaska Bronze HDHP 5500 - PPO
Moda Select Alaska Gold 1500 - PPO
Moda Select Alaska Silver 4500 - PPO
Moda Select Alaska Standard Bronze - PPO
Moda Select Alaska Standard Gold - PPO
Moda Select Alaska Standard Silver - PPO
Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
Moda Select Texas Bronze HDHP 7500 - EPO
Moda Select Texas Standard Bronze - EPO
Moda Select Texas Standard Gold - EPO
Moda Select Texas Standard Silver - EPO

PacificSource Health Plans

Core Bronze HSA 10600 - EPO
Core Bronze HSA 7500 - EPO
Core Bronze HSA 8300 - EPO
Core Gold 1500 - EPO
Core Gold 3000 - EPO
Core Silver 3500 - EPO
Core Silver 4500 - EPO
Core Silver 5000 - EPO
Core Silver 7500 - EPO
Core Standard Expanded Bronze HSA - EPO
Core Standard Gold - EPO
Core Standard Silver - EPO
PacificSource Oregon Standard Bronze HSA Plan Core - EPO
PacificSource Oregon Standard Gold Plan Core - EPO
PacificSource Oregon Standard Silver Plan Core - EPO

Providence Health Plan

HSA Qualified 7500 Bronze - Choice Network - EPO
HSA-E Qualified 7500 Bronze - Signature Network - EPO
Providence Oregon Standard Bronze Plan - Choice Network - EPO
Providence Oregon Standard Bronze Plan - Signature Network - EPO
Providence Oregon Standard Gold Plan - Choice Network - EPO
Providence Oregon Standard Gold Plan - Signature Network - EPO
Providence Oregon Standard Silver Plan - Choice Network - EPO
Providence Oregon Standard Silver Plan - Signature Network - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Jeffrey Lyman 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
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2022
Opt-Out End Date: 04-01-2026
Eligible to Order and Refer? 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

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

DME-Other DME (DE000N)
Continuous passive motion exercise device for use on knee only (HCPCS:E0935)
1 DME suppliers used 50 Medicare Claims 976 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint
Computer-assisted surgery for muscle and bone procedure
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Injection, dexamethasone sodium phosphate, 1 mg
Replacement of knee joint, both sides of knee
X-ray of knee, 3 views
X-ray of knee, 4 or more views

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 83814 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $81.13
Minimum New Patient Price $52.44
Maximum New Patient Price $160.17

Average New Patient Copayment $20.28
Minimum New Patient Copayment $13.11
Maximum New Patient Copayment $40.04

Established Patients Visit Costs *

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

Average Established Patient Price $65.77
Minimum Established Patient Price $16.68
Maximum Established Patient Price $130.93

Average Established Patient Copayment $16.44
Minimum Established Patient Copayment $4.17
Maximum Established Patient Copayment $32.73

* 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.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure	Performance	Number of Patients
Closing the Referral Loop: Receipt of Specialist Report	50%	105
Documentation of Current Medications in the Medical Record	56%	468
Falls: Screening for Future Fall Risk	0%	36
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	16%	354
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented	0%	417
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	67%	243
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	70%	243
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	72%	25
Use of High-Risk Medications in Older Adults	0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	46
Use of High-Risk Medications in Older Adults	0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	46
Use of High-Risk Medications in Older Adults	0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	46

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 1316945876, we treat the final digit (6) 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 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 2

Pos 4

Unchanged

Pos 5

Doubled → 18 → 1 + 8

Pos 6

Unchanged

Pos 7

Doubled → 10 → 1 + 0

Pos 8

Unchanged

Pos 9

Doubled → 14 → 1 + 4

Check

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 1 → 2 9 → 18 → 9 5 → 10 → 1 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

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

2 + 3 + 2 + 6 + 1 + 8 + 4 + 1 + 0 + 8 + 1 + 4 + 24 = 64

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

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6

This NPI is valid

The calculated check digit is 6, which matches the last digit of 1316945876.