THOMAS E FLYNN M.D. NPI 1316961048
Ophthalmology in New York, NY

Individual Male Years of Experience 37 Ophthalmology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 37.5 Medicare Quality Reporting

About THOMAS E FLYNN M.D.

Thomas Flynn is a provider established in New York, New York and his medical specialization is Ophthalmology with more than 37 years of experience. He graduated from George Washington University School Of Medicine in 1986. The NPI number of Thomas Flynn is 1316961048 and was assigned on July 2006. The practitioner's primary taxonomy code is 207W00000X with license number 173604-1 (NY). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI
1316961048
Provider Name THOMAS E FLYNN M.D.
Provider Location Address635 W 165TH ST BOX 92 NEW YORK, NY 10032
Provider Mailing Address635 W 165TH ST BOX 92 NEW YORK, NY 10032
GenderMale
NPI Entity TypeIndividual
Medical School NameGEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year1986
Is Sole Proprietor?Yes
Enumeration Date07-26-2006
Last Update Date07-08-2007

Thomas Flynn 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.

Thomas Flynn is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Maine General Medical Center and Northern Light Maine Coast Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 37.5, 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 provider also has detailed performance information the following quality measures: engagement of new medicaid patients and follow-up.

The typical physician office visit costs for Medicare beneficiaries in this area are: $39.54 for a new patient copayment and $21.49 for an established patient copayment.



Primary Taxonomy

Taxonomy Code207W00000X
ClassificationOphthalmology
TypeAllopathic & Osteopathic Physicians
License No.173604-1
License StateNY
Taxonomy DescriptionAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Business Address

THOMAS E FLYNN M.D.
635 W 165TH ST
BOX 92
NEW YORK, NY
ZIP 10032
Phone: (212) 305-3039

Get Directions


Mailing Address

THOMAS E FLYNN M.D.
635 W 165TH ST
BOX 92
NEW YORK, NY
ZIP 10032
Phone: (212) 305-3039


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
PECOS PAC ID2567404924
PECOS Enrollment IDI20050525000898, I20081112000475
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 order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 10032 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$69.45 $208.72 $158.18
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$17.36 $52.18 $39.54
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$21.65 $169.66 $85.96
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.41 $42.41 $21.49

* The physician office visit costs information is obtained by Medicare's 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 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% 0
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% 68
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% 20
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% 67.6
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 - 37.5
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.

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
Engagement of New Medicaid Patients and Follow-upYesN/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.

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.

  • 1797Diagnostic imaging of retina (HCPCS:92134)
  • 645Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
  • 443Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
  • 138Photography of the retina (HCPCS:92250)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Thomas Flynn is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
MAINE GENERAL MEDICAL CENTER35 MEDICAL CENTER PARKWAY
AUGUSTA, ME 4330
(207) 626-1000Acute Care Hospitals200039
NORTHERN LIGHT MAINE COAST HOSPITAL50 UNION STREET
ELLSWORTH, ME 4605
(207) 664-5608Acute Care Hospitals200050

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
83K351MEDICARE ID-TYPE UNSPECIFIED (04)
01471181MEDICAID (05)NY
E66152MEDICARE UPIN (02)

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.
1316961048
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2326186208
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 2 + 6 + 1 + 8 + 6 + 2 + 0 + 8 + 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 1316961048 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
1588627988DR. RAJENDRA K. BANSAL MD
Individual
Ophthalmology635 W 165TH ST SUITE 104
NEW YORK, NY 10032
(212) 350-2241
1871547752 SUSAN JEAN LEE M.D.
Individual
Ophthalmology635 W 165TH ST FLANZER SUITE
NEW YORK, NY 10032
(212) 305-9535
1992741722DR. MARY SCIUTTO M.D.
Individual
Psychiatry & Neurology (Psychiatry)635 W 165TH ST INTENSIVE OUTPATIENT PROGRAM - EI 4TH FLOOR
NEW YORK, NY 10032
(212) 305-9758
1689600363DR. REZA IRANMANESH MD
Individual
Ophthalmology635 W 165TH ST
NEW YORK, NY 10032
(212) 305-0648
1295764306DR. BENJAMIN MCCOMMON M.D.
Individual
Psychiatry & Neurology (Psychiatry)635 W 165TH ST INTENSIVE OUTPATIENT PROGRAM
NEW YORK, NY 10032
(212) 305-9758
1508895517DR. RICHARD HERSH M.D.
Individual
Psychiatry & Neurology (Psychiatry)635 W 165TH ST INTENSIVE OUTPATIENT PROGRAM - EI 4TH FLOOR
NEW YORK, NY 10032
(212) 305-9758
1861421877DR. CECILIA DINTINO PH.D.
Individual
Psychologist635 W 165TH ST INTENSIVE OUTPATIENT PROGRAM - EI 4TH FLOOR
NEW YORK, NY 10032
(212) 305-9758
1912936881DR. ANTHONY TRANGUCH M.D.
Individual
Psychiatry & Neurology (Psychiatry)635 W 165TH ST INTENSIVE OUTPATIENT PROGRAM - EI 4TH FLOOR
NEW YORK, NY 10032
(212) 305-9758
1376576892TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK
Organization
Ophthalmology635 W 165TH ST FLANZER SUITE
NEW YORK, NY 10032
(212) 305-9535
1508883497 HERMANN D SCHUBERT M.D.
Individual
Ophthalmology635 W 165TH ST
NEW YORK, NY 10032
(212) 305-6534
1174542542DR. MARK JOHN DONALDSON MBBS(HONS)
Individual
Ophthalmology635 W 165TH ST COLUMBIA UNIVERSITY MEDICAL CENTER
NEW YORK, NY 10032
(212) 305-2725
1265452213 MICHAEL KAZIM M.D.
Individual
Ophthalmology635 W 165TH ST
NEW YORK, NY 10032
(212) 305-5477
1982624201 MAX FORBES M.D.
Individual
Ophthalmology635 W 165TH ST BOX 92
NEW YORK, NY 10032
(212) 305-9535
1518987643 HOWARD M EGGERS M.D.
Individual
Ophthalmology635 W 165TH ST
NEW YORK, NY 10032
(212) 305-5409
1629098991 WILLIAM M SCHIFF M.D.
Individual
Ophthalmology635 W 165TH ST BOX 92
NEW YORK, NY 10032
(212) 305-9535
1659394294DR. STEVEN KANE M.D.
Individual
Ophthalmology635 W 165TH ST ROOM 102
NEW YORK, NY 10032
(212) 305-5400
1689698938 GAETANO BARILE M.D.
Individual
Ophthalmology635 W 165TH ST
NEW YORK, NY 10032
(212) 305-9535
1043234255 GEORGE HOWARD M.D.
Individual
Ophthalmology635 W 165TH ST
NEW YORK, NY 10032
(212) 305-5400
1962419218 AMILIA SCHRIER M.D.
Individual
Ophthalmology635 W 165TH ST
NEW YORK, NY 10032
(212) 305-9535
1801803150 RICHARD E BRAUNSTEIN M.D.
Individual
Ophthalmology635 W 165TH ST BOX 92
NEW YORK, NY 10032
(212) 305-9535

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
Thomas E Flynn M.d. 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.