MS. LISA RAE GERGEN APRN
NPI 1497748263
Nurse Practitioner in Edgewood, KY
NPI Status: Active since August 26, 2005
Contact Information
560 S LOOP RD
EDGEWOOD, KY
ZIP 41017
Phone: (859) 301-2663
Fax: (859) 301-0655
- Individual
- Female
- Nurse Practitioner
- PECOS Enrolled
- Medicare Quality Reporting
About LISA GERGEN
This page provides the complete NPI Profile along with additional information for Lisa Gergen, a provider established in Edgewood, Kentucky with a medical specialization in Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1497748263 assigned on August 2005. The practitioner's primary taxonomy code is 363L00000X with license number 3003813 (KY). The provider is registered as an individual and her NPI record was last updated 10 years ago.
- NPI
- 1497748263
- Provider Name
- MS. LISA RAE GERGEN APRN
- Other Name
- MS. LISA R. SIRONEN NP
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 560 S LOOP RD EDGEWOOD, KY 41017
- Location Phone
- (859) 301-2663
- Location Fax
- (859) 301-0655
- Mailing Address
- 560 S LOOP RD EDGEWOOD, KY 41017
- Mailing Phone
- (859) 301-2663
- Mailing Fax
- (859) 301-0655
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-26-2005
- Last Update Date
- 02-03-2016
- Code Navigator
A nurse practitioner (NP) like Lisa Gergen is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
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 Practitioner
- Taxonomy Code
- 363L00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 3003813
- License State
- KY
- Taxonomy Description
- (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | RN-232372 (OH) |
| 2 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 1067394 (KY) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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 |
|---|---|---|---|
| 000000248062 | OTHER (01) | ANTHEM | |
| P65717 | OTHER (01) | UPIN | |
| H406770 | MEDICARE PIN (08) | OH | |
| NP23231 | MEDICARE UPIN (02) | OH | |
| 78008083 | MEDICAID (05) | KY | |
| K119990 | MEDICARE PIN (08) | KY | |
| 0713903 | MEDICARE UPIN (02) | KY | |
| 2535028 | MEDICAID (05) | OH | |
| 500027765 | OTHER (01) | MEDICARE RR | |
| 2442191 | OTHER (01) | UHC |
Medicare Participation & PECOS Enrollment Status
Lisa Gergen 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
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 41017 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.24
- Minimum New Patient Price $52.76
- Maximum New Patient Price $162.27
- Average New Patient Copayment $20.56
- Minimum New Patient Copayment $13.19
- Maximum New Patient Copayment $40.56
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.94
- Minimum Established Patient Price $16.53
- Maximum Established Patient Price $131.99
- Average Established Patient Copayment $23.48
- Minimum Established Patient Copayment $4.13
- Maximum Established Patient Copayment $32.99
* 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.
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 |
|---|---|---|
| Pneumococcal Vaccination Status for Older Adults | 85% | 67 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 100% | 78 |
| 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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Screening for Osteoporosis for Women Aged 65-85 Years of Age | 93% | 40 |
| Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis | ||
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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 1497748263, we treat the final digit (3) 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
EDGEWOOD, KY 41017
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497748263, enumerated as an "individual" on August 26, 2005.
The provider is located at 560 S LOOP RD EDGEWOOD, KY 41017 and the phone number is (859) 301-2663.
Nurse Practitioner with taxonomy code 363L00000X.
The provider might be accepting Accepts: Anthem Blue Cross, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
