DR. JOHN F WARREN MD
NPI 1386634400
Ophthalmology in Greenfield, MA
Quality Rating: 60 out of 100 score
NPI Status: Active since October 28, 2005
Contact Information
33 RIDDELL ST
GREENFIELD, MA
ZIP 01301
Phone: (413) 774-7016
Fax: (413) 773-7596
- Individual
- Male
- Years of Experience 27
- Ophthalmology
- PECOS Enrolled
- Accepts Medicare Approved Payment
About JOHN WARREN
John Warren is a provider established in Greenfield, Massachusetts and his medical specialization is Ophthalmology with more than 27 years of experience. He graduated from Stanford University School Of Medicine in 1997. The healthcare provider is registered in the NPI registry with number 1386634400 assigned on October 2005. The practitioner's primary taxonomy code is 207W00000X with license number 223233 (MA). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1386634400
- Provider Name
- DR. JOHN F WARREN MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 33 RIDDELL ST GREENFIELD, MA 01301
- Location Phone
- (413) 774-7016
- Location Fax
- (413) 773-7596
- Mailing Address
- 33 RIDDELL ST GREENFIELD, MA 01301
- Mailing Phone
- (413) 774-7016
- Mailing Fax
- (413) 773-7596
- Medical School Name
- STANFORD UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 1997
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-28-2005
- Last Update Date
- 03-07-2023
- Code Navigator
Ophthalmologists like John Warren specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
John Warren 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 under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 60, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $35.07 for a new patient copayment and $19.15 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
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 223233
- License State
- MA
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
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 Louisiana
- Blue Max 100/100 $9450 - PPO
- Blue Max 70/50 $6700 - PPO
- Blue Max 90/70 $1500 - PPO
- Blue Max Copay 50/50 $3300 - PPO
- Blue Max Copay 50/50 $7500 Standardized Plan - PPO
- Blue Max Copay 60/40 $5900 Standardized Plan - PPO
- Blue Max Copay 75/55 $1500 Standardized Plan - PPO
- Blue Saver 60/40 $6100 - PPO
- Blue Saver 90/70 $3400 - PPO
Blue Cross Blue Shield of Wyoming
- BlueSelect Bronze Balance - PPO
- BlueSelect Bronze Basic - PPO
- BlueSelect Bronze Core - PPO
- BlueSelect Bronze Value - PPO
- BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
- BlueSelect Gold Balance - PPO
- BlueSelect Gold Classic - PPO
- BlueSelect Gold Core - PPO
- BlueSelect Gold HealthPlus - PPO
- BlueSelect Gold Standard without Kid's Dental - PPO
- BlueSelect Silver Balance - PPO
- BlueSelect Silver Balance without Kid's Dental - PPO
- BlueSelect Silver Classic - PPO
- BlueSelect Silver Classic without Kid's Dental - PPO
- BlueSelect Silver HealthPlus - PPO
- BlueSelect Silver Standard without Kid's Dental - PPO
- BlueSelect Silver Value - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
PECOS Enrollment and Medicare Participation Status
John Warren 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: 8022090075
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: I20050223000612
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
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 01301 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $140.28
- Minimum New Patient Price $61.32
- Maximum New Patient Price $185.12
- Average New Patient Copayment $35.07
- Minimum New Patient Copayment $15.33
- Maximum New Patient Copayment $46.28
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $76.6
- Minimum Established Patient Price $19.31
- Maximum Established Patient Price $151.47
- Average Established Patient Copayment $19.15
- Minimum Established Patient Copayment $4.82
- Maximum Established Patient Copayment $37.86
* 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 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.
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Final Score: 60 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.
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Quality Score: N/A
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 Score: N/A
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: N/A
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: N/A
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: N/A
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.
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.
- 716
Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
- 237
Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
- 135
Diagnostic imaging of optic nerve of eye (HCPCS:92133)
- 103
Measurement of field of vision during daylight conditions (HCPCS:92083)
- 95
Diagnostic imaging of retina (HCPCS:92134)
- 43
Photography of the retina (HCPCS:92250)
- 29
Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)
Reviews for DR. JOHN F WARREN MD
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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 | 3 | 4 | 4 | 0 | 0 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 3 | 16 | 6 | 12 | 3 | 8 | 4 | 0 | |
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 + 3 + 8 + 4 + 0 + 24 = 60 | |||||||||
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
0 |
The NPI number 1386634400 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 17 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1649237199 | DR. RAYMOND ALAN COLBERT M.D. Individual | Internal Medicine (Geriatric Medicine) | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 774-5505 |
1841303278 | DR. STEVEN A GELLER DMD Individual | Dentist (Periodontics) | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 773-7100 |
1295829828 | MS. JANET LOUISE PORCELLI LICSW Individual | Social Worker | 33 RIDDELL ST SUITE 8 GREENFIELD, MA 01301 (413) 548-6217 |
1225182249 | MRS. LISA BOSTROM Individual | Occupational Therapist (Hand) | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 772-0853 |
1255487534 | DR. THOMAS SHEARER ECHEVERRIA MD Individual | Specialist | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 772-0853 |
1699818922 | MELISSA J BUTLER OD OPTOMETRIST Individual | Optometrist | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 774-7016 |
1457559197 | MARGARET A. FERRY, M.D.,P.C. Organization | Clinic/Center (Medical Specialty) | 33 RIDDELL ST 8 GREENFIELD, MA 01301 (413) 773-7400 |
1386830883 | FREDERICK D. MESLOH PC Organization | Dentist (General Practice) | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 774-7996 |
1235303488 | FRANKLIN EYE CARE Organization | Ophthalmology | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 774-7016 |
1962632091 | DR. KRISTIN A GLAVINE O.D. Individual | Optometrist | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 774-7016 |
1720309347 | DR. KAREN M GINGRAS OD Individual | Optometrist | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 774-7016 |
1649316712 | FRANKLIN ORTHOPAEDICS GROUP Organization | Specialist | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 772-0853 |
1083670574 | FRANKLIN EYE CARE ASSOCIATES, LLC Organization | Optometrist | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 774-7016 |
1023167186 | EYE CENTER OPTICAL, INC. Organization | Eyewear Supplier | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 774-9986 |
1457454894 | MARGARET ANNE FERRY MD Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 33 RIDDELL ST SUITE 8 GREENFIELD, MA 01301 (413) 773-7400 |
1972889657 | MOLLY SPATCHER O.D. Individual | Optometrist | 33 RIDDELL ST EYE & LASIK CENTER GREENFIELD, MA 01301 (413) 774-7016 |
1053301135 | ANDREW WALKOWIAK OD Individual | Optometrist | 33 RIDDELL ST GREENFIELD, MA 01301 (413) 774-7016 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386634400, enumerated in the NPI registry as an "individual" on October 28, 2005
The provider is located at 33 Riddell St Greenfield, Ma 01301 and the phone number is (413) 774-7016
The provider's speciality is Ophthalmology with taxonomy code 207W00000X
The provider has more than 27 years of experience. He graduated from Stanford University School Of Medicine in 1997.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Louisiana and Blue. 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), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $140.28 with an average copayment of $35.07 for new patient appointments. Established patients should expect a typical charge of $76.6 and an average copayment of 19.15. 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: Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits, Eye and medical examination for diagnosis and treatment, established patient, Diagnostic imaging of optic nerve of eye, Measurement of field of vision during daylight conditions, Diagnostic imaging of retina, Photography of the retina and Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits.
This NPI record was last updated on October 28, 2005. 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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