DR. JENNIE S WHEELER M.D.
NPI 1336351790
Internal Medicine in Sylacauga, AL


Quality Rating: 83.51 out of 100 score

NPI Status: Active since May 05, 2007

Contact Information

315 W HICKORY ST
SYLACAUGA, AL
ZIP 35150
Phone: (256) 401-4000

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  • Individual
  • Female
  • Years of Experience 21
  • Internal Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About JENNIE WHEELER

Jennie Wheeler is an internist established in Sylacauga, Alabama and her medical specialization is Internal Medicine with more than 21 years of experience. She graduated from University Of Alabama School Of Medicine in 2004. The healthcare provider is registered in the NPI registry with number 1336351790 assigned on May 2007. The practitioner's primary taxonomy code is 207R00000X with license number MD.27178 (AL). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI
1336351790
Provider Name
DR. JENNIE S WHEELER M.D.
Gender
Female
Entity Type
Individual
Location Address
315 W HICKORY ST SYLACAUGA, AL 35150
Location Phone
(256) 401-4000
Mailing Address
315 W HICKORY ST SYLACAUGA, AL 35150
Mailing Phone
(256) 401-4000
Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year
2004
Is Sole Proprietor?
No
Enumeration Date
05-05-2007
Last Update Date
02-08-2023
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An internist like Jennie Wheeler 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.

Jennie Wheeler 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 83.51, 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: $32.26 for a new patient copayment and $24.83 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

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
MD.27178
License State
AL
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Insurance Plans Accepted

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

  • Blue Cross and Blue Shield of Alabama

    • Blue HSA Bronze - PPO
    • Blue Protect - PPO
    • Blue Saver Bronze - PPO
    • Blue Value Gold - PPO
    • Blue Value Silver - PPO
    • Blue Access Gold for Business - PPO
    • Blue Choice Platinum for Business - PPO
    • Blue HSA Silver for Business - PPO
    • Blue Saver Bronze for Business - PPO
    • Blue Saver Gold for Business - PPO
    • Blue Secure Gold for Business - PPO
    • Blue Secure Silver for Business - PPO

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

PECOS Enrollment and Medicare Participation Status

Jennie Wheeler 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: 3476645466

    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: I20070822000855

    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

  • Hospital beds (D1B)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress (HCPCS:E0261)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Oxygen and supplies (D1C)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    1 DME suppliers used 48 Medicare Claims 48 Services Paid

  • Oxygen and supplies (D1C)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    2 DME suppliers used 57 Medicare Claims 57 Services Paid

  • Wheelchairs (D1D)

    Lightweight wheelchair (HCPCS:K0003)

    1 DME suppliers used 13 Medicare Claims 13 Services Paid

  • Other DME (D1E)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    1 DME suppliers used 21 Medicare Claims 21 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 35150 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $129.05
  • Minimum New Patient Price $55.54
  • Maximum New Patient Price $170.61
  • Average New Patient Copayment $32.26
  • Minimum New Patient Copayment $13.88
  • Maximum New Patient Copayment $42.65

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.33
  • Minimum Established Patient Price $16.93
  • Maximum Established Patient Price $139.08
  • Average Established Patient Copayment $24.83
  • Minimum Established Patient Copayment $4.23
  • Maximum Established Patient Copayment $34.77

* 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: 83.51 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: 84.74

    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: 73

    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.

  • 46

    Blood test, comprehensive group of blood chemicals (HCPCS:80053)

  • 41

    Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS:85025)

  • 32

    Hemoglobin a1c level (HCPCS:83036)

  • 30

    Insertion of needle into vein for collection of blood sample (HCPCS:36415)

  • 20

    Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

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. Jennie Wheeler is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
COOSA VALLEY MEDICAL CENTER315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 249-5000Acute Care 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.
1336351790
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2366652718
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 6 + 6 + 6 + 5 + 2 + 7 + 1 + 8 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1336351790 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
1043215114 SANDRA B MARTIN MD
Individual
Specialist315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 249-5000
1063477339MR. RONALD E MAIDEN CRNA
Individual
Nurse Anesthetist, Certified Registered315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 249-5000
1649235649 ANTHONY ANDREW CIBULSKI M.D.
Individual
Emergency Medicine315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 249-5700
1588621718SYLACAUGA HEALTHCARE AUTHORITY
Organization
Home Health315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 249-5027
1598792665 RONALD PEARSON MD
Individual
Emergency Medicine315 W HICKORY ST
SYLACAUGA, AL 35150
(205) 995-7980
1881621274DR. WILLIAM BRADEN PITTMAN MD
Individual
Emergency Medicine315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 249-5700
1366539538SYLACAUGA HEALTH CARE AUTHORITY
Organization
Skilled Nursing Facility315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 249-5690
1841372190 KRYSTAL J. MAGOUIRK C.R.N.A.
Individual
Nurse Anesthetist, Certified Registered315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 249-5000
1427176031 BRANDY S. RIVERS C.R.N.A.
Individual
Nurse Anesthetist, Certified Registered315 W HICKORY ST
SYLACAUGA, AL 35150
(334) 286-3579
1124235320THE SYLACAUGA HEALTH CARE AUTHORITY
Organization
Family Medicine315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 401-4000
1942417142THE SYLACAUGA HEALTH CARE AUTHORITY
Organization
General Acute Care Hospital315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 401-4606
1366689887MRS. ALLISON D WOOLLEY CRNA
Individual
Nurse Anesthetist, Certified Registered315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 249-5000
1538488143 JENNIFER LACEY CRNP
Individual
Nurse Practitioner315 W HICKORY ST
SYLACAUGA, AL 35150
(406) 600-9186
1386853125THE SYLACAUGA HEALTH CARE AUTHORITY
Organization
General Acute Care Hospital315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 401-4000
1891075602LABORATORY CORPORATION OF AMERICA HOLDINGS
Organization
Clinical Medical Laboratory315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 401-4160
1447287891 JAIMEE TULLOS SANDLIN PA
Individual
Physician Assistant315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 249-5700
1093834855 CAROLYN J PROKOPYK CRNA
Individual
Nurse Anesthetist, Certified Registered315 W HICKORY ST
SYLACAUGA, AL 35150
(334) 396-6930
1669723748 JOHN LUCAS SCOTT CRNA
Individual
Nurse Anesthetist, Certified Registered315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 401-4605
1770940132MRS. TRACEY ALLEN RPH
Individual
Pharmacist315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 401-4065
1023475498DR. NANCY MEADORS PHARM D
Individual
Pharmacist315 W HICKORY ST
SYLACAUGA, AL 35150
(256) 401-4065

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1336351790, enumerated in the NPI registry as an "individual" on May 05, 2007

The provider is located at 315 W Hickory St Sylacauga, Al 35150 and the phone number is (256) 401-4000

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 21 years of experience. She graduated from University Of Alabama School Of Medicine in 2004.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Alabama. 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.

Medicare beneficiaries should expect a typical cost of $129.05 with an average copayment of $32.26 for new patient appointments. Established patients should expect a typical charge of $99.33 and an average copayment of 24.83. 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: Blood test, comprehensive group of blood chemicals, Complete blood cell count (red cells, white blood cell, platelets), automated test, Hemoglobin a1c level, Insertion of needle into vein for collection of blood sample and Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit.

The practitioner is affiliated to the following hospital(s): COOSA VALLEY MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on May 05, 2007. 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.