DOUGLAS PATRICK MCINNIS MD
NPI 1326151150
Orthopaedic Surgery in Coeur D Alene, ID


Quality Rating: 97.3 out of 100 score

NPI Status: Active since August 16, 2006

Contact Information

850 W IRONWOOD DR
SUITE 202
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 664-2175
Fax: (208) 664-1226

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  • Individual
  • Male
  • Years of Experience 28
  • Orthopaedic Surgery
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About DOUGLAS MCINNIS

Douglas Mcinnis is a provider established in Coeur D Alene, Idaho and his medical specialization is Orthopaedic Surgery with more than 28 years of experience. He graduated from University Of Washington School Of Medicine in 1997. The healthcare provider is registered in the NPI registry with number 1326151150 assigned on August 2006. The practitioner's primary taxonomy code is 207X00000X with license number M8798 (ID). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1326151150
Provider Name
DOUGLAS PATRICK MCINNIS MD
Gender
Male
Entity Type
Individual
Location Address
850 W IRONWOOD DR SUITE 202 COEUR D ALENE, ID 83814
Location Phone
(208) 664-2175
Location Fax
(208) 664-1226
Mailing Address
850 W IRONWOOD DR STE 202 COEUR D ALENE, ID 83814
Mailing Phone
(208) 664-2175
Mailing Fax
(208) 664-1226
Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduation Year
1997
Is Sole Proprietor?
No
Enumeration Date
08-16-2006
Last Update Date
12-05-2023
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Douglas Mcinnis is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 97.3, 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: $20.84 for a new patient copayment and $17.01 for an established patient copayment.

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.
M8798
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.

Insurance Plans Accepted

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

  • Mountain Health CO-OP

    • Connect Bronze Expanded - PPO
    • Connect Bronze Expanded Standard - PPO
    • Connect Bronze HDHP - PPO
    • Connect Catastrophic - PPO
    • Connect Gold - PPO
    • Connect Gold Standard - PPO
    • Connect Silver - PPO
    • Connect Silver Option 2 - PPO
    • Connect Silver Standard - PPO
    • High Plains Bronze HDHP - PPO
    • High Plains Bronze Standard Expanded - PPO
    • High Plains Gold - PPO
    • High Plains Gold HDHP - PPO
    • High Plains Gold Standard - PPO
    • High Plains Silver - PPO
  • PacificSource Health Plans

    • Navigator Bronze 7000 - PPO
    • Navigator Bronze 7000 Exchange - PPO
    • Navigator Bronze 9400 - PPO
    • Navigator Bronze 9400 Exchange - PPO
    • Navigator Bronze HSA 7500 - PPO
    • Navigator Gold 1500 - PPO
    • Navigator Gold 1500 Exchange - PPO
    • Navigator Gold 500 Exchange - PPO
    • Navigator Silver 3500 Exchange - PPO
    • Navigator Silver 4000 Exchange - PPO
    • Navigator Silver 5000 - PPO
    • Navigator Silver HSA 3500 - PPO
    • Navigator Standard Expanded Bronze - PPO
    • Navigator Standard Gold - PPO
    • Navigator Standard Silver - PPO
  • Medicare

  • Medicaid


*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
M8798OTHER (01)IDMEDICAL LICENSE

PECOS Enrollment and Medicare Participation Status

Douglas Mcinnis 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

  • PECOS PAC ID: 1355331356

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20040513000047

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • 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 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

  • Other DME (D1E)

    Walker, folding, wheeled, adjustable or fixed height (HCPCS:E0143)

    2 DME suppliers used 15 Medicare Claims 15 Services Paid

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 $83.36
  • Minimum New Patient Price $53.93
  • Maximum New Patient Price $165.44
  • Average New Patient Copayment $20.84
  • Minimum New Patient Copayment $13.48
  • Maximum New Patient Copayment $41.36

Established Patients Visit Costs *

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

  • Average Established Patient Price $68.04
  • Minimum Established Patient Price $16.64
  • Maximum Established Patient Price $135.44
  • Average Established Patient Copayment $17.01
  • Minimum Established Patient Copayment $4.16
  • Maximum Established Patient Copayment $33.86

* 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.

Overall MIPS Quality 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: 97.3 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: 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 Score: 91

    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: N/A

    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: N/A

    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.

Clinician Services

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 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 252

    Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)

  • 192

    X-ray of hip with pelvis, 2-3 views (HCPCS:73502)

  • 113

    X-ray of knee, 3 views (HCPCS:73562)

  • 78

    Repair of knee joint (HCPCS:27447)

  • 73

    Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Douglas Mcinnis is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
KOOTENAI HEALTH2003 KOOTENAI HEALTH WAY
COEUR D'ALENE, ID 83814
(208) 625-4000Acute Care Hospitals
NORTHWEST SPECIALTY HOSPITAL1593 EAST POLSTON AVENUE
POST FALLS, ID 83854
(208) 262-2300Acute Care Hospitals
BOUNDARY COMMUNITY HOSPITAL6640 KANIKSU STREET
BONNERS FERRY, ID 83805
(208) 267-3140Critical Access Hospitals
SHOSHONE MEDICAL CENTER25 JACOBS GULCH ROAD
KELLOGG, ID 83837
(208) 784-1221Critical Access Hospitals
BONNER GENERAL HOSPITAL520 NORTH THIRD AVENUE
SANDPOINT, ID 83864
(208) 263-1441Critical Access Hospitals

