THOMAS JAKUBCZAK CRNA
NPI 1477561629
Nurse Anesthetist, Certified Registered in Detroit, MI


Quality Rating: 100 out of 100 score

NPI Status: Active since August 04, 2006

Contact Information

3990 JOHN R ST
DETROIT, MI
ZIP 48201
Phone: (952) 442-9770

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  • Individual
  • Male
  • Years of Experience 36
  • Nurse Anesthetist, Certified Registered
  • Accepts Insurance
  • May Accept Medicare Approved Payment
  • Medicare Quality Reporting

About THOMAS JAKUBCZAK

This page provides the complete NPI Profile along with additional information for Thomas Jakubczak, a provider established in Detroit, Michigan with a medical specialization in Nurse Anesthetist, Certified Registered and more than 36 years of experience. The healthcare provider is registered in the NPI registry with number 1477561629 assigned on August 2006. The practitioner's primary taxonomy code is 367500000X with license number 4704144957 (MI). The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI
1477561629
Provider Name
THOMAS JAKUBCZAK CRNA
Gender
Male
Entity Type
Individual
Location Address
3990 JOHN R ST DETROIT, MI 48201
Location Phone
(952) 442-9770
Mailing Address
PO BOX 67000 DEPT 203401 DETROIT, MI 48267
Mailing Phone
(952) 442-9770
Mailing Fax
Medical School Name
OTHER
Graduation Year
1990
Is Sole Proprietor?
No
Enumeration Date
08-04-2006
Last Update Date
07-08-2007
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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

Nurse Anesthetist, Certified Registered

Taxonomy Code
367500000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
4704144957
License State
MI
Taxonomy Description
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Insurance Plans Accepted

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

  • Blue Cross� Local HMO Bronze Extra - HMO
  • Blue Cross� Local HMO Bronze Secure - HMO
  • Blue Cross� Local HMO Silver Extra - HMO
  • Blue Cross� Local HMO Silver Saver - HMO
  • Blue Cross� Preferred HMO Bronze Extra - HMO
  • Blue Cross� Preferred HMO Bronze Saver HSA - HMO
  • Blue Cross� Preferred HMO Bronze Secure - HMO
  • Blue Cross� Preferred HMO Gold - HMO
  • Blue Cross� Preferred HMO Gold Extra - HMO
  • Blue Cross� Preferred HMO Silver - HMO
  • Blue Cross� Premier PPO Bronze Extra - PPO
  • Blue Cross� Premier PPO Bronze Saver HSA - PPO
  • Blue Cross� Premier PPO Bronze Secure - PPO
  • Blue Cross� Premier PPO Gold - PPO
  • Blue Cross� Premier PPO Gold Extra - PPO
  • Blue Cross� Premier PPO Silver - PPO
  • Blue Cross� Premier PPO Silver Extra - PPO
  • Blue Cross� Premier PPO Silver Saver HSA - PPO
  • Blue Cross� Premier PPO Value - PPO
  • MyPriority Balanced Silver - HMO
  • MyPriority Premier Silver - HMO
  • MyPriority Standard Bronze - HMO
  • MyPriority Standard Bronze - Travel - HMO
  • MyPriority Standard Gold - HMO
  • MyPriority Standard Silver - HMO
  • MyPriority Standard Silver - Travel - HMO
  • MyPriority Value Bronze - HMO
  • MyPriority Value Bronze HSA - 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.

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
TJ144957OTHER (01)MIBLUE CROSS OF MI
N24360095MEDICARE ID-TYPE UNSPECIFIED (04)MI 

Medicare Participation & PECOS Enrollment Status

Thomas Jakubczak is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

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.

  • PECOS PAC ID: 2961682224

    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: I20110203001088

    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? Maybe

    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.

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 100, 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: 100 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: 88.26

    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: N/A

    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
Use of QCDR data for quality improvement such as comparative analysis reports across patient populationsYesN/A
Participation in a QCDR, clinical data registries, or other registries run by other government agencies such as FDA, or private entities such as a hospital or medical or surgical society. Activity must include use of QCDR data for quality improvement (e.g., comparative analysis across specific patient populations for adverse outcomes after an outpatient surgical procedure and corrective steps to address adverse outcome).
Use of QCDR for feedback reports that incorporate population healthYesN/A
Use of a QCDR to generate regular feedback reports that summarize local practice patterns and treatment outcomes, including for vulnerable populations.
Use of QCDR to support clinical decision makingYesN/A
Participation in a QCDR, demonstrating performance of activities that promote implementation of shared clinical decision making capabilities.

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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 1477561629, we treat the final digit (9) 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 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

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
7
Doubled → 14 → 1 + 4
Pos 4
7
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
1
Doubled → 2
Pos 8
6
Unchanged
Pos 9
2
Doubled → 4
Check
9
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 7 → 14 → 5 5 → 10 → 1 1 → 2 2 → 4

Step 2: Add all digits plus the NPI constant

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

2 + 4 + 1 + 4 + 7 + 1 + 0 + 6 + 2 + 6 + 4 + 24 = 61

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

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1477561629.

Other Providers at the Same Location


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

Pharmacist (Pharmacotherapy)
3990 JOHN R ST, DEPARTMENT OF PHARMACY
DETROIT, MI 48201
Emergency Medicine
3990 JOHN R ST
DETROIT, MI 48201
Emergency Medicine
3990 JOHN R ST
DETROIT, MI 48201
General Acute Care Hospital
3990 JOHN R ST
DETROIT, MI 48201
Internal Medicine (Cardiovascular Disease)
3990 JOHN R ST, HARPER 1 WEBBER CORE
DETROIT, MI 48201
Specialist
3990 JOHN R ST
DETROIT, MI 48201
Anesthesiology
3990 JOHN R ST
DETROIT, MI 48201
Internal Medicine
3990 JOHN R ST, SUITE 805
DETROIT, MI 48201
Orthopaedic Surgery
3990 JOHN R ST, SUITE 1621
DETROIT, MI 48201
Anesthesiology
3990 JOHN R ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1477561629, enumerated as an "individual" on August 04, 2006.

The provider is located at 3990 JOHN R ST DETROIT, MI 48201 and the phone number is (952) 442-9770.

Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.