CAROL DITTMANN M.D.
NPI 1427052414
Pathology - Anatomic Pathology & Clinical Pathology in Aurora, CO


Quality Rating: 97.58 out of 100 score

NPI Status: Active since June 08, 2005

Contact Information

12605 E 16TH AVE
AURORA, CO
ZIP 80045
Phone: (720) 848-0000

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  • Individual
  • Female
  • Pathology
  • Anatomic Pathology & Clinical Pathology
  • Accepts Insurance
  • PECOS Enrolled
  • Medicare Quality Reporting

About CAROL DITTMANN

This page provides the complete NPI Profile along with additional information for Carol Dittmann, a provider established in Aurora, Colorado with a medical specialization in Pathology, focusing in anatomic pathology & clinical pathology . The healthcare provider is registered in the NPI registry with number 1427052414 assigned on June 2005. The practitioner's primary taxonomy code is 207ZP0102X with license number DR.0062359 (CO). The provider is registered as an individual and her NPI record was last updated 7 years ago.

NPI
1427052414
Provider Name
CAROL DITTMANN M.D.
Gender
Female
Entity Type
Individual
Location Address
12605 E 16TH AVE AURORA, CO 80045
Location Phone
(720) 848-0000
Mailing Address
PO BOX 110429 AURORA, CO 80042
Mailing Phone
(303) 493-7000
Is Sole Proprietor?
No
Enumeration Date
06-08-2005
Last Update Date
05-23-2019
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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

Pathology Anatomic Pathology & Clinical Pathology

Taxonomy Code
207ZP0102X
Type
Allopathic & Osteopathic Physicians
License No.
DR.0062359
License State
CO
Taxonomy Description
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

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)
1207ZP0102XAllopathic & Osteopathic Physicians

Pathology
Anatomic Pathology & Clinical Pathology

26282 (OK)

Insurance Plans Accepted

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

  • Medica Insure Bronze $0 Copay PCP Visits - EPO
  • Medica Insure Bronze Premier - EPO
  • Medica Insure Bronze Share - EPO
  • Medica Insure Expanded Bronze Standard - EPO
  • Medica Insure Gold $0 Copay PCP Visits - EPO
  • Medica Insure Gold Share - EPO
  • Medica Insure Gold Standard - EPO
  • Medica Insure Silver $0 Copay PCP Visits - EPO
  • Medica Insure Silver Share - EPO
  • Medica Insure Silver Standard - EPO
  • Bronze Classic 4700 - HMO
  • Bronze Classic Standard - HMO
  • Bronze Elite + PCP Saver Plus - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Bronze Simple Chronic Care CKM - HMO
  • Bronze Simple Diabetes - HMO
  • Gold Classic - HMO
  • Gold Classic Standard - HMO
  • Gold Elite Saver Plus - HMO
  • Silver Classic Standard - HMO
  • Bronze Classic 4700 - HMO
  • Bronze Classic 4700 | with AdventHealth - HMO
  • Bronze Classic Standard - HMO
  • Bronze Classic Standard | with AdventHealth - HMO
  • Bronze Elite + PCP Saver Plus - HMO
  • Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Bronze Simple Chronic Care CKM - HMO
  • Bronze Simple Diabetes - HMO
  • Gold Classic Standard - HMO
  • Bronze Classic Standard - HMO
  • Bronze Elite + PCP Saver Plus - HMO
  • Bronze Simple - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Bronze Simple Chronic Care CKM - HMO
  • Buena Salud Bronce Simple Para Diabetes - HMO
  • Gold Classic - HMO
  • Gold Classic Standard - HMO
  • Gold Simple - HMO
  • Gold Simple Diabetes - HMO
  • Bronze Classic - EPO
  • Bronze Classic | with Bryan Health - EPO
  • Bronze Classic 4700 - EPO
  • Bronze Classic 4700 | MercyOne - EPO
  • Bronze Classic Standard - EPO
  • Bronze Classic Standard - PPO
  • Bronze Classic Standard | MercyOne - EPO
  • Bronze Classic Standard | with Bryan Health - EPO
  • Bronze Elite + PCP Saver - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Classic PCP Saver | Cleveland Clinic - HMO
  • Bronze Classic Standard | Cleveland Clinic - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits | Cleveland Clinic - HMO
  • Bronze Simple Chronic Care CKM | Cleveland Clinic - HMO
  • Bronze Simple Diabetes | Cleveland Clinic - HMO
  • Bronze Simple HSA | Cleveland Clinic - HMO
  • Gold Classic Standard | Cleveland Clinic - HMO
  • Gold Elite | Cleveland Clinic - HMO
  • Gold Elite Saver Plus | Cleveland Clinic - HMO
  • Silver Classic Standard | Cleveland Clinic - HMO

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

Medicare Participation & PECOS Enrollment Status

Carol Dittmann 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

  • 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.

