DR. THOMAS JOSEPH CARRICO M.D. NPI 1386640266

Emergency Medicine (Undersea and Hyperbaric Medicine) in Lynchburg, VA

NPI 1386640266 Individual Male Emergency Medicine Undersea and Hyperbaric Medicine MIPS Quality Score 98.3

NPI Profile for DR. THOMAS JOSEPH CARRICO M.D.

Thomas Carrico is a provider established in Lynchburg, Virginia and his medical specialization is emergency medicine (undersea and hyperbaric medicine) . The NPI number of Thomas Carrico is 1386640266 and was assigned on June 2005. The practitioner's primary taxonomy code is 207PE0005X with license number 0101032447 (VA). The provider is registered as an individual and his NPI record was last updated 14 years ago.

Thomas Carrico is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 98.3, 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.

NPI

1386640266

Provider NameDR. THOMAS JOSEPH CARRICO M.D.
Provider Location Address3300 RIVERMONT AVE LYNCHBURG, VA 24503
Provider Mailing Address1204 FENWICK DR LYNCHBURG, VA 24502
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-24-2005
Last Update Date03-11-2008


Primary Taxonomy

Taxonomy Code207PE0005X
ClassificationEmergency Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationUndersea and Hyperbaric Medicine
License No.0101032447
License StateVA
Taxonomy DescriptionA specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide poisoning, gas gangrene, non-healing wounds, tissue damage from radiation and burns, and bone infections. This specialist also serves as a consultant to other physicians in all aspects of hyperbaric chamber operations, and assesses risks and applies appropriate standards to prevent disease and disability in divers and other persons working in altered atmospheric conditions.

Business Address

DR. THOMAS JOSEPH CARRICO M.D.
3300 RIVERMONT AVE
LYNCHBURG, VA
ZIP 24503
Phone: (434) 947-1801

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Mailing Address

DR. THOMAS JOSEPH CARRICO M.D.
1204 FENWICK DR
LYNCHBURG, VA
ZIP 24502
Phone:



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
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 (PI) 25% 83.8
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 15% 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 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 20% 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.
MIPS Final Score - 98.3
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.

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.

  • 475Management and supervision of oxygen chamber therapy per session (HCPCS:99183)
  • 76Removal of tissue from wounds per session (HCPCS:97597)
  • 33Removal of skin and tissue first 20 sq cm or less (HCPCS:11042)
  • 28Ultrasound study of arteries of both arms and legs (HCPCS:93922)

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
1208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery0101032447VANo

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.

2208600000XAllopathic & Osteopathic PhysiciansSurgery0101032447VANo

Taxonomy Description: a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
186304OTHER (01)ANTHEM PROVIDER NUMBER
90402OTHER (01)SENTARA/OPTIMA PROVIDER N
203639329006OTHER (01)TRICARE PROVIDER NUMBER
00W872C64MEDICARE PIN (08)
329096OTHER (01)SOUTHERN HEALTH PROVIDER
B07082MEDICARE UPIN (02)VA
P00282951MEDICARE PIN (08)

NPI Validation Check Digit Calculation


The following table explains step by step the 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.
1386640266
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
231661240212
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 + 4 + 0 + 2 + 1 + 2 + 24 = 54
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 54 = 66

The NPI number 1386640266 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1750384137DR. JAMES CUMMINGS DUNSTAN JR. M.D.
Individual
Physical Medicine & Rehabilitation3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 947-4651
1699771493DR. TERRY O. MILLER M.D.
Individual
Orthopaedic Surgery3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 947-1801
1831198464DR. PATRICIA A. PLETKE M.D.
Individual
Family Medicine (Geriatric Medicine)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-4651
1487654364DR. JOHN G. FISHER M.D.
Individual
Psychiatry & Neurology (Child & Adolescent Psychiatry)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1871592790DR. PETER BETZ MD
Individual
Psychiatry & Neurology (Psychiatry)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1699775593DR. JOHN L. HENDRICKSON M.D.
Individual
Psychiatry & Neurology (Child & Adolescent Psychiatry)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1871593145DR. MICHAEL E. JUDD M.D.
Individual
Psychiatry & Neurology (Psychiatry)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1932100815DR. KARA M. ROONEY M.D.
Individual
Psychiatry & Neurology (Psychiatry)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1164423976 ARTHUR FRANK SELDEN PHD
Individual
Psychologist (Clinical)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1669473567 MIRANDA BREIT PHD
Individual
Psychologist (Clinical)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1528069267DR. RANDALL A. SCOTT
Individual
Psychiatry & Neurology (Psychiatry)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1700887478 ANNE R. NEFF LPC
Individual
Counselor (Professional)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1164423836DR. JOHN M. WILSON M.D.
Individual
Psychiatry & Neurology (Psychiatry)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1821099565DR. RICHARD W. OLIVER
Individual
Psychiatry & Neurology (Psychiatry)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1568463230 GARY A. SIBCY PHD
Individual
Psychologist (Clinical)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1225039316 STACEY C. FELMLEE PHD
Individual
Psychologist (Clinical)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1477555332 JUDITH P CAMPBELL
Individual
Counselor (Professional)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1588666291 MELISA M. STONE LPC
Individual
Counselor (Professional)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-5999
1396710422DR. VERNA R SELLERS MD
Individual
Internal Medicine (Geriatric Medicine)3300 RIVERMONT AVE
LYNCHBURG, VA 24503
(434) 200-4651
1437111564DR. ALLEN MAJEWSKI MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)3300 RIVERMONT AVE VA. BAPT. HOSP. NEONATOLOGY OFFICE
LYNCHBURG, VA 24503
(434) 947-4000

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Thomas Joseph Carrico M.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.