MR. KODAVAYOUR S NIRMAL MD NPI 1487691572
Internal Medicine in Galveston, TX
About MR. KODAVAYOUR S NIRMAL MD
Kodavayour Nirmal is an internist established in Galveston, Texas and her medical specialization is Internal Medicine with more than 39 years of experience. The NPI number of this provider is 1487691572 and was assigned on May 2006. The practitioner's primary taxonomy code is 207R00000X with license number M6314 (TX). The provider is registered as an individual and her NPI record was last updated 14 years ago.
| NPI | 1487691572 |
| Provider Name | MR. KODAVAYOUR S NIRMAL MD |
| Location Address | 301 UNIVERSITY BLVD GALVESTON, TX 77555 |
| Location Phone | (409) 772-2222 |
| Mailing Address | 301 UNIVERSITY BLVD GALVESTON, TX 77555 |
| Gender | Female |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 1984 |
| Is Sole Proprietor? | No |
| Enumeration Date | 05-31-2006 |
| Last Update Date | 11-06-2008 |
An internist like Kodavayour Nirmal is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.Kodavayour Nirmal 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.
Kodavayour Nirmal is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with Houston Methodist Hospital.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 59.1, 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: leadership engagement in regular guidance and demonstrated commitment for implementing practice improvement changes, measurement and improvement at the practice and panel level, participation in an ahrq-listed patient safety organization. and use of qcdr data for ongoing practice assessment and improvements.
The typical physician office visit costs for Medicare beneficiaries in this area are: $34.21 for a new patient copayment and $26.53 for an established patient copayment.
Primary Taxonomy
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 207R00000X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| License No. | M6314 |
| License State | TX |
| Taxonomy Description | A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
301 UNIVERSITY BLVD
GALVESTON, TX
ZIP 77555
Phone: (409) 772-2222
Mailing Address
301 UNIVERSITY BLVD
GALVESTON, TX
ZIP 77555
Phone: (409) 772-2222
Location Map
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 2062424377 |
| PECOS Enrollment ID | I20081022000268 |
| 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 order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 77555 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99204 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $59.68 | $180.62 | $136.85 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $14.92 | $45.15 | $34.21 |
| Established Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for established patients office visits: 99214 | ||
| Minimum Established Patient Pricing | Maximum Established Patient Pricing | Typical Established Patient Pricing |
| $18.8 | $148.04 | $106.15 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.7 | $37.01 | $26.53 |
* The physician office visit costs information is obtained by Medicare's 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 Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's 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.
| MIPS Measure | Score Weight | Score | |
|---|---|---|---|
| Quality | 40% | 43.3 | |
|
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 (PI) | 25% | 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 | 15% | 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 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 | 20% | 62 | |
|
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 Final Score | - | 59.1 | |
| 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. | |||
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 |
|---|---|---|
| Leadership engagement in regular guidance and demonstrated commitment for implementing practice improvement changes | Yes | N/A |
| Ensure full engagement of clinical and administrative leadership in practice improvement that could include one or more of the following: Make responsibility for guidance of practice change a component of clinical and administrative leadership roles; Allocate time for clinical and administrative leadership for practice improvement efforts, including participation in regular team meetings; and/orIncorporate population health, quality and patient experience metrics in regular reviews of practice performance. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following:- Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or - Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Participation in an AHRQ-listed patient safety organization. | Yes | N/A |
| Participation in an AHRQ-listed patient safety organization. | ||
| Use of QCDR data for ongoing practice assessment and improvements | Yes | N/A |
| Use of QCDR data, for ongoing practice assessment and improvements in patient safety. | ||
Hospital Affiliations
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Kodavayour Nirmal is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| HOUSTON METHODIST HOSPITAL | 6565 FANNIN HOUSTON, TX 77030 | (713) 790-2221 | Acute Care Hospitals | 450358 |
