DR. EDWARD J PAPA D.O.
NPI 1447517842
Anesthesiology - Pain Medicine in Stony Brook, NY


Quality Rating: 92.62 out of 100 score

NPI Status: Active since April 23, 2012

Contact Information

101 NICOLLS ROAD
STONY BROOK ANESTHESIOLOGY
STONY BROOK, NY
ZIP 11794
Phone: (631) 444-2975
Fax: (631) 444-2907

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  • Individual
  • Male
  • Years of Experience 13
  • Anesthesiology
  • Pain Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About EDWARD PAPA

Edward Papa is a provider established in Stony Brook, New York and his medical specialization is Anesthesiology with a focus in pain medicine with more than 13 years of experience. The healthcare provider is registered in the NPI registry with number 1447517842 assigned on April 2012. The practitioner's primary taxonomy code is 207LP2900X with license number 273202 (NY). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1447517842
Provider Name
DR. EDWARD J PAPA D.O.
Gender
Male
Entity Type
Individual
Location Address
101 NICOLLS ROAD STONY BROOK ANESTHESIOLOGY STONY BROOK, NY 11794
Location Phone
(631) 444-2975
Location Fax
(631) 444-2907
Mailing Address
101 NICOLLS ROAD STONY BROOK ANESTHESIOLOGY PO BOX 1559 STONY BROOK, NY 11794
Mailing Phone
(631) 988-9289
Mailing Fax
(631) 444-2907
Medical School Name
OTHER
Graduation Year
2012
Is Sole Proprietor?
Yes
Enumeration Date
04-23-2012
Last Update Date
04-13-2017
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Edward Papa 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.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.62, 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.

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

Anesthesiology Pain Medicine

Taxonomy Code
207LP2900X
Type
Allopathic & Osteopathic Physicians
License No.
273202
License State
NY
Taxonomy Description
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

PECOS Enrollment and Medicare Participation Status

Edward Papa 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: 6507134194

    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: I20170623000359

    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

Overall MIPS Quality 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: 92.62 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: 85.24

    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.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 1083

    Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)

  • 73

    Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)

  • 73

    Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance (HCPCS:64483)

  • 42

    Injections of lower or sacral spine facet joint using imaging guidance (HCPCS:64493)

  • 39

    Injections of lower or sacral spine facet joint using imaging guidance (HCPCS:64494)

  • 29

    Injection procedure into sacroiliac joint for anesthetic or steroid (HCPCS:27096)

  • 24

    Ultrasonic guidance imaging supervision and interpretation for insertion of needle (HCPCS:76942)

  • 22

    Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance (HCPCS:20611)

  • 19

    Insertion of needle into vein for collection of blood sample (HCPCS:36415)

  • 17

    Destruction of lower or sacral spinal facet joint nerves using imaging guidance (HCPCS:64635)

  • 15

    Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)

  • 15

    Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)

Hospital Affiliations

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. Edward Papa is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ST CHARLES HOSPITAL200 BELLE TERRE ROAD
PORT JEFFERSON, NY 11777
(631) 474-6000Acute 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.
1447517842
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
24871011488
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 8 + 7 + 1 + 0 + 1 + 1 + 4 + 8 + 8 + 24 = 68
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 68 = 22

