DR. DAVID L. RAJKOWSKI O.D.
NPI 1386622140
Optometrist in North Haledon, NJ
NPI Status: Active since January 03, 2006
Contact Information
33 SICOMAC RD
SUITE 204
NORTH HALEDON, NJ
ZIP 07508
Phone: (973) 427-7801
Fax: (973) 427-7969
- Individual
- Male
- Years of Experience 34
- Optometrist
- PECOS Enrolled
- Accepts Medicare Approved Payment
- Medicare Quality Reporting
About DAVID RAJKOWSKI
David Rajkowski is a provider established in North Haledon, New Jersey and his medical specialization is Optometrist with more than 34 years of experience. He graduated from State University Of New York - State College Optometry in 1990. The healthcare provider is registered in the NPI registry with number 1386622140 assigned on January 2006. The practitioner's primary taxonomy code is 152W00000X with license number OA5324 (NJ). The provider is registered as an individual and his NPI record was last updated 16 years ago.
- NPI
- 1386622140
- Provider Name
- DR. DAVID L. RAJKOWSKI O.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 33 SICOMAC RD SUITE 204 NORTH HALEDON, NJ 07508
- Location Phone
- (973) 427-7801
- Location Fax
- (973) 427-7969
- Mailing Address
- 33 SICOMAC RD SUITE 204 NORTH HALEDON, NJ 07508
- Mailing Phone
- (973) 427-7801
- Mailing Fax
- (973) 427-7969
- Medical School Name
- STATE UNIVERSITY OF NEW YORK - STATE COLLEGE OPTOMETRY
- Graduation Year
- 1990
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 01-03-2006
- Last Update Date
- 01-22-2008
- Code Navigator
David Rajkowski 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.
The provider participated in CMS Quality Payment Program and the following quality measures were reported: e-prescribing, patient-specific education, provide patient access, secure messaging, security risk analysis and tcpi participation. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.
The typical physician office visit costs for Medicare beneficiaries in this area are: $37.64 for a new patient copayment and $20.64 for an established patient copayment.
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
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- OA5324
- License State
- NJ
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Blue Cross and Blue Shield of Illinois
- Blue Choice Preferred Bronze PPO℠ 201 - PPO
- Blue Choice Preferred Bronze PPO℠ 202 - PPO
- Blue Choice Preferred Bronze PPO℠ 601 - Rx Copays - PPO
- Blue Choice Preferred Bronze PPO℠ 701 - Rx Copays - PPO
- Blue Choice Preferred Bronze PPO℠ 708 - PPO
- Blue Choice Preferred Gold PPO℠ 204 - Rx Copays - PPO
- Blue Choice Preferred Gold PPO℠ 707 - PPO
- Blue Choice Preferred Security PPO℠ 200 - PPO
- Blue Choice Preferred Silver PPO℠ 203 - PPO
- Blue Choice Preferred Silver PPO℠ 706 - PPO
Blue Cross and Blue Shield of Montana
- Blue Focus Bronze POS℠ 205 - POS
- Blue Focus Bronze POS℠ 705 - POS
- Blue Focus Bronze POS℠ 708 - POS
- Blue Focus Gold POS℠ 207 - POS
- Blue Focus Gold POS℠ 707 - POS
- Blue Focus Silver POS℠ 206 - POS
- Blue Focus Silver POS℠ 706 - POS
- Blue Preferred Bronze PPO℠ 201 - PPO
- Blue Preferred Bronze PPO℠ 202 - PPO
- Blue Preferred Bronze PPO℠ 301 - PPO
Blue Cross and Blue Shield of Oklahoma
- Blue Advantage Bronze PPO℠ 801 - PPO
- Blue Advantage Bronze PPO℠ 202 - PPO
- Blue Advantage Bronze PPO℠ 203 - PPO
- Blue Advantage Gold PPO℠ 309 - PPO
- Blue Advantage Gold PPO℠ 604 - PPO
- Blue Advantage Gold PPO℠ 803 - PPO
- Blue Advantage Silver PPO℠ 204 - PPO
- Blue Advantage Silver PPO℠ 501 - PPO
- Blue Advantage Silver PPO℠ 605 - PPO
- Blue Advantage Silver PPO℠ 802 - PPO
Blue Cross and Blue Shield of Texas
- Blue Advantage Bronze HMO℠ 204 - HMO
- Blue Advantage Bronze HMO℠ 301 - HMO
- Blue Advantage Bronze HMO℠ 302 - HMO
- Blue Advantage Bronze HMO℠ 707 - HMO
- Blue Advantage Gold HMO℠ 206 - HMO
- Blue Advantage Gold HMO℠ 603 - HMO
- Blue Advantage Gold HMO℠ 706 - HMO
- Blue Advantage Plus Bronze℠ 303 - POS
- Blue Advantage Plus Bronze℠ 305 - POS
- Blue Advantage Plus Bronze℠ 707 - POS
Medicare
Medicaid
*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 |
---|---|---|---|
631657NXT | MEDICARE ID-TYPE UNSPECIFIED (04) | NJ | |
U55002 | MEDICARE UPIN (02) | NJ |
PECOS Enrollment and Medicare Participation Status
David Rajkowski 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) and a Home Health Agency (HHA).
