SCOTT THOMPSON PA-C
NPI 1417909987
Physician Assistant in Saint Clair Shores, MI
Quality Rating: 20.72 out of 100 score
NPI Status: Active since May 16, 2006
Contact Information
21709 GROSSEDALE ST
SAINT CLAIR SHORES, MI
ZIP 48082
Phone: (586) 489-6958
- Individual
- Male
- Years of Experience 23
- Physician Assistant
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About SCOTT THOMPSON
This page provides the complete NPI Profile along with additional information for Scott Thompson, a primary care provider established in Saint Clair Shores, Michigan with a medical specialization in Physician Assistant and more than 23 years of experience. The healthcare provider is registered in the NPI registry with number 1417909987 assigned on May 2006. The practitioner's primary taxonomy code is 363A00000X with license number 5601004193 (MI). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1417909987
- Provider Name
- SCOTT THOMPSON PA-C
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 21709 GROSSEDALE ST SAINT CLAIR SHORES, MI 48082
- Location Phone
- (586) 489-6958
- Mailing Address
- 21709 GROSSEDALE ST SAINT CLAIR SHORES, MI 48082
- Mailing Phone
- (586) 489-6958
- Medical School Name
- OTHER
- Graduation Year
- 2003
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-16-2006
- Last Update Date
- 10-30-2007
- Code Navigator
A primary care provider (PCP) like Scott Thompson sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
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
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 5601004193
- License State
- MI
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
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 | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | 5601004193 (MI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- MHP Bronze - HMO
- MHP Bronze Saver (Expanded) - HMO
- MHP Expanded Bronze Standard - HMO
- MHP Gold - HMO
- MHP Gold Standard - HMO
- MHP Silver Exchange - HMO
- MHP Silver Exchange Rewards - HMO
- MHP Silver Standard - HMO
- MHP Young Adult/Catastrophic - HMO
- MyPriority Balanced Silver - HMO
- MyPriority Balanced Silver Bronson Healthcare Partners - HMO
- MyPriority Balanced Silver Corewell Health West Michigan Network - HMO
- MyPriority Balanced Silver Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Balanced Silver Southeast Michigan Network - HMO
- MyPriority Balanced Silver Trinity Health East Network - HMO
- MyPriority Enhanced Gold Bronson Healthcare Partners - HMO
- MyPriority Enhanced Gold Corewell Health West Michigan Network - HMO
- MyPriority Enhanced Gold Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Enhanced Gold Southeast Michigan Network - HMO
- MyPriority Enhanced Gold Trinity Health East Network - HMO
- MyPriority Premier Silver - HMO
- MyPriority Premier Silver Bronson Healthcare Partners - HMO
- MyPriority Premier Silver Corewell Health West Michigan Network - HMO
- MyPriority Premier Silver Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Premier Silver Trinity Health East Network - HMO
- MyPriority Standard Bronze - HMO
- MyPriority Standard Bronze - Bronson Healthcare Partners - HMO
- MyPriority Standard Bronze - Corewell Health West Michigan Network - HMO
- MyPriority Standard Bronze - Corewell Health West Michigan Network (Allegan, Barry) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*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 |
|---|---|---|---|
| P28070044 | MEDICARE PIN (08) | MI | |
| Q03407 | MEDICARE UPIN (02) | MI |
Medicare Participation & PECOS Enrollment Status
Scott Thompson 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.
Scott Thompson 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: 3072407923
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: I20040211000530
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.
Follow-up nursing facility visit per day, typically 10 minutes
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Follow-up nursing facility visit per day, typically 35 minutes
Initial nursing facility visit per day, typically 25 minutes
Initial nursing facility visit per day, typically 35 minutes
Initial nursing facility visit per day, typically 45 minutes
A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.
This service was performed 42 times for 41 patientsA follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 527 times for 296 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 492 times for 286 patientsA follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
This service was performed 71 times for 60 patientsAn initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.
This service was performed 11 times for 11 patientsAn initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
This service was performed 88 times for 88 patientsAn initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
This service was performed 87 times for 87 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.69 for a new patient copayment and $18.09 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 48082 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $90.76
- Minimum New Patient Price $58.04
- Maximum New Patient Price $177.36
- Average New Patient Copayment $22.69
- Minimum New Patient Copayment $14.51
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $72.38
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $143.49
- Average Established Patient Copayment $18.09
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $35.87
* 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 provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 20.72, 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 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: 20.72 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: 0
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: 0
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: 0
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: 69.09
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: 69.09
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.
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 |
|---|---|---|
| Care Plan | 100% | 686 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| Dementia Associated Behavioral and Psychiatric Symptoms Screening and Management | 100% | 736 |
| Percentage of patients with dementia for whom there was a documented symptoms screening* for behavioral and psychiatric symptoms, including depression, AND for whom, if symptoms screening was positive, there was also documentation of recommendations for symptoms management in the last 12 months | ||
| Dementia: Caregiver Education and Support | 100% | 736 |
| Percentage of patients with dementia whose caregiver(s)* were provided with education** on dementia disease management and health behavior changes AND were referred to additional resources*** for support in the last 12 months | ||
| Dementia: Functional Status Assessment | 100% | 735 |
| Percentage of patients with dementia for whom an assessment of functional status* was performed at least once in the last 12 months | ||
| Dementia: Safety Concerns Screening and Mitigation Recommendations or Referral for Patients with Dementia | 100% | 736 |
| Percentage of patients with dementia or their caregiver(s) for whom there was a documented safety concerns screening * in two domains of risk: 1) dangerousness to self or others and 2) environmental risks; and if safety concerns screening was positive in the last 12 months, there was documentation of mitigation recommendations, including but not limited to referral to other resources or orders for home safety evaluation | ||
| 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. | ||
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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 1417909987, we treat the final digit (7) 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 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417909987, enumerated as an "individual" on May 16, 2006.
The provider is located at 21709 GROSSEDALE ST SAINT CLAIR SHORES, MI 48082 and the phone number is (586) 489-6958.
Physician Assistant with taxonomy code 363A00000X.
The provider might be accepting Accepts: McLaren Health Plan Community, Priority Health,. Please consult your insurance carrier or call the provider to verify.