The NPI number 1447517842 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


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

NPI Name / Type Taxonomy Address
1144487968DR. VASILEIOS KOSTARAS MD
Individual
Student in an Organized Health Care Education/Training Program101 NICOLLS ROAD HSC 19
STONY BROOK, NY 11794
(631) 444-1791
1174767420MR. SANDEEP RAO BHASHYAM M.D.
Individual
Internal Medicine101 NICOLLS ROAD HSC T16-020
STONY BROOK, NY 11794
(631) 444-8478
1700103983DR. TRAVIS ALLEN PARKER M.D.
Individual
Student in an Organized Health Care Education/Training Program101 NICOLLS ROAD LEVEL 2, ROOM 749 DEPT. OF PATHOLOGY
STONY BROOK, NY 11794
(631) 444-2214
1427375203DR. DIMPLE M PANDYA M.D.
Individual
Student in an Organized Health Care Education/Training Program101 NICOLLS ROAD LEVEL 2, RM 749 DEPARTMENT OF PATHOLOGY
STONY BROOK, NY 11794
(631) 444-2222
1558747774 YULIYA SANDMAN A-GNP-C
Individual
Nurse Practitioner (Adult Health)101 NICOLLS ROAD STONY BROOK UNIVERSITY MEDICAL CENTER
STONY BROOK, NY 11794
(631) 444-4000
1922060110DR. ROBERTO B GIL M.D.
Individual
Psychiatry & Neurology (Psychiatry)101 NICOLLS ROAD STONY BROOK UNIVERSITY HOSPITAL, PSYCHIATRY DEPARTMENT
STONY BROOK, NY 11794
(631) 638-1561
1285180828MRS. ALLISON TAYLOR BISCHOFF NP-C
Individual
Nurse Practitioner (Adult Health)101 NICOLLS ROAD
STONY BROOK, NY 11794
(631) 444-6000
1235668369MR. ROBERT ANTHONY MELE MS, NNP
Individual
Nurse Practitioner (Neonatal)101 NICOLLS ROAD HSC T11, ROOM 060
STONY BROOK, NY 11794
(631) 444-7653
1205332624DR. MICHAEL GIANCARLO ROSCO MD
Individual
Student in an Organized Health Care Education/Training Program101 NICOLLS ROAD HSC LEVEL 4, ROOM 176
STONY BROOK, NY 11794
(631) 638-8517
1114487295DR. MEREDITH MOSER DO
Individual
Student in an Organized Health Care Education/Training Program101 NICOLLS ROAD HSC LEVEL 10 ROOM 020
STONY BROOK, NY 11794
(631) 444-3005
1578805974DR. SURAJ H RAMBHIA M.D.
Individual
Radiology (Diagnostic Radiology)101 NICOLLS ROAD
STONY BROOK, NY 11794
(631) 444-5400
1215153358DR. HEIDI RACHEL BURRY M.D.
Individual
Radiology (Diagnostic Radiology)101 NICOLLS ROAD
STONY BROOK, NY 11794
(631) 444-5400
1083000558DR. BAHAA E DAOUD MD
Individual
Anesthesiology101 NICOLLS ROAD HSC LEVEL 4 ROOM 60
STONY BROOK, NY 11794
(631) 444-2078
1134756687DR. DAWEI WU DO
Individual
Student in an Organized Health Care Education/Training Program101 NICOLLS ROAD HEALTH SCIENCES CENTER LEVEL 4, ROOM 176
STONY BROOK, NY 11794
(631) 638-8517
1316575277 ZAINA NAEEM MD, MPH
Individual
Student in an Organized Health Care Education/Training Program101 NICOLLS ROAD DEPT OF SURGERY, HSC T-19, RM 030
STONY BROOK, NY 11794
(631) 444-1791
1063040806 DAOD PAK
Individual
Student in an Organized Health Care Education/Training Program101 NICOLLS ROAD HSC T12/020
STONY BROOK, NY 11794
(631) 444-2599
1558990002 KATIE ELIZABETH BROWN
Individual
Student in an Organized Health Care Education/Training Program101 NICOLLS ROAD STONY BROOK MEDICINE HSC LEVEL 11 RM 040
STONY BROOK, NY 11794
(631) 444-2020
1003337700 MUZAMMIL KHAN MD
Individual
Hospitalist101 NICOLLS ROAD HSC T16-020
STONY BROOK, NY 11794
(631) 444-8478
1003492893 JUSTIN ALEXANDER BELL MD
Individual
Student in an Organized Health Care Education/Training Program101 NICOLLS ROAD DEPARTMENT OF ANESTHESIOLOGY, HSC LEVEL 4, ROOM 060
STONY BROOK, NY 11794
(631) 444-2975
1518543156 ALEXANDRA HAILEY DONNELLY DO
Individual
Student in an Organized Health Care Education/Training Program101 NICOLLS ROAD HSC LEVEL 4, 050
STONY BROOK, NY 11794
(631) 444-3880

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1447517842, enumerated in the NPI registry as an "individual" on April 23, 2012

The provider is located at 101 Nicolls Road Stony Brook Anesthesiology Stony Brook, Ny 11794 and the phone number is (631) 444-2975

The provider's speciality is Anesthesiology with taxonomy code 207LP2900X with a focus in Pain Medicine

The provider has more than 13 years of experience.

Yes, as of July 16, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

The most common procedures or services performed by this practitioner are: Injection, triamcinolone acetonide, not otherwise specified, 10 mg, Aspiration and/or injection of large joint or joint capsule, Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance, Injections of lower or sacral spine facet joint using imaging guidance, Injections of lower or sacral spine facet joint using imaging guidance, Injection procedure into sacroiliac joint for anesthetic or steroid, Ultrasonic guidance imaging supervision and interpretation for insertion of needle, Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance, Insertion of needle into vein for collection of blood sample, Destruction of lower or sacral spinal facet joint nerves using imaging guidance, Injection beneath the skin or into muscle for therapy, diagnosis, or prevention and Injection, dexamethasone sodium phosphate, 1 mg.

The practitioner is affiliated to the following hospital(s): ST CHARLES HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on April 23, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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