STEVEN R GAMMON MD
NPI 1356552657
Orthopaedic Surgery in Grand Junction, CO
Quality Rating: 80.29 out of 100 score
NPI Status: Active since May 25, 2007
Contact Information
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
Phone: (970) 242-3535
Fax: (970) 623-8599
- Individual
- Male
- Years of Experience 20
- Orthopaedic Surgery
- Accepts Medicare Approved Payment
- PECOS Enrolled
About STEVEN GAMMON
This page provides the complete NPI Profile along with additional information for Steven Gammon, a provider established in Grand Junction, Colorado with a medical specialization in Orthopaedic Surgery and more than 20 years of experience. He graduated from Saint Louis University School Of Medicine in 2006. The healthcare provider is registered in the NPI registry with number 1356552657 assigned on May 2007. The practitioner's primary taxonomy code is 207X00000X with license number 51478 (CO). The provider is registered as an individual and his NPI record was last updated 13 years ago.
- NPI
- 1356552657
- Provider Name
- STEVEN R GAMMON MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 627 25 1/2 RD GRAND JUNCTION, CO 81505
- Location Phone
- (970) 242-3535
- Location Fax
- (970) 623-8599
- Mailing Address
- 627 25 1/2 RD GRAND JUNCTION, CO 81505
- Mailing Phone
- (970) 242-3535
- Mailing Fax
- (970) 623-8599
- Medical School Name
- SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2006
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-25-2007
- Last Update Date
- 07-26-2012
- Code Navigator
Location Map
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.
- 51478
- License State
- CO
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 57012209 (OH) |
Medicare Participation & PECOS Enrollment Status
Steven Gammon 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.
Steven Gammon 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: 3375712557
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: I20120910000374
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
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.
Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Hip replacement
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Knee replacement
Musculoskeletal surgical navigational orthopedic operation using imaging guidance
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Replacement of knee joint, both sides of knee
Replacement of thigh bone and hip joint with prosthesis
X-ray of hip, 1 view
X-ray of hip, 2-3 views
X-ray of knee, 4 or more views
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 50 times for 42 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 53 times for 46 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 98 times for 76 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 19 times for 19 patientsA hip replacement is a surgical procedure where a worn-out or damaged hip joint is replaced with an artificial one. This procedure can greatly reduce pain and improve mobility. It's often recommended when other treatments like physical therapy or medications fail to alleviate symptoms.
This service was performed for 42 patientsTriamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
This service was performed 165 times for 30 patientsA knee replacement is a surgical procedure where a damaged or diseased knee joint is replaced with an artificial one. This can relieve pain and improve mobility. The procedure involves removing damaged parts of the knee and inserting a prosthetic joint. Recovery may take several weeks.
This service was performed for 40 patientsThis is a precise orthopedic surgery using advanced imaging technology. It helps the surgeon navigate through your musculoskeletal system (bones, muscles, and joints) accurately. This method reduces the risk of damage to nearby areas and aids in a more successful operation.
This service was performed 58 times for 53 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 36 times for 36 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 24 times for 24 patientsA bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.
This service was performed 24 times for 22 patientsThis procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.
This service was performed 38 times for 36 patientsAn X-ray of the hip, 1 view, is a quick, painless test where a small amount of radiation is used to produce images of the hip joint. This helps in diagnosing conditions like arthritis or fractures. You'll be positioned so that the X-ray machine can capture the best image of your hip.
This service was performed 15 times for 15 patientsAn X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
This service was performed 48 times for 43 patientsAn X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
This service was performed 55 times for 43 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.35 for a new patient copayment and $18.05 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 81505 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $89.43
- Minimum New Patient Price $58.06
- Maximum New Patient Price $174.82
- Average New Patient Copayment $22.35
- Minimum New Patient Copayment $14.51
- Maximum New Patient Copayment $43.7
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $72.2
- Minimum Established Patient Price $18.88
- Maximum Established Patient Price $142.79
- Average Established Patient Copayment $18.05
- Minimum Established Patient Copayment $4.72
- Maximum Established Patient Copayment $35.69
* 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 80.29, 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: 80.29 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: 80.47
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.
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Promoting Interoperability Score: 81
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: 69.68
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: 69.68
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.
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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. | |||||||||
1 | 3 | 5 | 6 | 5 | 5 | 2 | 6 | 5 | 7 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 3 | 10 | 6 | 10 | 5 | 4 | 6 | 10 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 3 + 1 + 0 + 6 + 1 + 0 + 5 + 4 + 6 + 1 + 0 + 24 = 53 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 53 = 7 | 7 |
The NPI number 1356552657 is valid because the calculated check digit 7 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.
DR. JEFFREY M NAKANO MD
Orthopaedic Surgery
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
DR. MICHAEL P DOHM MD
Orthopaedic Surgery
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
DR. MARK G LUKER MD
Orthopaedic Surgery
(Sports Medicine)
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
DR. DAVID P FISHER MD
Orthopaedic Surgery
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
DR. STEVEN J HEIL MD
Orthopaedic Surgery
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
DR. JAMES S GEBHARD MD
Orthopaedic Surgery
(Orthopaedic Surgery of the Spine)
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
MR. DAVID M MAYER MD
Orthopaedic Surgery
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
DR. ROBERT L FRAZHO MD
Physical Medicine & Rehabilitation
(Spinal Cord Injury Medicine)
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
MR. MICHAEL H SCHROEDER PA-C
Physician Assistant
(Surgical)
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
ROCKY MOUNTAIN ORTHOPAEDIC ASSOCIATES PC
Orthopaedic Surgery
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
MR. WILLIAM ETENBURN OPA-C
Physician Assistant
(Surgical)
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
DR. MARY BETH DEERING M.D.
Orthopaedic Surgery
(Pediatric Orthopaedic Surgery)
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
DR. KIRK D CLIFFORD MD
Orthopaedic Surgery
(Orthopaedic Surgery of the Spine)
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
JENNIFER L RAPIEJKO MMS, PA-C
Physician Assistant
(Surgical)
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
MR. TODD DAVID OUSLEY PA-C
Physician Assistant
(Surgical)
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
MRS. SHARON A BROWN RN
Registered Nurse
(Medical-Surgical)
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
MRS. LINDA TIPPING RN
Registered Nurse
(Medical-Surgical)
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
MRS. KATHLEEN A RICHMOND ORT-CERTIFIED
Technician
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
MS. MICHAELA A SESSUM
Technician, Other
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
ROCKY MOUNTAIN ORTHOPAEDIC ASSOCIATES, PC
627 25 1/2 RD
GRAND JUNCTION, CO
ZIP 81505
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356552657, enumerated as an "individual" on May 25, 2007.
The provider is located at 627 25 1/2 RD GRAND JUNCTION, CO 81505 and the phone number is (970) 242-3535.
Orthopaedic Surgery with taxonomy code 207X00000X.