MARGARET BAILEY RN
NPI 1336668912
Internal Medicine - Cardiovascular Disease in West Reading, PA
About Margaret Bailey Rn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARGARET BAILEY RN (NPI 1336668912) is an individual cardiovascular disease provider in West Reading, Pennsylvania, licensed in Pennsylvania (SP018099) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Margaret Bailey Rn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
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 (DE013N)
Automatic external defibrillator, with integrated electrocardiogram analysis, garment type (HCPCS:K0606)
1 DME suppliers used 13 Medicare Claims 13 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.
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
Hospital discharge day management, more than 30 minutes
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 20 times for 19 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 90 times for 85 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 73 times for 71 patientsHospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
This service was performed 11 times for 11 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.58 for a new patient copayment and $17.09 for an established patient copayment.
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 19611 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.34
- Minimum New Patient Price $54.64
- Maximum New Patient Price $166.87
- Average New Patient Copayment $31.58
- Minimum New Patient Copayment $13.66
- Maximum New Patient Copayment $41.71
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.36
- Minimum Established Patient Price $17.33
- Maximum Established Patient Price $135.84
- Average Established Patient Copayment $17.09
- Minimum Established Patient Copayment $4.33
- Maximum Established Patient Copayment $33.96
* 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 provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 81.19, 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 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.
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Final Score: 81.19 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.
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Quality Score: 74.56
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 comprises 40% of a provider's final MIPS score.
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.
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Promoting Interoperability Score: 97
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 comprises 25% of a provider's final MIPS score.
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 comprises 15% of a provider's final MIPS score.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score. -
Cost Score: 65.23
The Cost performance category assesses 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 comprises 20% of a provider's final MIPS score.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
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. Margaret Bailey is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| READING HOSPITAL | 420 S 5TH AVENUE WEST READING, PA 19611 | (610) 988-8000 | Acute Care Hospitals |
Other Providers at the Same Location
The following 15 providers are registered at the same or a nearby location.
WEST READING, PA 19611
WEST READING, PA 19611
WEST READING, PA 19611
WEST READING, PA 19611
WEST READING, PA 19611
WEST READING, PA 19611
WEST READING, PA 19611
WEST READING, PA 19611
WEST READING, PA 19611
WEST READING, PA 19611
WEST READING, PA 19611
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336668912, enumerated as an "individual" on September 14, 2017.
The provider is located at 301 S 7TH AVE STE 2020 WEST READING, PA 19611 and the phone number is (610) 375-6565.
Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.
Margaret Bailey is affiliated with: READING HOSPITAL.
