CRAIG WILLIAM DOWNEY MD
NPI 1407856701
Pediatrics in Union City, IN

Q: What is Craig Downey's NPI number?

The NPI number for Craig Downey is 1407856701. It was assigned to this individual provider in the NPPES registry on July 28, 2005.

Q: What is Craig Downey's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Craig Downey was last updated on June 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 28, 2005PECOS EnrolledAccepts Medicare Assignment

330 W DEERFIELD RD, UNION CITY, IN 47390(765) 964-6200 Get Directions Write a Review

NPPES record last updated: June 20, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Craig William Downey Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRAIG WILLIAM DOWNEY MD (NPI 1407856701) is an individual pediatrics provider in Union City, Indiana, licensed in Indiana (01052404A) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Reid Health, and is a graduate of Ohio State University College Of Medicine (1996).

NPPES Registry Identity

NPI1407856701

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameCRAIG WILLIAM DOWNEYCredential: MD

Location Address330 W DEERFIELD RDUnion City, IN 47390-1039

Mailing Address330 W Deerfield RdUnion City, IN 47390-1039

Phone(765) 964-6200

Sole ProprietorNo

Medical School CMSOhio State University College Of MedicineGraduated 1996

Enumeration DateJuly 28, 2005

Last NPPES UpdateJune 20, 2022

NPPES CertifiedJune 20, 2022

✔ NPI 1407856701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in IN · 01052404A

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 01052404A (IN)

Also ListedInternal MedicineTaxonomy 207R00000X · License 01052404A (IN)

330 W DEERFIELD RD, Union City, IN 47390

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Other Identifiers 4

Other000000173965IN · Bc/bs #

Medicaid2197797OH

Medicaid200299860IN

Other370018329IN · Railroad

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Craig William Downey Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224024773

PECOS Enrollment IDI20090623000060

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

21 services19 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

17 services14 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Reid Health

Acute Care Hospitals · Richmond, IN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150048

Location1100 Reid PkwyRichmond, IN 47374 · Wayne County

Emergency services Birthing friendly

Indiana University Health Ball Memorial Hospital

Acute Care Hospitals · Muncie, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150089

Location2401 University AveMuncie, IN 47303 · Delaware County

Emergency services Birthing friendly

Ascension St Vincent Randolph

Critical Access Hospitals · Winchester, IN

OwnershipVoluntary non-profit - Private

CMS Certification Number151301

Location473 E Greenville AveWinchester, IN 47394 · Randolph County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47390 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

52%159 patients3/55-star benchmark: 92%

Cervical Cancer Screening

Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…

58%262 patients

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

56%393 patients3/55-star benchmark: 85%

Depression Utilization of the PHQ-9 Tool

The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit

Patients 4MonthsOfEnd: 82% · 38 patients

Patients 4MonthsOfStart: 72% · 39 patients

47%38 patients

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

28%128 patients2/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

97%6,150 patients4/55-star benchmark: 99%

Health Information Exchange

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…

32%681 patients2/55-star benchmark: 88%

Medication Reconciliation

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.

100%282 patients5/55-star benchmark: 100%

Patient-Specific Education

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.

53%1,866 patients3/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

63%1,016 patients3/55-star benchmark: 97%

Provide Patient Access

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…

82%1,866 patients4/55-star benchmark: 100%

Secure Messaging

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…

96%1,866 patients5/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

28%1,866 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers44 claims126 services$5.75 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers17 claims17 services$0.93 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress E0294

DME-Hospital Beds · category DB000N

1 supplier11 claims11 services$66.57 avg. paid by Medicare

Bed side rails, half length E0305

DME-Hospital Beds · category DB000N

1 supplier11 claims11 services$10.06 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

4 suppliers41 claims41 services$20.79 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers22 claims22 services$113.83 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOPE MOORE MSN, APRN, FNP-BC

Nurse Practitioner (Family)