MR. GLYN E. JONES MD
NPI 1366462475
Plastic Surgery in Peoria, IL
NPI Status: Active since July 20, 2006
Contact Information
1001 MAIN STREET
3RD FLOOR
PEORIA, IL
ZIP 61606
Phone: (309) 495-0200
Fax: (309) 676-6545
- Individual
- Male
- Plastic Surgery
- PECOS Enrolled
- Medicare Quality Reporting
About GLYN JONES
This page provides the complete NPI Profile along with additional information for Glyn Jones, a provider established in Peoria, Illinois with a medical specialization in Plastic Surgery. The healthcare provider is registered in the NPI registry with number 1366462475 assigned on July 2006. The practitioner's primary taxonomy code is 208200000X with license number 036118115 (IL). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1366462475
- Provider Name
- MR. GLYN E. JONES MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1001 MAIN STREET 3RD FLOOR PEORIA, IL 61606
- Location Phone
- (309) 495-0200
- Location Fax
- (309) 676-6545
- Mailing Address
- 1001 MAIN STREET 3RD FLOOR PEORIA, IL 61606
- Mailing Phone
- (309) 495-0200
- Mailing Fax
- (309) 676-6545
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-20-2006
- Last Update Date
- 10-01-2008
- 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
Plastic Surgery
- Taxonomy Code
- 208200000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036118115
- License State
- IL
- Taxonomy Description
- A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| K37419 | OTHER (01) | IL | MEDICARE ID TYPE UNSPECI |
| 036118115-1 | MEDICAID (05) | IL | |
| 7215166 | OTHER (01) | BCBS OF ILLINOIS | |
| F40855 | MEDICARE UPIN (02) |
Medicare Participation & PECOS Enrollment Status
Glyn Jones 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
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
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 61606 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.71
- Minimum New Patient Price $54.8
- Maximum New Patient Price $168.44
- Average New Patient Copayment $21.42
- Minimum New Patient Copayment $13.7
- Maximum New Patient Copayment $42.11
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.64
- Minimum Established Patient Price $17.16
- Maximum Established Patient Price $136.56
- Average Established Patient Copayment $17.16
- Minimum Established Patient Copayment $4.29
- Maximum Established Patient Copayment $34.14
* 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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Annual registration in the Prescription Drug Monitoring Program | Yes | N/A |
| Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months. | ||
| Breast Cancer Screening | 50% | 269 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Closing the Referral Loop: Receipt of Specialist Report | 96% | 55 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred | ||
| Collection and use of patient experience and satisfaction data on access | Yes | N/A |
| Collection of patient experience and satisfaction data on access to care and development of an improvement plan, such as outlining steps for improving communications with patients to help understanding of urgent access needs. | ||
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| e-Prescribing | 96% | 197 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Implementation of documentation improvements for practice/process improvements | Yes | N/A |
| Implementation of practices/processes that document care coordination activities (e.g., a documented care coordination encounter that tracks all clinical staff involved and communications from date patient is scheduled for outpatient procedure through day of procedure). | ||
| Implementation of formal quality improvement methods, practice changes, or other practice improvement processes | Yes | N/A |
| Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data. | ||
| Implementation of improvements that contribute to more timely communication of test results | Yes | N/A |
| Timely communication of test results defined as timely identification of abnormal test results with timely follow-up. | ||
| Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop | Yes | N/A |
| Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology. | ||
| Leadership engagement in regular guidance and demonstrated commitment for implementing practice improvement changes | Yes | N/A |
| Ensure full engagement of clinical and administrative leadership in practice improvement that could include one or more of the following: Make responsibility for guidance of practice change a component of clinical and administrative leadership roles; Allocate time for clinical and administrative leadership for practice improvement efforts, including participation in regular team meetings; and/or Incorporate population health, quality and patient experience metrics in regular reviews of practice performance. | ||
| Medication Reconciliation | 88% | 1123 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 1% | 858 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 99% | 858 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | Yes | N/A |
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | ||
| Secure Messaging | 3% | 858 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1366462475, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 9 providers are registered at the same or a nearby location.
PEORIA, IL 61606
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1366462475, enumerated as an "individual" on July 20, 2006.
The provider is located at 1001 MAIN STREET 3RD FLOOR PEORIA, IL 61606 and the phone number is (309) 495-0200.
Plastic Surgery with taxonomy code 208200000X.
The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.