Cell examination of specimen, concentration technique

Cell examination of a specimen using a concentration technique is a lab process that enhances the detection of cells in a sample. This method helps to focus on key areas of the sample, making it easier to spot abnormalities or changes. It's a crucial part of diagnosing and monitoring certain health conditions.

This service was performed 31 times for 30 patients

Evaluation of fine needle aspirate

Evaluation of fine needle aspirate is a diagnostic procedure where a thin needle is used to collect cells from a lump or mass. This sample is then examined under a microscope to determine the nature of the lump, whether it's benign (non-cancerous) or malignant (cancerous).

This service was performed 24 times for 20 patients

Evaluation of fine needle aspirate with interpretation and report

This procedure involves using a thin needle to collect a small sample from an abnormal area or lump. The sample is then examined under a microscope to identify any potential issues. A report of the findings is provided for further analysis.

This service was performed 25 times for 21 patients

Microscopic genetic analysis of tumor, manual

Microscopic genetic analysis of a tumor involves examining your tumor's genes under a microscope. This helps identify specific genetic changes in the tumor cells. This information can aid in diagnosing, predicting disease progression, and determining the most effective treatment options.

This service was performed 72 times for 22 patients

Pathology clinical consultation for clinical problem, 5-20 minutes

A pathology clinical consultation is a brief meeting with a medical expert to discuss health concerns. The consultation, lasting between 5-20 minutes, involves reviewing your medical history and possibly conducting tests to diagnose or understand your health condition better.

This service was performed 16 times for 15 patients

Pathology cytologic examination of specimen during surgery, initial site

A pathology cytologic examination during surgery involves taking a small sample of cells from the initial site of concern. This sample is then examined under a microscope by a pathologist to check for any abnormal or disease-causing cells. This helps guide the ongoing surgical procedure.

This service was performed 15 times for 13 patients

Pathology examination of specimen during surgery, each additional tissue block

During surgery, a pathology examination may be done on additional tissue blocks. This involves taking small samples of tissue and examining them under a microscope. This helps identify any abnormal cells or diseases present, aiding in the precise diagnosis and treatment planning.

This service was performed 85 times for 23 patients

Pathology examination of specimen during surgery, first tissue block

A pathology examination during surgery involves the immediate analysis of a removed tissue sample. This helps the surgeon make decisions during your operation. The "first tissue block" refers to the initial sample examined. It's a vital step to ensure your health.

This service was performed 192 times for 45 patients

Pathology examination of tissue using a microscope, high complexity

A high complexity pathology examination involves studying body tissue under a microscope to identify any abnormalities. This intricate process helps in diagnosing various conditions and deciding on the best treatment plan.

This service was performed 21 times for 20 patients

Pathology examination of tissue using a microscope, intermediate complexity

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

This service was performed 503 times for 256 patients

Pathology examination of tissue using a microscope, moderately high complexity

A pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.

This service was performed 197 times for 69 patients

Pathology examination of tissue using a microscope, moderately low complexity

A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.

This service was performed 42 times for 37 patients

Preparation of tissue for examination by removing any calcium present

This procedure involves treating tissue samples to remove any calcium, which can interfere with the examination. The tissue is soaked in a special solution that safely dissolves the calcium, leaving the tissue intact for accurate analysis. This helps in making precise diagnoses.

This service was performed 38 times for 29 patients

Special stained specimen slides to examine tissue, each additional procedure

Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.

This service was performed 208 times for 61 patients

Special stained specimen slides to examine tissue, initial procedure

This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.

This service was performed 142 times for 100 patients

Special stained specimen slides to identify organisms including interpretation and report

This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.

This service was performed 14 times for 11 patients

Surgical pathology consultation and report on referred slides prepared elsewhere

A surgical pathology consultation involves reviewing slides prepared at a different lab to confirm or clarify a diagnosis. It's a second opinion to ensure accuracy. A report with findings and interpretations is then provided for your doctor's reference.

This service was performed 15 times for 15 patients

Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method

This procedure involves taking a small tissue sample from your gland located beneath your bladder. The sample is then examined under a microscope by a pathologist to check for any abnormalities or diseases. This is a standard method to ensure your well-being.

