DR. MARK W PETERSON M.D. NPI 1356312524

Radiology (Diagnostic Radiology) in Lewiston, ID

NPI 1356312524 Individual Male Years of Experience 39 Radiology Diagnostic Radiology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 96

About MARK PETERSON

Mark Peterson is a provider established in Lewiston, Idaho and his medical specialization is radiology (diagnostic radiology) with more than 39 years of experience. He graduated from Columbia University College Of Physicians And Surgeons in 1983. The NPI number of Mark Peterson is 1356312524 and was assigned on January 2006. The practitioner's primary taxonomy code is 2085R0202X with license number M5240 (ID). The provider is registered as an individual and his NPI record was last updated 15 years ago.

Mark Peterson 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

Mark Peterson 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 St Anthony Hospital and Tri-state Memorial 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 96, 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.

NPI

1356312524

Provider NameDR. MARK W PETERSON M.D.
Provider Location Address415 6TH ST LEWISTON, ID 83501
Provider Mailing Address531 4TH AVE LEWISTON, ID 83501
GenderMale
NPI Entity TypeIndividual
Medical School NameCOLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Graduation Year1983
Is Sole Proprietor?N/A
Is Organization Subpart?N/A
Enumeration Date01-27-2006
Last Update Date07-08-2007


Primary Taxonomy

Taxonomy Code2085R0202X
ClassificationRadiology
TypeAllopathic & Osteopathic Physicians
SpecializationDiagnostic Radiology
License No.M5240
License StateID
Taxonomy DescriptionA radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Business Address

DR. MARK W PETERSON M.D.
415 6TH ST
LEWISTON, ID
ZIP 83501
Phone: (208) 799-5335

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Mailing Address

DR. MARK W PETERSON M.D.
531 4TH AVE
LEWISTON, ID
ZIP 83501
Phone: (208) 743-4393
Fax: (208) 743-4214



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 ID9830092857
PECOS Enrollment IDI20040812001408, I20041006001228, I20201117002494
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 83501 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$53.93 $165.44 $83.36
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.48 $41.36 $20.84
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
$16.64 $135.44 $68.04
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.16 $33.86 $17.01

* 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% 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 (PI) 25% 76.9
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% 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.
MIPS Final Score - 96
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.

  • 431X-ray of chest, 1 view, front (HCPCS:71010)
  • 304X-ray of chest, 2 views, front and side (HCPCS:71020)
  • 153CT scan of abdomen and pelvis with contrast (HCPCS:74177)
  • 55CT scan of abdomen and pelvis (HCPCS:74176)
  • 48Ultrasound guidance for accessing into blood vessel (HCPCS:76937)
  • 44Fluoroscopic guidance for insertion, replacement or removal of central venous access device (HCPCS:77001)
  • 38Nuclear medicine study with CT imaging skull base to mid-thigh (HCPCS:78815)
  • 38Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)
  • 38Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers (HCPCS:93971)
  • 35Ultrasound study of arteries and arterial grafts of both legs (HCPCS:93925)
  • 31Ultrasound study of arteries of both arms and legs (HCPCS:93922)
  • 30X-ray of foot, minimum of 3 views (HCPCS:73630)
  • 23Nuclear medicine study of vessels of heart using drugs or exercise multiple studies (HCPCS:78452)
  • 21Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers (HCPCS:93970)
  • 21X-ray of knee, 3 views (HCPCS:73562)
  • 18X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • 17Bone and/or joint imaging, whole body (HCPCS:78306)
  • 15X-ray of hand, minimum of 3 views (HCPCS:73130)
  • 15X-ray of ribs of one side of body, minimum of 2 views (HCPCS:73510)
  • 14X-ray of wrist, minimum of 3 views (HCPCS:73110)
  • 12X-ray of abdomen, single view (HCPCS:74000)
  • 11Radiological supervision and interpretation of CT guidance for needle insertion (HCPCS:77012)
  • 11X-ray of knee, 4 or more views (HCPCS:73564)

