HIRENKUMAR JANI M.D. NPI 1366596405
Internal Medicine in Clanton, AL
About HIRENKUMAR JANI M.D.
Hirenkumar Jani is an internist established in Clanton, Alabama and his medical specialization is Internal Medicine with more than 41 years of experience. The NPI number of this provider is 1366596405 and was assigned on January 2007. The practitioner's primary taxonomy code is 207R00000X with license number 19650 (AL). The provider is registered as an individual and his NPI record was last updated 15 years ago.
| NPI | 1366596405 |
| Provider Name | HIRENKUMAR JANI M.D. |
| Location Address | 260 HEALTH CENTER DRIVE CLANTON, AL 35045 |
| Location Phone | (205) 280-1080 |
| Mailing Address | PO BOX 1388 ALABASTER, AL 35007 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 1983 |
| Is Sole Proprietor? | No |
| Enumeration Date | 01-23-2007 |
| Last Update Date | 11-17-2008 |
An internist like Hirenkumar Jani is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.Hirenkumar Jani 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.
Hirenkumar Jani 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 .
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, 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 provider also has detailed performance information the following quality measures: breast cancer screening, colorectal cancer screening, documentation of current medications in the medical record, implementation of improvements that contribute to more timely communication of test results, implementation of medication management practice improvements, pneumococcal vaccination status for older adults, preventive care and screening: influenza immunization, preventive care and screening: screening for depression and follow-up plan and use of telehealth services that expand practice access.
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.26 for a new patient copayment and $24.83 for an established patient copayment.
The CLIA number of Hirenkumar Jani is 01D0975737 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Hirenkumar Jani to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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.
| Taxonomy Code | 207R00000X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| License No. | 19650 |
| License State | AL |
| Taxonomy Description | A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Blue Cross Blue Shield
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
260 HEALTH CENTER DRIVE
CLANTON, AL
ZIP 35045
Phone: (205) 280-1080
Fax: (205) 280-1470
Mailing Address
PO BOX 1388
ALABASTER, AL
ZIP 35007
Phone: (205) 280-1080
Fax: (205) 280-1470
Location Map
PECOS Enrollment and Medicare Participation Status
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 Medicare providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in the Medicare program need to enroll in PECOS with their NPI number to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 7416007067 |
| PECOS Enrollment ID | I20090603000083 |
| 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 Imaging | Yes |
| Eligible order or refer Durable Medical Equipment (DMEPOS) | Yes |
| Eligible order r refer Home Health Agency (HHA) | Yes |
| Eligible order r refer Power Mobility Devices | Yes |
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 35045 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99204 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $55.54 | $170.61 | $129.05 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $13.88 | $42.65 | $32.26 |
| Established Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for established patients office visits: 99214 | ||
| Minimum Established Patient Pricing | Maximum Established Patient Pricing | Typical Established Patient Pricing |
| $16.93 | $139.08 | $99.33 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.23 | $34.77 | $24.83 |
* 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 | |
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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 (PI) | 25% | N/A | |
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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. |
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| Improvement Activities | 15% | 40 | |
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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. |
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| Cost | 20% | N/A | |
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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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| MIPS Final Score | - | 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. | |||
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Breast Cancer Screening | 100% | 35 |
| Percentage of women 50 - 74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the measurement period. | ||
| Colorectal Cancer Screening | 100% | 55 |
| Percentage of patients 50-75 years of age who had appropriate screening for colorectal cancer. | ||
| Documentation of Current Medications in the Medical Record | 100% | 3519 |
| Percentage of visits for patients aged 18 years and older for which the MIPS eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration. | ||
| 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 medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following:Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups;Integrate a pharmacist into the care team; and/orConduct periodic, structured medication reviews. | ||
| Pneumococcal Vaccination Status for Older Adults | 84% | 231 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine. | ||
| Preventive Care and Screening: Influenza Immunization | 99% | 169 |
| Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization. | ||
| Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 44% | 382 |
| Percentage of patients aged 12 years and older screened for depression on the date of the encounter or 14 days prior to the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the eligible encounter. | ||
| Use of telehealth services that expand practice access | Yes | N/A |
| Use of telehealth services and analysis of data for quality improvement, such as participation in remote specialty care consults or teleaudiology pilots that assess ability to still deliver quality care to patients. | ||
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.
- 72Administration of influenza virus vaccine (HCPCS:G0008)
- 34Urinalysis, manual test (HCPCS:81002)
- 23Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
- 17Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem (HCPCS:G0180)
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
| CLIA Number | 01D0975737 |
| Facility Type | PHYSICIAN OFFICE |
| Certificate Type | Certificate of Waiver |
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 |
|---|---|---|---|---|---|---|---|
| 1 | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 19650 | AL | No |
Taxonomy Description: an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. | |||||||
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 |
|---|---|---|---|
| 000096510 | MEDICARE ID-TYPE UNSPECIFIED (04) | AL | |
| 000096510 | MEDICAID (05) | AL | |
| 51096510 | OTHER (01) | AL | BCBS OF ALABAMA |
| G40306 | MEDICARE UPIN (02) | AL |
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 | 6 | 6 | 5 | 9 | 6 | 4 | 0 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 12 | 6 | 10 | 9 | 12 | 4 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 2 + 6 + 1 + 0 + 9 + 1 + 2 + 4 + 0 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1366596405 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
What is Hirenkumar Jani M.D. NPI number?
The NPI number assigned to this healthcare provider is 1366596405, registered as an "individual" on January 23, 2007
Where is the provider located?
The provider is located at 260 Health Center Drive Clanton, Al 35045 and the phone number is (205) 280-1080
What is the provider specialty code?
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
How many years of experience does Hirenkumar Jani M.D. have?
The provider has more than 41 years of experience.
What insurance does Hirenkumar Jani M.D. accept?
The provider might be accepting Blue Cross Blue Shield, Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Hirenkumar Jani M.D. registered in PECOS?
Yes, as of September 14, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary 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 are Hirenkumar Jani M.D. Quality Ratings?
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences. The provider obtained a high score in the following performance measures: Breast Cancer Screening, Colorectal Cancer Screening, Documentation of Current Medications in the Medical Record, Pneumococcal Vaccination Status for Older Adults , Preventive Care and Screening: Influenza Immunization. The quality ratings are based on unbiased reviews and reported submissions to Medicare's Quality Payment Program.
How much is a visit to Hirenkumar Jani M.D.?
Medicare beneficiaries should expect a typical cost of $129.05 with an average copayment of $32.26 for new patient appointments. Established patients should expect a typical charge of $99.33 and an average copayment of 24.83. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Hirenkumar Jani M.D.?
The most common procedures or services performed by this practitioner are: Administration of influenza virus vaccine, Urinalysis, manual test, Injection beneath the skin or into muscle for therapy, diagnosis, or prevention and Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem.
What is Hirenkumar Jani M.D. CLIA number?
The provider's CLIA number is 01D0975737 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
How do I update my NPI information?
This NPI record was last updated on January 23, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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