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | MD00047095 | WA | No | |
Taxonomy Description: family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| MD00047095 | OTHER (01) | WA | LICENSE |
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 | 8 | 7 | 6 | 9 | 1 | 5 | 7 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 16 | 7 | 12 | 9 | 2 | 5 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 6 + 7 + 1 + 2 + 9 + 2 + 5 + 1 + 4 + 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 = 2 | 2 | ||||||||
The NPI number 1487691572 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 |
|---|---|---|---|
| 1902804461 | GERALD JOSEPH FRANKEL M.D. Individual | Urology | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2222 |
| 1205838612 | DR. HAROLD SCOTT PINE MD Individual | Otolaryngology (Pediatric Otolaryngology) | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2702 |
| 1932191160 | DR. CHRISTINE ANN BOODLEY RN, FNP Individual | Nurse Practitioner (Family) | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-0909 |
| 1407844483 | KEVIN W JOHNSON CRNA Individual | Nurse Anesthetist, Certified Registered | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2222 |
| 1922097781 | DR. ALEXIS LYNLEY M.D. Individual | Anesthesiology | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2222 |
| 1083604193 | DR. AMR E ABOULEISH M.D. Individual | Specialist | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2222 |
| 1821064262 | MS. SUZANNE ELIZABETH WARITZ ALTON N.P. Individual | Nurse Practitioner (Family) | 301 UNIVERSITY BLVD UNIVERSITY OF TEXAS MEDICAL BRANCH GALVESTON, TX 77555 (409) 772-8270 |
| 1497711477 | THE UNIVERSITY OF TEXAS MEDICAL BRANCH Organization | Psychiatric Unit | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 747-9734 |
| 1366409047 | ZITA SUSAN SAMUEL MD Individual | Psychiatry & Neurology (Psychiatry) | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2222 |
| 1053361287 | SHIVAIAH BALACHANDRA MD Individual | Pediatrics (Pediatric Nephrology) | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2222 |
| 1811949167 | JESSICA M SENS FNP Individual | Nurse Practitioner (Obstetrics & Gynecology) | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2222 |
| 1336191212 | KJELL N LINDGREN MD Individual | Emergency Medicine | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-5845 |
| 1568400430 | SUNIL K JAIN MD Individual | Pediatrics (Neonatal-Perinatal Medicine) | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2222 |
| 1578505962 | DR. ERICA B KELLY M.D. Individual | Dermatology | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2222 |
| 1891739892 | DR. SHARON SMITH RAIMER M.D. Individual | Dermatology | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 747-0890 |
| 1346278728 | JOSEPH HSUAN-YEE CHANG MD Individual | Emergency Medicine | 301 UNIVERSITY BLVD RT 1022 GALVESTON, TX 77555 (409) 772-2222 |
| 1982633137 | SALAH AYACHI PA Individual | Physician Assistant (Medical) | 301 UNIVERSITY BLVD PROVIDER ENROLLMENT -- RT. 1022 GALVESTON, TX 77555 (409) 772-2222 |
| 1225062169 | PIER LUIGI DIPATRE MD Individual | Pathology (Anatomic Pathology) | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2222 |
| 1518992411 | DR. DAVID L CALLENDER M.D. Individual | Otolaryngology | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-1902 |
| 1982622148 | OWEN BRYAN HOLLAND MD Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 301 UNIVERSITY BLVD GALVESTON, TX 77555 (409) 772-2222 |
Frequently Asked Questions
What is Mr. Kodavayour Nirmal MD NPI number?
The NPI number assigned to this healthcare provider is 1487691572, registered as an "individual" on May 31, 2006
Where is Mr. Kodavayour Nirmal MD located?
The provider is located at 301 University Blvd Galveston, Tx 77555 and the phone number is (409) 772-2222
Which is Mr. Kodavayour Nirmal MD specialty?
The provider's speciality is Internal Medicine
How many years of experience does Mr. Kodavayour Nirmal MD have?
The provider has more than 39 years of experience.
What insurance does Mr. Kodavayour Nirmal MD accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Mr. Kodavayour Nirmal MD registered in PECOS?
Yes, as of March 13, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare 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.
How much is a visit to Mr. Kodavayour Nirmal MD?
Medicare beneficiaries should expect a typical cost of $136.85 with an average copayment of $34.21 for new patient appointments. Established patients should expect a typical charge of $106.15 and an average copayment of 26.53. Please review your insurance plan or contact the provider directly to determine your specific costs.
Is Mr. Kodavayour Nirmal MD affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: HOUSTON METHODIST HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
The NPI record of Mr. Kodavayour Nirmal MD was last updated on May 31, 2006. 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]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.