JUSTIN H BAIN DO
NPI 1437369527
Internal Medicine - Nephrology in Sikeston, MO

Active since May 23, 2007PECOS EnrolledAccepts Medicare Assignment
92.57/100
CMS Quality Rating
1012 N MAIN ST, SIKESTON, MO 63801(573) 471-0330(573) 471-0461 Get Directions Write a Review

NPPES record last updated: August 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 8, 2024, Dec 29, 2020 (2 updates tracked since 2020).

About Justin H Bain Do NPPES

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

JUSTIN H BAIN DO (NPI 1437369527) is an individual nephrology provider in Sikeston, Missouri, licensed in Missouri (2011007197) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital Southeast, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1437369527
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameJUSTIN H BAINCredential: DO
Location Address1012 N MAIN STSikeston, MO 63801-5044
Mailing AddressPo Box 801143Kansas City, MO 64180-1143 · (573) 331-5583 · Fax (573) 331-5079
Fax(573) 471-0461
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateMay 23, 2007
Last NPPES UpdateAugust 8, 20242 updates tracked since enumeration
NPPES CertifiedAugust 8, 2024
NPI 1437369527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License Licensed in MO · 2011007197
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedInternal MedicineTaxonomy 207R00000X · License 2011007197 (MO)
1012 N MAIN ST, Sikeston, MO 63801

Accepted 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

Justin H Bain Do 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 ID5698944973
PECOS Enrollment IDI20110802000500
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 7

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.

Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
442 services72 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
189 services65 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
173 services73 patients
Home dialysis services per month (20 years or older) 90966
Home dialysis services provide kidney treatment for patients aged 20 or older right in their own homes. This service includes necessary equipment, supplies, and support for performing dialysis. It's a convenient option that allows patients to maintain their daily routines while receiving essential care.
134 services18 patients
Complete ultrasound scan behind abdominal cavity 76770
A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.
54 services54 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
44 services43 patients

Hospital Affiliations CMS Care Compare 3

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

Mercy Hospital Southeast

Acute Care Hospitals · Cape Girardeau, MO
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260110
Location1701 Lacey StCape Girardeau, MO 63701 · Cape Girardeau County
Emergency services Birthing friendly

Missouri Delta Medical Center

Acute Care Hospitals · Sikeston, MO
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260113
Location1008 North Main StSikeston, MO 63801 · Scott County
Emergency services Birthing friendly

Saint Francis Medical Center

Acute Care Hospitals · Cape Girardeau, MO
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260183
Location211 St Francis DrCape Girardeau, MO 63703 · Cape Girardeau County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63801 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
$121.96 typical visit price
range $52.28 – $161.24
Typical copayment $30.49 (range $13.07 – $40.31)
Most-billed visit code 99204
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
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.

92.57/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.03
Promoting Interoperability88
Improvement Activities40

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
100%283 patients5/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
93%1,851 patients4/55-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.
92%1,874 patients4/55-star benchmark: 100%
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…
71%59 patients4/55-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.
92%760 patients4/55-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.
41%1,363 patients2/55-star benchmark: 99%
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…
75%855 patients4/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 575 patients
Patients tobacco: 97% · 575 patients
76%63 patients4/55-star benchmark: 98%
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…
89%1,363 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…
44%1,363 patients4/55-star benchmark: 59%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 3% · 559 patients
8%559 patients3/55-star benchmark: 100%
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.
12%1,363 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 2

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

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers20 claims2,430 services$0.35 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
2 suppliers19 claims19 services$18.98 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 20

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

Nurse Practitioner (Family)
1012 N MAIN ST
SIKESTON, MO 63801
Clinic/Center
1012 N MAIN ST
SIKESTON, MO 63801
Nurse Practitioner (Family)
1012 N MAIN ST
SIKESTON, MO 63801
Nurse Practitioner (Family)
1012 N MAIN ST
SIKESTON, MO 63801
Social Worker (Clinical)
1012 N MAIN ST
SIKESTON, MO 63801
Nurse Practitioner (Family)
1012 N MAIN ST
SIKESTON, MO 63801
Family Medicine
1012 N MAIN ST
SIKESTON, MO 63801
Nurse Practitioner (Psychiatric/Mental Health)
1012 N MAIN ST
SIKESTON, MO 63801

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Bain's NPI number?

The NPI number for Justin Bain is 1437369527. It was assigned to this individual provider in the NPPES registry on May 23, 2007.

Where is Justin Bain located?

Justin Bain practices at 1012 N Main St, Sikeston, MO 63801. The listed phone number is (573) 471-0330.

What is Justin Bain's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Justin Bain enrolled in Medicare?

Yes. Justin Bain is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Justin Bain accept?

Health plans from UnitedHealthcare list Justin Bain as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Justin Bain affiliated with any hospitals?

According to CMS data, Justin Bain is affiliated with Mercy Hospital Southeast, Missouri Delta Medical Center and Saint Francis Medical Center.

When was this NPI record last updated?

The NPPES record for Justin Bain was last updated on August 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.