This service was performed 32 times for 32 patients

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 80045 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $132.55
  • Minimum New Patient Price $58.06
  • Maximum New Patient Price $174.82
  • Average New Patient Copayment $33.13
  • Minimum New Patient Copayment $14.51
  • Maximum New Patient Copayment $43.7

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $102.03
  • Minimum Established Patient Price $18.88
  • Maximum Established Patient Price $142.79
  • Average Established Patient Copayment $25.5
  • Minimum Established Patient Copayment $4.72
  • Maximum Established Patient Copayment $35.69

* 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 97.58, 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.

  • Final Score: 97.58 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.

  • Quality Score: 86.53

    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 Score: 100

    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: 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 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.

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
Completion of an Accredited Safety or Quality Improvement ProgramYesN/A
Completion of an accredited performance improvement continuing medical education program that addresses performance or quality improvement according to the following criteria: • The activity must address a quality or safety gap that is supported by a needs assessment or problem analysis, or must support the completion of such a needs assessment as part of the activity; • The activity must have specific, measurable aim(s) for improvement; • The activity must include interventions intended to result in improvement; • The activity must include data collection and analysis of performance data to assess the impact of the interventions; and The accredited program must define meaningful clinician participation in their activity, describe the mechanism for identifying clinicians who meet the requirements, and provide participant completion information.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral LoopYesN/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.
Participation in MOC Part IVYesN/A
Participation in Maintenance of Certification (MOC) Part IV, such as the American Board of Internal Medicine (ABIM) Approved Quality Improvement (AQI) Program, National Cardiovascular Data Registry (NCDR) Clinical Quality Coach, Quality Practice Initiative Certification Program, American Board of Medical Specialties Practice Performance Improvement Module or ASA Simulation Education Network, for improving professional practice including participation in a local, regional or national outcomes registry or quality assessment program. Performance of monthly activities across practice to regularly assess performance in practice, by reviewing outcomes addressing identified areas for improvement and evaluating the results.

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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 1427052414, we treat the final digit (4) 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 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

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
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
2
Doubled → 4
Pos 4
7
Unchanged
Pos 5
0
Doubled → 0
Pos 6
5
Unchanged
Pos 7
2
Doubled → 4
Pos 8
4
Unchanged
Pos 9
1
Doubled → 2
Check
4
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 2 → 4 0 → 0 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 4 + 4 + 7 + 0 + 5 + 4 + 4 + 2 + 24 = 56

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

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1427052414.

Other Providers at the Same Location


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

Nurse Anesthetist, Certified Registered
12605 E 16TH AVE
AURORA, CO 80045
Advanced Practice Midwife
12605 E 16TH AVE, UNIVERSITY OF COLORADO HOSPITAL
AURORA, CO 80045
Radiology (Diagnostic Radiology)
12605 E 16TH AVE
AURORA, CO 80045
Dermatology
12605 E 16TH AVE
AURORA, CO 80045
Advanced Practice Midwife
12605 E 16TH AVE
AURORA, CO 80045
Internal Medicine (Hematology & Oncology)
12605 E 16TH AVE
AURORA, CO 80045
Emergency Medicine
12605 E 16TH AVE
AURORA, CO 80045
Emergency Medicine
12605 E 16TH AVE
AURORA, CO 80045
Internal Medicine
12605 E 16TH AVE
AURORA, CO 80045
Pathology (Anatomic Pathology & Clinical Pathology)
12605 E 16TH AVE
AURORA, CO 80045
Nurse Anesthetist, Certified Registered
12605 E 16TH AVE
AURORA, CO 80045
Radiology (Body Imaging)
12605 E 16TH AVE
AURORA, CO 80045
Advanced Practice Midwife
12605 E 16TH AVE
AURORA, CO 80045
Nurse Anesthetist, Certified Registered
12605 E 16TH AVE
AURORA, CO 80045
Advanced Practice Midwife
12605 E 16TH AVE
AURORA, CO 80045
Emergency Medicine
12605 E 16TH AVE
AURORA, CO 80045
Nurse Anesthetist, Certified Registered
12605 E 16TH AVE
AURORA, CO 80045
Psychologist (Clinical)
12605 E 16TH AVE
AURORA, CO 80045
Nurse Anesthetist, Certified Registered
12605 E 16TH AVE
AURORA, CO 80045
Nurse Practitioner (Acute Care)
12605 E 16TH AVE
AURORA, CO 80045

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1427052414, enumerated as an "individual" on June 08, 2005.

The provider is located at 12605 E 16TH AVE AURORA, CO 80045 and the phone number is (720) 848-0000.

Pathology with taxonomy code 207ZP0102X and a focus in Anatomic Pathology & Clinical Pathology.

The provider might be accepting Accepts: Medica, Oscar Health Insurance, Oscar Health. Please consult your insurance carrier or call the provider to verify.