AMY E CATALFAMO MD
NPI 1396044806
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Bloomington, MN

NPI Status: Active since March 23, 2011

Contact Information

3601 MINNESOTA DR STE 200
BLOOMINGTON, MN
ZIP 55435
Phone: (612) 879-1000
Fax: (612) 879-9116

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 17
Psychiatry & Neurology
Neurology with Special Qualifications in...
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About AMY CATALFAMO

This page provides the complete NPI Profile along with additional information for Amy Catalfamo, a provider established in Bloomington, Minnesota with a medical specialization in Psychiatry & Neurology, focusing in neurology with special qualifications in child neurology and more than 17 years of experience. The healthcare provider is registered in the NPI registry with number 1396044806 assigned on March 2011. The practitioner's primary taxonomy code is 2084N0402X with license number 60696 (MN). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI: 1396044806
Provider Name: AMY E CATALFAMO MD
Gender: Female
Entity Type: Individual
Location Address: 3601 MINNESOTA DR STE 200 BLOOMINGTON, MN 55435
Location Phone: (612) 879-1000
Location Fax: (612) 879-9116
Mailing Address: 3601 MINNESOTA DR STE 200 BLOOMINGTON, MN 55435
Mailing Phone: (612) 879-1000
Mailing Fax: (612) 879-9116
Medical School Name: OTHER
Graduation Year: 2010
Is Sole Proprietor?: No
Enumeration Date: 03-23-2011
Last Update Date: 08-23-2024
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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: Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology
Taxonomy Code: 2084N0402X
Type: Allopathic & Osteopathic Physicians
License No.: 60696
License State: MN
Taxonomy Description: A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.

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)
1	2084N0400X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology Neurology	60696 (MN)

Insurance Plans Accepted

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

HealthPartners

Atlas $1,300 Gold - PPO
Atlas $2,000 Standard Gold - PPO
Atlas $3,050 Plus Silver - PPO
Atlas $3,800 HSA Silver - PPO
Atlas $6,000 Standard Silver - PPO
Atlas $6,800 Plus Bronze HSA - PPO
Atlas $7,500 Standard Bronze HSA - PPO
Atlas $8,400 HSA Bronze - PPO

Medica

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

Sanford Health Plan

Sanford Individual Simplicity $1,750 - PPO
Sanford Individual Simplicity $10,600 - PPO
Sanford Individual Simplicity $3,500 - PPO
Sanford Individual Simplicity $4,750 - PPO
Sanford Individual Simplicity $6,500 - PPO
Sanford Individual Simplicity $7,200 HSA Qualified - PPO
Sanford Individual Simplicity Standardized $2,000 - PPO
Sanford Individual Simplicity Standardized $6,000 - PPO
Sanford Individual Simplicity Standardized $7,500 - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Amy Catalfamo 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.

Amy Catalfamo 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: 8224311378
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: I20170215001343
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

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.

Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.9 for a new patient copayment and $24.65 for an established patient copayment.

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 55435 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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. 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	89%	2451
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange	3%	118
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
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/or Conduct periodic, structured medication reviews.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop	Yes	N/A
Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology.
MEDICATION PRESCRIBED FOR ACUTE MIGRAINE ATTACK	58%	88
Percentage of patients age 12 years and older with a diagnosis of migraine who were prescribed a guideline recommended medication for acute migraine attacks within the 12 month measurement period.
Medication Reconciliation	58%	743
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Practice Improvements for Bilateral Exchange of Patient Information	Yes	N/A
Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: • Participate in a Health Information Exchange if available; and/or • Use structured referral notes.
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access	73%	1103
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.
Quality of Life Assessment For Patients With Primary Headache Disorders	40%	190
Percentage of patients with a diagnosis of primary headache disorder whose health related quality of life (HRQoL) was assessed with a tool(s) during at least two visits during the 12 month measurement period AND whose health related quality of life score stayed the same or improved
Screening for Psychiatric or Behavioral Health Disorders	72%	480
Percent of all visits for patients with a diagnosis of epilepsy where the patient was screened for psychiatric or behavioral disorders.
Secure Messaging	32%	1103
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.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of QCDR for feedback reports that incorporate population health	Yes	N/A
Use of a QCDR to generate regular feedback reports that summarize local practice patterns and treatment outcomes, including for vulnerable populations.
Use of QCDR to promote standard practices, tools and processes in practice for improvement in care coordination	Yes	N/A
Participation in a Qualified Clinical Data Registry, demonstrating performance of activities that promote use of standard practices, tools and processes for quality improvement (e.g., documented preventative screening and vaccinations that can be shared across MIPS eligible clinician or groups).

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 1396044806, we treat the final digit (6) 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 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 0

Pos 6

Unchanged

Pos 7

Doubled → 8

Pos 8

Unchanged

Pos 9

Doubled → 0

Check

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 9 → 18 → 9 0 → 0 4 → 8 0 → 0

Step 2: Add all digits plus the NPI constant

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

2 + 3 + 1 + 8 + 6 + 0 + 4 + 8 + 8 + 0 + 24 = 64

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

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6

This NPI is valid

The calculated check digit is 6, which matches the last digit of 1396044806.