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: 1456417161
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: I20090304000749
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: No
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 07508 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $150.56
- Minimum New Patient Price $66.45
- Maximum New Patient Price $198.48
- Average New Patient Copayment $37.64
- Minimum New Patient Copayment $16.61
- Maximum New Patient Copayment $49.62
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $82.58
- Minimum Established Patient Price $21.27
- Maximum Established Patient Price $162.58
- Average Established Patient Copayment $20.64
- Minimum Established Patient Copayment $5.31
- Maximum Established Patient Copayment $40.64
* 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 following quality measures meet Medicare's statistical reporting standards for the year 2018. 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 |
---|---|---|
e-Prescribing | 88% | 49 |
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
Patient-Specific Education | 58% | 809 |
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 Patient Access | 59% | 809 |
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. | ||
Secure Messaging | 1% | 809 |
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. | ||
TCPI Participation | Yes | N/A |
Participation in the CMS Transforming Clinical Practice Initiative |
Clinician Services
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 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.
- 261
Photography of the retina (HCPCS:92250)
- 253
Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
- 54
Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)
- 54
Diagnostic imaging of optic nerve of eye (HCPCS:92133)
- 46
Measurement of field of vision during daylight conditions (HCPCS:92083)
- 26
Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
- 16
Diagnostic imaging of retina (HCPCS:92134)
Reviews for DR. DAVID L. RAJKOWSKI O.D.
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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 | 8 | 6 | 6 | 2 | 2 | 1 | 4 | 0 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 3 | 16 | 6 | 12 | 2 | 4 | 1 | 8 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 3 + 1 + 6 + 6 + 1 + 2 + 2 + 4 + 1 + 8 + 24 = 60 | |||||||||
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
0 |
The NPI number 1386622140 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1396837456 | DR. KEN DAVIS DMD Individual | Dentist (General Practice) | 33 SICOMAC RD NORTH HALEDON, NJ 07508 (973) 427-0300 |
1376635128 | DR. GREGORY JOHN VANVLIET DENTIST Individual | Dentist (General Practice) | 33 SICOMAC RD SUITE 202 NORTH HALEDON, NJ 07508 (973) 427-0300 |
1730265547 | DR. PAMELA ZIMMITTI RAJKOWSKI OD Individual | Optometrist | 33 SICOMAC RD NORTH HALEDON, NJ 07508 (973) 427-7801 |
1144351560 | HIGH MOUNTAIN EYECARE, LLC Organization | Optometrist | 33 SICOMAC RD SUITE 204 NORTH HALEDON, NJ 07508 (973) 427-7801 |
1073681060 | GREGORY VANVLIETDDS,PETER PERERA DMD,PA Organization | Dentist (General Practice) | 33 SICOMAC RD NORTH HALEDON, NJ 07508 (973) 427-0300 |
1730762717 | TASNIM ZAKARIA OD Individual | Optometrist | 33 SICOMAC RD NORTH HALEDON, NJ 07508 (973) 427-7801 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386622140, enumerated in the NPI registry as an "individual" on January 03, 2006
The provider is located at 33 Sicomac Rd Suite 204 North Haledon, Nj 07508 and the phone number is (973) 427-7801
The provider's speciality is Optometrist with taxonomy code 152W00000X
The provider has more than 34 years of experience. He graduated from State University Of New York - State College Optometry in 1990.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Blue Cross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
Medicare beneficiaries should expect a typical cost of $150.56 with an average copayment of $37.64 for new patient appointments. Established patients should expect a typical charge of $82.58 and an average copayment of 20.64. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Photography of the retina, Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits, Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits, Diagnostic imaging of optic nerve of eye, Measurement of field of vision during daylight conditions, Eye and medical examination for diagnosis and treatment, established patient and Diagnostic imaging of retina.
This NPI record was last updated on January 03, 2006. 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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