TESSA ALLEN PA-C
NPI 1356996847
Physician Assistant in Wyomissing, PA

Quality Rating: 86.62 out of 100 score

NPI Status: Active since August 02, 2019

Contact Information

950A N WYOMISSING BLVD
WYOMISSING, PA
ZIP 19610
Phone: (610) 898-2400
Fax: (610) 378-7839

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Table of Contents

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
Overall Quality Performance
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 7
Physician Assistant
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About TESSA ALLEN

This page provides the complete NPI Profile along with additional information for Tessa Allen, a primary care provider established in Wyomissing, Pennsylvania with a medical specialization in Physician Assistant and more than 7 years of experience. The healthcare provider is registered in the NPI registry with number 1356996847 assigned on August 2019. The practitioner's primary taxonomy code is 363A00000X. The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI: 1356996847
Provider Name: TESSA ALLEN PA-C
Gender: Female
Entity Type: Individual
Location Address: 950A N WYOMISSING BLVD WYOMISSING, PA 19610
Location Phone: (610) 898-2400
Location Fax: (610) 378-7839
Mailing Address: PO BOX 13579 READING, PA 19612
Medical School Name: OTHER
Graduation Year: 2019
Is Sole Proprietor?: No
Enumeration Date: 08-02-2019
Last Update Date: 12-08-2022
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A primary care provider (PCP) like Tessa Allen sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

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: Physician Assistant
Taxonomy Code: 363A00000X
Type: Physician Assistants & Advanced Practice Nursing Providers
Taxonomy Description: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

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

Anthem Blue Cross and Blue Sheld

Anthem Bronze Preferred Blue PPO 5000/10%/8000 w/HSA - PPO
Anthem Bronze Preferred Blue PPO 5000/20%/8000 w/HSA - PPO
Anthem Bronze Preferred Blue PPO 6500/30%/9200 Value - PPO
Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO
Anthem Gold Preferred Blue PPO 3000/0%/5500 RxD - PPO
Anthem Gold Preferred Blue PPO 500/25%/7000 - PPO
Anthem Platinum Preferred Blue PPO 250/10%/3500 - PPO
Anthem Silver Preferred Blue PPO 2000/30%/9000 Value - PPO
Anthem Silver Preferred Blue PPO 3000/20%/8500 - PPO
Anthem Silver Preferred Blue PPO 3000/30%/9000 Value - PPO
Anthem Silver Preferred Blue PPO 3500/20%/7250 w/HSA - PPO
Anthem Silver Preferred Blue PPO 4000/0%/8500 - PPO
Anthem Silver Preferred Blue PPO 4000/0%/8500 RxD - PPO
Anthem Silver Preferred Blue PPO 4000/10%/7250 w/HSA - PPO

Anthem Blue Cross and Blue Shield

Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
Anthem Bronze Pathway X Enhanced 6500/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
Anthem Catastrophic Pathway X Enhanced 9200/0% - HMO
Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Gold Pathway X Enhanced 1500/25% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Heart Healthy Bronze Pathway X Enhanced 6000/30% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
Anthem Silver Pathway X Enhanced 5000/40% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
Anthem Silver Pathway X Enhanced 5500/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
Anthem Bronze Pathway X HMO 5000/10%/8000 w/HSA - HMO
Anthem Bronze Pathway X HMO 5000/20%/8000 w/HSA - HMO
Anthem Bronze Pathway X HMO 6500/30%/9200 Value - HMO

Harvard Pilgrim Health Care

NH Local Choice HMO Bronze 8000 - HMO
NH Local Choice HMO Gold - HMO
NH Local Choice HMO Gold 1400 - HMO
NH Local Choice HMO HSA Bronze 6000 - HMO
NH Local Choice HMO Silver 3500 - HMO
NH Local Choice HMO Silver 5000 - HMO
NH Local HMO Bronze 7500 Standard - HMO
NH Local HMO Gold 1500 Standard - HMO
NH Local HMO Silver 5000 Standard - HMO

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

Medicare Participation & PECOS Enrollment Status

Tessa Allen 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.

Tessa Allen 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: 5991138851
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: I20240326000905
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

DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
6 DME suppliers used 11 Medicare Claims 28 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
2 DME suppliers used 14 Medicare Claims 14 Services Paid

Drugs Administered Through DME

DME-Drugs Administered Through DME (DG006N)
Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms (HCPCS:J7606)
1 DME suppliers used 13 Medicare Claims 780 Services Paid
DME-Drugs Administered Through DME (DG006N)
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)
2 DME suppliers used 14 Medicare Claims 990 Services Paid
DME-Drugs Administered Through DME (DG000N)
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)
1 DME suppliers used 13 Medicare Claims 780 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.

Administration of influenza virus vaccine
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Influenza vaccine, quadrivalent derived from recombinant dna
Online digital evaluation and management service for an established patient for up to 7 days, total time 5-10 minutes
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Telephone medical discussion with physician, 11-20 minutes
Transitional care management services for problem of high complexity

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.22 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 19610 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $84.88
Minimum New Patient Price $54.64
Maximum New Patient Price $166.87

Average New Patient Copayment $21.22
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 86.62, 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.

Final Score: 86.62 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: 80.5

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: 100

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: 74.89

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: 74.89

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.

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. Tessa Allen is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type
LITTLETON REGIONAL HEALTHCARE	600 ST JOHNSBURY ROAD LITTLETON, NH 03561	(603) 444-9000	Critical Access Hospitals
WEEKS MEDICAL CENTER	173 MIDDLE STREET LANCASTER, NH 03584	(603) 788-4911	Critical Access Hospitals
READING HOSPITAL	420 S 5TH AVENUE WEST READING, PA 19611	(610) 988-8000	Acute Care Hospitals

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	9	9	6	8	4	7
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	3	10	6	18	9	12	8	8
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 0 + 6 + 1 + 8 + 9 + 1 + 2 + 8 + 8 + 24 = 73
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 73 = 7									7

The NPI number 1356996847 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.