MARTHA COHEN MD
NPI 1427306893
Obstetrics & Gynecology in Summerville, SC
Quality Rating: 90.52 out of 100 score
NPI Status: Active since August 16, 2012
Contact Information
83 SPRINGVIEW LN
SUMMERVILLE, SC
ZIP 29485
Phone: (843) 797-3664
Fax: (843) 820-1007
- Individual
- Female
- Years of Experience 11
- Obstetrics & Gynecology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About MARTHA COHEN
This page provides the complete NPI Profile along with additional information for Martha Cohen, a women's health care provider established in Summerville, South Carolina with a medical specialization in Obstetrics & Gynecology and more than 11 years of experience. She graduated from Mercer University School Of Medicine in 2015. The healthcare provider is registered in the NPI registry with number 1427306893 assigned on August 2012. The practitioner's primary taxonomy code is 207V00000X with license number 82472 (SC). The provider is registered as an individual and her NPI record was last updated 4 years ago.
- NPI
- 1427306893
- Provider Name
- MARTHA COHEN MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 83 SPRINGVIEW LN SUMMERVILLE, SC 29485
- Location Phone
- (843) 797-3664
- Location Fax
- (843) 820-1007
- Mailing Address
- 9291 MEDICAL PLAZA DR CHARLESTON, SC 29406
- Mailing Phone
- (843) 797-3664
- Mailing Fax
- (843) 820-1007
- Medical School Name
- MERCER UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2015
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-16-2012
- Last Update Date
- 02-08-2021
- Code Navigator
Women's health care providers like Martha Cohen treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, 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
Obstetrics & Gynecology
- Taxonomy Code
- 207V00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 82472
- License State
- SC
- Taxonomy Description
- An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Complete Silver with Atrium Health - HMO
- Complete Silver with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Blue Direction Silver 1 - POS
- Blue Direction Silver 1 + Adult Vision - POS
- Blue Direction Silver 2 - POS
- Blue Direction Standard Gold - POS
- Blue Direction Standard Silver - POS
- Blue VirtuConnect Bronze 1 - EPO
- Blue VirtuConnect Gold 1 - EPO
- Blue VirtuConnect Silver 1 - EPO
- BlueEssentials Bronze 4 - EPO
- BlueEssentials Bronze 6 - EPO
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- First Choice Next Bronze Essential - HMO
- First Choice Next Bronze Premier - HMO
- First Choice Next Bronze Signature - HMO
- First Choice Next Gold Deluxe - HMO
- First Choice Next Gold Signature - HMO
- First Choice Next Silver Deluxe - HMO
- First Choice Next Silver Premier - HMO
- First Choice Next Silver Signature - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 - HMO
- Silver 8 - HMO
- Standard Expanded Bronze WellCare - PPO
- Standard Gold WellCare - PPO
- Standard Silver WellCare - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Martha Cohen 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.
Martha Cohen 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: 4385954262
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: I20190918000107
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, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
New patient office or other outpatient visit, 30-44 minutes
Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina
Urinalysis, manual test
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 35 times for 31 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 31 times for 24 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 22 times for 22 patientsAn ultrasound scan of the lower abdominal region is a safe, non-invasive procedure that uses sound waves to create images of internal structures. This helps in checking the health of reproductive organs and detecting any abnormalities. The scan is done via a small probe inserted into the body.
This service was performed 15 times for 12 patientsA urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
This service was performed 39 times for 33 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.01 for a new patient copayment and $16.78 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 29485 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $124.04
- Minimum New Patient Price $53.57
- Maximum New Patient Price $163.84
- Average New Patient Copayment $31.01
- Minimum New Patient Copayment $13.39
- Maximum New Patient Copayment $40.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $67.12
- Minimum Established Patient Price $16.96
- Maximum Established Patient Price $133.52
- Average Established Patient Copayment $16.78
- Minimum Established Patient Copayment $4.24
- Maximum Established Patient Copayment $33.38
* 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 90.52, 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 provider also has detailed performance information the following quality measures: .
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: 90.52 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: 93.9
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: 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: 74.51
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: 74.51
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 Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
Quality Measure | Performance | Number of Patients |
---|---|---|
Breast Cancer Screening | 44% | 213 |
Cervical Cancer Screening | 82% | 1410 |
Closing the Referral Loop: Receipt of Specialist Report | 24% | 412 |
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) | 84% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 25 |
Documentation of Current Medications in the Medical Record | 96% | 4163 |
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 28% | 1526 |
Preventive Care and Screening: Influenza Immunization | 2% | 976 |
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented | 39% | 3792 |
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 0% | 1570 |
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 0% | 1570 |
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Martha Cohen is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
TRIDENT MEDICAL CENTER | 9330 MEDICAL PLAZA DR CHARLESTON, SC 29406 | (843) 847-4100 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step 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. | |||||||||
1 | 4 | 2 | 7 | 3 | 0 | 6 | 8 | 9 | 3 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 4 | 4 | 7 | 6 | 0 | 12 | 8 | 18 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 4 + 4 + 7 + 6 + 0 + 1 + 2 + 8 + 1 + 8 + 24 = 67 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 67 = 3 | 3 |
The NPI number 1427306893 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 10 providers are registered at the same or nearby location.
LOW COUNTRY WOMEN'S SPECIALISTS
Obstetrics & Gynecology
83 SPRINGVIEW LN
SUMMERVILLE, SC
ZIP 29485
CHRISTOPHER R ACCETTA MD
Obstetrics & Gynecology
83 SPRINGVIEW LN
SUMMERVILLE, SC
ZIP 29485
CHRISTINE L HUNTER MD
Obstetrics & Gynecology
83 SPRINGVIEW LN
SUMMERVILLE, SC
ZIP 29485
WILLIAM M REEVES III MD
Obstetrics & Gynecology
83 SPRINGVIEW LN
SUMMERVILLE, SC
ZIP 29485
RONNIE M GIVENS II MD
Obstetrics & Gynecology
83 SPRINGVIEW LN
SUMMERVILLE, SC
ZIP 29485
JENNIFER J. HEINEMANN M.D.
Obstetrics & Gynecology
83 SPRINGVIEW LN
SUMMERVILLE, SC
ZIP 29485
DR. HUNTER ALEXANDER SMITH M.D.
Obstetrics & Gynecology
83 SPRINGVIEW LN
SUMMERVILLE, SC
ZIP 29485
WILLIAM MILES REEVES IV MD
Obstetrics & Gynecology
(Obstetrics)
83 SPRINGVIEW LN
SUMMERVILLE, SC
ZIP 29485
DR. ALICIA NICOLE FARRIS MD
Obstetrics & Gynecology
83 SPRINGVIEW LN
SUMMERVILLE, SC
ZIP 29485
UWH OF THE CAROLINAS, PLLC
Obstetrics & Gynecology
83 SPRINGVIEW LN
SUMMERVILLE, SC
ZIP 29485
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1427306893, enumerated as an "individual" on August 16, 2012.
The provider is located at 83 SPRINGVIEW LN SUMMERVILLE, SC 29485 and the phone number is (843) 797-3664.
Obstetrics & Gynecology with taxonomy code 207V00000X.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.
Martha Cohen is affiliated with: TRIDENT MEDICAL CENTER.