JOHN R MORGAN M.D.
NPI 1487767224
Family Medicine in Cullman, AL


Quality Rating: 99.29 out of 100 score

NPI Status: Active since August 16, 2006

Contact Information

1948 AL HIGHWAY 157 STE 450
CULLMAN, AL
ZIP 35058
Phone: (256) 735-5075
Fax: (256) 735-5076

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  • Individual
  • Male
  • Years of Experience 32
  • Family Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About JOHN MORGAN

John Morgan is a primary care provider established in Cullman, Alabama and his medical specialization is Family Medicine with more than 32 years of experience. He graduated from University Of Alabama School Of Medicine in 1992. The healthcare provider is registered in the NPI registry with number 1487767224 assigned on August 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 18933 (AL). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1487767224
Provider Name
JOHN R MORGAN M.D.
Gender
Male
Entity Type
Individual
Location Address
1948 AL HIGHWAY 157 STE 450 CULLMAN, AL 35058
Location Phone
(256) 735-5075
Location Fax
(256) 735-5076
Mailing Address
PO BOX 2895 CULLMAN, AL 35056
Mailing Phone
(256) 735-5075
Mailing Fax
(256) 735-5076
Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year
1992
Is Sole Proprietor?
No
Enumeration Date
08-16-2006
Last Update Date
09-23-2022
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A primary care provider (PCP) like John Morgan sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

John Morgan 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 99.29, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $21.48 for a new patient copayment and $24.83 for an established patient copayment.

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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
18933
License State
AL
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.

PECOS Enrollment and Medicare Participation Status

John Morgan 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: 1456475169

    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: I20100902000290

    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

Physician Visit Costs

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 35058 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $85.95
  • Minimum New Patient Price $55.54
  • Maximum New Patient Price $170.61
  • Average New Patient Copayment $21.48
  • Minimum New Patient Copayment $13.88
  • Maximum New Patient Copayment $42.65

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.33
  • Minimum Established Patient Price $16.93
  • Maximum Established Patient Price $139.08
  • Average Established Patient Copayment $24.83
  • Minimum Established Patient Copayment $4.23
  • Maximum Established Patient Copayment $34.77

* 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 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: 99.29 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: 98.72

    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.

  • 98

    Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS:85025)

  • 93

    Hemoglobin a1c level (HCPCS:83036)

  • 61

    Administration of influenza virus vaccine (HCPCS:G0008)

  • 56

    Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

  • 53

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

  • 38

    Automated urinalysis test (HCPCS:81003)

  • 18

    X-ray of chest, 2 views (HCPCS:71046)

  • 12

    Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem (HCPCS:G0180)

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. John Morgan is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
CULLMAN REGIONAL MEDICAL CENTER1912 ALABAMA HIGHWAY 157
CULLMAN, AL 35058
(256) 737-2000Acute 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.
1487767224
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
241671461424
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 6 + 7 + 1 + 4 + 6 + 1 + 4 + 2 + 4 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1487767224 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1548422868DR. CARLOS VILLAR-GOSALVEZ M.D.
Individual
Family Medicine1948 AL HIGHWAY 157 STE 450
CULLMAN, AL 35058
(256) 735-5075
1467083675CRMC MEDICAL GROUP LLC
Organization
Clinic/Center (Multi-Specialty)1948 AL HIGHWAY 157 STE 450
CULLMAN, AL 35058
(256) 735-5075
1467957993DR. THOMAS CAMERON BRIMER MD
Individual
Internal Medicine1948 AL HIGHWAY 157 STE 450
CULLMAN, AL 35058
(256) 735-5075
1851898399 SHAHDEEN SHAMS ALAM DO
Individual
Internal Medicine1948 AL HIGHWAY 157 STE 450
CULLMAN, AL 35058
(256) 735-5075
1114542396 LAUREN C ROBINSON DO
Individual
Family Medicine1948 AL HIGHWAY 157 STE 450
CULLMAN, AL 35058
(256) 735-5075

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487767224, enumerated in the NPI registry as an "individual" on August 16, 2006

The provider is located at 1948 Al Highway 157 Ste 450 Cullman, Al 35058 and the phone number is (256) 735-5075

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 32 years of experience. He graduated from University Of Alabama School Of Medicine in 1992.

Yes, as of April 12, 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.

Medicare beneficiaries should expect a typical cost of $85.95 with an average copayment of $21.48 for new patient appointments. Established patients should expect a typical charge of $99.33 and an average copayment of 24.83. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Complete blood cell count (red cells, white blood cell, platelets), automated test, Hemoglobin a1c level, Administration of influenza virus vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Injection beneath the skin or into muscle for therapy, diagnosis, or prevention, Automated urinalysis test, X-ray of chest, 2 views and Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem.

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

This NPI record was last updated on August 16, 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].
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