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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.
1326151150
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2346252110
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 4 + 6 + 2 + 5 + 2 + 1 + 1 + 0 + 24 = 50
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1326151150 is valid because the calculated check digit 0 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
1326042045DR. MICHAEL J DRAGER DPM
Individual
Podiatrist (Foot & Ankle Surgery)850 W IRONWOOD DR STE 301
COEUR D ALENE, ID 83814
(208) 667-9762
1689669798DR. RAYMOND KARL GREENE OD
Individual
Optometrist850 W IRONWOOD DR SUITE 104
COEUR D ALENE, ID 83814
(208) 765-2020
1184717696PHYSICAL THERAPY & SPORTS MEDICINE INSTITUTE INC
Organization
Physical Therapist850 W IRONWOOD DR SUITE 103
COEUR D ALENE, ID 83814
(208) 664-1119
1619294303INLAND NORTHWEST ANESTHESIA PLLC
Organization
Nurse Anesthetist, Certified Registered850 W IRONWOOD DR STE 300
COEUR D ALENE, ID 83814
(208) 667-1376
1568778298AVANTI HEALTH LLC
Organization
Chiropractor850 W IRONWOOD DR SUITE 302
COEUR D ALENE, ID 83814
(208) 664-5225
1902196595 KELLY GRACE LMP
Individual
Massage Therapist850 W IRONWOOD DR 302
COEUR D ALENE, ID 83814
(208) 664-5225
1821374893MRS. MELINDA MICHELLE SEGRAVES
Individual
Massage Therapist850 W IRONWOOD DR 302
COEUR D ALENE, ID 83814
(509) 868-8699
1225388028MS. AMANDA DEE ROBY N.P.
Individual
Nurse Practitioner850 W IRONWOOD DR # 500
COEUR D ALENE, ID 83814
(208) 667-1376
1952797672MS. DENEIGE KRISTINE HAAR L.M.T
Individual
Chiropractor (Rehabilitation)850 W IRONWOOD DR SUITE 302
COEUR D ALENE, ID 83814
(208) 664-5225
1073988184 REBECCA MOORE
Individual
Massage Therapist850 W IRONWOOD DR 302
COEUR D ALENE, ID 83814
(208) 664-5225
1255706099 LEAH ALLEN M.T.
Individual
Massage Therapist850 W IRONWOOD DR SUITE 302
COEUR D ALENE, ID 83814
(208) 664-5225
1861851370PACIFIC CAPITAL AND CONSULTING, LLC
Organization
Chiropractor850 W IRONWOOD DR SUITE 302
COEUR D ALENE, ID 83814
(208) 664-5225
1902802549 MICHAEL ANTHONY WHITING PT
Individual
Physical Therapist (Orthopedic)850 W IRONWOOD DR STE 103
COEUR D ALENE, ID 83814
(208) 664-1119
1578935524DR. FABIAN HARPER D.C.
Individual
Chiropractor850 W IRONWOOD DR SUITE 302
COEUR D ALENE, ID 83814
(208) 664-5225
1740390137 ROGER CHARLES DUNTEMAN MD
Individual
Orthopaedic Surgery850 W IRONWOOD DR SUITE 202
COEUR D ALENE, ID 83814
(208) 664-2175
1083729438ORTHOPEDIC SURGERY AND SPORTS
Organization
Orthopaedic Surgery850 W IRONWOOD DR SUITE 202
COEUR D ALENE, ID 83814
(208) 664-2175
1700974714INLAND NORTHWEST SPINE PLLC
Organization
Orthopaedic Surgery850 W IRONWOOD DR SUITE 300
COEUR D ALENE, ID 83814
(208) 667-1376
1912628629 ALENA NOEL FOURNIER LMT
Individual
Massage Therapist850 W IRONWOOD DR
COEUR D ALENE, ID 83814
(208) 664-5225
1053734608ADDUS HEALTHCARE (IDAHO), INC.
Organization
In Home Supportive Care850 W IRONWOOD DR SUITE 101
COEUR D ALENE, ID 83814
(208) 667-2309
1285708354 JEFF E. LIEN PA
Individual
Physician Assistant850 W IRONWOOD DR SUITE 202
COEUR D ALENE, ID 83814
(208) 664-2175

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1326151150, enumerated in the NPI registry as an "individual" on August 16, 2006

The provider is located at 850 W Ironwood Dr Suite 202 Coeur D Alene, Id 83814 and the phone number is (208) 664-2175

The provider's speciality is Orthopaedic Surgery with taxonomy code 207X00000X

The provider has more than 28 years of experience. He graduated from University Of Washington School Of Medicine in 1997.

The provider might be accepting Accepts: Mountain Health CO-OP, PacificSource Health Plans,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of July 02, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $83.36 with an average copayment of $20.84 for new patient appointments. Established patients should expect a typical charge of $68.04 and an average copayment of 17.01. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Injection, triamcinolone acetonide, not otherwise specified, 10 mg, X-ray of hip with pelvis, 2-3 views, X-ray of knee, 3 views, Repair of knee joint and Aspiration and/or injection of large joint or joint capsule.

The practitioner is affiliated to the following hospital(s): KOOTENAI HEALTH, NORTHWEST SPECIALTY HOSPITAL, BOUNDARY COMMUNITY HOSPITAL, SHOSHONE MEDICAL CENTER and BONNER GENERAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on August 16, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.