GLEN LOY PORTWOOD M.D. NPI 1316965726

Internal Medicine (Gastroenterology) in Charlotte, NC

NPI 1316965726 Individual Male Years of Experience 33 Internal Medicine Gastroenterology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 71

About GLEN PORTWOOD

Glen Portwood is an internal medicine provider established in Charlotte, North Carolina and his medical specialization is internal medicine (gastroenterology) with more than 33 years of experience. He graduated from Medical College Of Georgia School Of Medicine in 1989. The NPI number of Glen Portwood is 1316965726 and was assigned on July 2006. The practitioner's primary taxonomy code is 207RG0100X with license number 9300570 (NC). The provider is registered as an individual and his NPI record was last updated 5 years ago.

An internist like Glen Loy Portwood M.d. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Glen Portwood is enrolled in PECOS and is eligible to order or refer healthcare 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

Glen Portwood 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 Carolinas Medical Center/behav Health, Atrium Health University City, Novant Health Huntersville Medical Center, Carolinas Medical Center-northeast and Novant Health Presbyterian Medical Center.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 71, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $32.67 for a new patient copayment and $25.2 for an established patient copayment.

NPI

1316965726

Provider Name GLEN LOY PORTWOOD M.D.
Provider Location Address101 E WT HARRIS BLVD STE 3111 CHARLOTTE, NC 28262
Provider Mailing Address11301 CARMEL COMMONS BLVD STE 302 CHARLOTTE, NC 28226
GenderMale
NPI Entity TypeIndividual
Medical School NameMEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduation Year1989
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date07-17-2006
Last Update Date05-04-2017


Primary Taxonomy

Taxonomy Code207RG0100X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationGastroenterology
License No.9300570
License StateNC
Taxonomy DescriptionAn internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Business Address

GLEN LOY PORTWOOD M.D.
101 E WT HARRIS BLVD STE 3111
CHARLOTTE, NC
ZIP 28262
Phone: (704) 547-8818
Fax: (704) 547-9865

Get Directions


Mailing Address

GLEN LOY PORTWOOD M.D.
11301 CARMEL COMMONS BLVD
STE 302
CHARLOTTE, NC
ZIP 28226
Phone: (704) 372-7974
Fax: (704) 372-5166



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 ID345274908
PECOS Enrollment IDI20050922000789
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 28262 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
$56.51 $172.65 $130.68
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.12 $43.16 $32.67
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.43 $140.98 $100.83
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.35 $35.24 $25.2

* 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% 66.5
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% 51
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% 73.2
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 - 71
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.

  • 294Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43239)
  • 145Biopsy of large bowel using an endoscope (HCPCS:45380)
  • 141Removal of polyps or growths of large bowel using an endoscope (HCPCS:45385)
  • 54Diagnostic examination of large bowel using an endoscope (HCPCS:45378)
  • 12Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43235)

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. Glen Portwood is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
CAROLINAS MEDICAL CENTER/BEHAV HEALTH1000 BLYTHE BLVD
CHARLOTTE, NC 28203
(704) 355-2000Acute Care Hospitals340113
ATRIUM HEALTH UNIVERSITY CITY8800 NORTH TYRON STREET
CHARLOTTE, NC 28262
(704) 548-6000Acute Care Hospitals340166
NOVANT HEALTH HUNTERSVILLE MEDICAL CENTER10030 GILEAD ROAD
HUNTERSVILLE, NC 28078
(704) 316-4000Acute Care Hospitals340183
CAROLINAS MEDICAL CENTER-NORTHEAST920 CHURCH ST N
CONCORD, NC 28025
(704) 783-3000Acute Care Hospitals340001
NOVANT HEALTH PRESBYTERIAN MEDICAL CENTER200 HAWTHORNE LANE BOX 33549
CHARLOTTE, NC 28233
(704) 384-4000Acute Care Hospitals340053

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
5901259MEDICAID (05)NC
F20611MEDICARE UPIN (02)NC
2195041AMEDICARE ID-TYPE UNSPECIFIED (04)NC

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1326066705 FRED CHARLES FOWLER M.D.
Individual
Internal Medicine (Gastroenterology)101 E WT HARRIS BLVD STE 3111
CHARLOTTE, NC 28262
(704) 547-8818
1669490991 BARRY RANDALL SCHNEIDER M.D.
Individual
Internal Medicine (Gastroenterology)101 E WT HARRIS BLVD STE 3111
CHARLOTTE, NC 28262
(704) 547-8818

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
The code describing 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.