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. Mark Peterson is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
ST ANTHONY HOSPITAL2801 ST ANTHONY WAY
PENDLETON, OR 97801
(541) 276-5121Critical Access Hospitals381319
TRI-STATE MEMORIAL HOSPITAL1221 HIGHLAND AVENUE
CLARKSTON, WA 99403
(509) 758-5511Critical Access Hospitals501332

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
12085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyM5240IDN/A

Taxonomy Description: a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

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
1123012MEDICARE ID-TYPE UNSPECIFIED (04)ID
E08576MEDICARE UPIN (02)ID
000010005909OTHER (01)ID
P00165374OTHER (01)
0192980OTHER (01)WA
71498OTHER (01)ID
8156473MEDICAID (05)WA

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1912984477DR. ROBERT WILLIAM CIHAK MD
Individual
Pathology (Clinical Pathology/Laboratory Medicine)415 6TH ST PATHOLOGISTS REGIONAL LABORATORY
LEWISTON, ID 83501
(208) 746-0516
1891772117DR. MORGAN SCOTT WILSON MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)415 6TH ST
LEWISTON, ID 83501
(208) 746-0516
1700863024DR. KIM JANET WILSON MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)415 6TH ST
LEWISTON, ID 83501
(208) 746-0516
1649228446 MARK A TERRY MD
Individual
Radiology (Radiological Physics)415 6TH ST
LEWISTON, ID 83501
(208) 799-5335
1093753360DR. MICHAEL ROONEY M.D.
Individual
Internal Medicine (Medical Oncology)415 6TH ST
LEWISTON, ID 83501
(208) 743-2511
1124064647VALLEY ANESTHESIA, P.A.
Organization
Anesthesiology415 6TH ST
LEWISTON, ID 83501
(208) 743-2511
1053344085LAENNEC INPATIENT SERVICES
Organization
Internal Medicine415 6TH ST
LEWISTON, ID 83501
(208) 799-5522
1841392982DR. JEFFREY CARL BICKEL M.D
Individual
Radiology (Body Imaging)415 6TH ST
LEWISTON, ID 83501
(208) 799-5335
1750465514DR. PAUL J SANCHIRICO MD
Individual
Radiology (Diagnostic Radiology)415 6TH ST
LEWISTON, ID 83501
(208) 799-5335
1285709121 PAMELA DENISE BROOKS CRNFA
Individual
Registered Nurse (Registered Nurse First Assistant)415 6TH ST
LEWISTON, ID 83501
(208) 799-5400
1992870836DR. THOMAS STEPHENSON HOLMES M.D.
Individual
Psychiatry & Neurology (Psychiatry)415 6TH ST
LEWISTON, ID 83501
(208) 743-2511
1629144274ST JOSEPH SNF UNIT
Organization
Skilled Nursing Facility415 6TH ST
LEWISTON, ID 83501
(208) 799-5200
1730244542DR. MATTHEW LYSNE M.D.
Individual
Emergency Medicine415 6TH ST
LEWISTON, ID 83501
(208) 743-2511
1316002033DR. ARNOLD KADRMAS M.D.
Individual
Psychiatry & Neurology (Psychiatry)415 6TH ST
LEWISTON, ID 83501
(208) 743-2511
1700941572DR. DAVID KENDRICK M.D.
Individual
Emergency Medicine415 6TH ST
LEWISTON, ID 83501
(208) 743-2511
1275698987DR. JAY HUNTER M.D.
Individual
Emergency Medicine415 6TH ST
LEWISTON, ID 83501
(208) 743-2511
1164587887DR. NANCY BERKHEISER M.D.
Individual
Emergency Medicine415 6TH ST
LEWISTON, ID 83501
(208) 743-2511
1417095191DR. WILLIAM C MANKEL M.D.
Individual
Psychiatry & Neurology (Psychiatry)415 6TH ST
LEWISTON, ID 83501
(208) 743-2511
1376681098 PHILIP N MACKINNON PH D
Individual
Psychologist415 6TH ST
LEWISTON, ID 83501
(208) 743-2511
1932247665 JUDY A METELKO CNS,ARNP
Individual
Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)415 6TH ST
LEWISTON, ID 83501
(208) 743-2511

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.