DR. NANCY LEE VANBUREN M.D.
NPI 1376561811
Pathology - Blood Banking & Transfusion Medicine in Woodbury, MN


Quality Rating: 91.42 out of 100 score

NPI Status: Active since July 17, 2006

Contact Information

1875 WOODWINDS DRIVE
SUITE 220
WOODBURY, MN
ZIP 55125
Phone: (651) 264-1500
Fax: (651) 264-1646

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  • Individual
  • Female
  • Pathology
  • Blood Banking & Transfusion Medicine
  • Accepts Insurance
  • PECOS Enrolled

About NANCY VANBUREN

This page provides the complete NPI Profile along with additional information for Nancy Vanburen, a provider established in Woodbury, Minnesota with a medical specialization in Pathology, focusing in blood banking & transfusion medicine . The healthcare provider is registered in the NPI registry with number 1376561811 assigned on July 2006. The practitioner's primary taxonomy code is 207ZB0001X with license number 29007 (MN). The provider is registered as an individual and her NPI record was last updated 11 years ago.

NPI
1376561811
Provider Name
DR. NANCY LEE VANBUREN M.D.
Gender
Female
Entity Type
Individual
Location Address
1875 WOODWINDS DRIVE SUITE 220 WOODBURY, MN 55125
Location Phone
(651) 264-1500
Location Fax
(651) 264-1646
Mailing Address
737 PELHAM BLVD INNOVATIVE BLOOD RESOURCES SAINT PAUL, MN 55114
Mailing Phone
(651) 332-7272
Mailing Fax
(651) 264-1646
Is Sole Proprietor?
No
Enumeration Date
07-17-2006
Last Update Date
11-02-2015
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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

Pathology Blood Banking & Transfusion Medicine

Taxonomy Code
207ZB0001X
Type
Allopathic & Osteopathic Physicians
License No.
29007
License State
MN
Taxonomy Description
A physician who specializes in blood banking/transfusion medicine is responsible for the maintenance of an adequate blood supply, blood donor and patient-recipient safety and appropriate blood utilization. Pre-transfusion compatibility testing and antibody testing assure that blood transfusions, when indicated, are as safe as possible. This physician directs the preparation and safe use of specially prepared blood components, including red blood cells, white blood cells, platelets and plasma constituents, and marrow or stem cells for transplantation.

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)
1207ZP0102XAllopathic & Osteopathic Physicians

Pathology
Anatomic Pathology & Clinical Pathology

29007 (MN)

Insurance Plans Accepted

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

  • Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
  • Medica Individual Choice Bronze HSA - EPO
  • Medica Individual Choice Bronze Share - EPO
  • Medica Individual Choice Bronze Share - HMO
  • Medica Individual Choice Expanded Bronze Standard - EPO
  • Medica Individual Choice Expanded Bronze Standard - HMO
  • Medica Individual Choice Gold $0 Copay PCP Visits - EPO
  • Medica Individual Choice Gold $0 Copay PCP Visits - HMO
  • Medica Individual Choice Gold Share - EPO
  • Medica Individual Choice Gold Share - HMO
  • Medica Individual Choice Gold Standard - EPO
  • Medica Individual Choice Gold Standard - HMO
  • Medica Individual Choice Silver $0 Copay PCP Visits - EPO
  • Medica Individual Choice Silver $0 Copay PCP Visits - HMO
  • Medica Individual Choice Silver Share - EPO
  • Medica Individual Choice Silver Share - HMO
  • Medica Individual Choice Silver Standard - EPO
  • Medica Individual Choice Silver Standard - HMO

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
C01224MEDICARE ID-TYPE UNSPECIFIED (04)GROUP UPP
013957200MEDICAID (05)MN 
191813300MEDICAID (05)MN 
099565700MEDICAID (05)MN 
690610930MEDICARE ID-TYPE UNSPECIFIED (04)GROUP CRPL
220000947MEDICARE ID-TYPE UNSPECIFIED (04)INDIV UPP
F07659MEDICARE UPIN (02) 

Medicare Participation & PECOS Enrollment Status

Nancy Vanburen 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

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.

Blood bank physician services with written report

A blood bank physician service involves a specialized doctor overseeing all aspects of blood collection, storage, and transfusion. They ensure the process is safe and effective. A written report details all procedures and findings for your reference and understanding.

This service was performed 20 times for 19 patients

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 55125 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $127.61
  • Minimum New Patient Price $56
  • Maximum New Patient Price $168.28
  • Average New Patient Copayment $31.9
  • Minimum New Patient Copayment $14
  • Maximum New Patient Copayment $42.07

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $98.61
  • Minimum Established Patient Price $18.32
  • Maximum Established Patient Price $138.04
  • Average Established Patient Copayment $24.65
  • Minimum Established Patient Copayment $4.58
  • Maximum Established Patient Copayment $34.51

* 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 91.42, 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: 91.42 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: 78.78

    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: 62.8

    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: 62.8

    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 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 1376561811, we treat the final digit (1) 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 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

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.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
6
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
1
Doubled → 2
Pos 8
8
Unchanged
Pos 9
1
Doubled → 2
Check
1
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 7 → 14 → 5 5 → 10 → 1 1 → 2 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 4 + 6 + 1 + 0 + 6 + 2 + 8 + 2 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1376561811.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Pathology (Anatomic Pathology)
1875 WOODWINDS DRIVE, SUITE 220
WOODBURY, MN 55125
Obstetrics & Gynecology
1875 WOODWINDS DRIVE, SUITE 110
WOODBURY, MN 55125
Pathology (Anatomic Pathology & Clinical Pathology)
1875 WOODWINDS DRIVE, SUITE 220
WOODBURY, MN 55125

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1376561811, enumerated as an "individual" on July 17, 2006.

The provider is located at 1875 WOODWINDS DRIVE SUITE 220 WOODBURY, MN 55125 and the phone number is (651) 264-1500.

Pathology with taxonomy code 207ZB0001X and a focus in Blood Banking & Transfusion Medicine.

The provider might be accepting Accepts: Medica, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.