DR. BRAIN J MARSHALL MD NPI 1497781421

Emergency Medicine in Columbus, OH

NPI 1497781421 Individual Male Emergency Medicine PECOS Enrolled MIPS Quality Score 93.8

NPI Profile for DR. BRAIN J MARSHALL MD

Brain Marshall is a provider established in Columbus, Ohio and his medical specialization is emergency medicine. The NPI number of Brain Marshall is 1497781421 and was assigned on June 2006. The practitioner's primary taxonomy code is 207P00000X with license number 35-082801 (OH). The provider is registered as an individual and his NPI record was last updated 15 years ago.

Brain Marshall 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..

Brain Marshall is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 93.8, 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.

NPI

1497781421

Provider NameDR. BRAIN J MARSHALL MD
Provider Location Address3535 OLENTANGY RIVER RD COLUMBUS, OH 43214
Provider Mailing Address14050 NW 14TH ST SUITE 190 SUNRISE, FL 33323
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-23-2006
Last Update Date07-08-2007


Primary Taxonomy

Taxonomy Code207P00000X
ClassificationEmergency Medicine
TypeAllopathic & Osteopathic Physicians
License No.35-082801
License StateOH
Taxonomy DescriptionAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Business Address

DR. BRAIN J MARSHALL MD
3535 OLENTANGY RIVER RD
COLUMBUS, OH
ZIP 43214
Phone: (614) 566-5000

Get Directions


Mailing Address

DR. BRAIN J MARSHALL MD
14050 NW 14TH ST
SUITE 190
SUNRISE, FL
ZIP 33323
Phone: (800) 424-3672
Fax: (954) 377-3042



PECOS Enrollment and Medicare Participation

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
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

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% 89.3
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% 89.6
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 - 93.8
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.

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
I05453MEDICARE UPIN (02)OH
MA4131782MEDICARE ID-TYPE UNSPECIFIED (04)OH
2461312MEDICAID (05)OH

NPI Validation Check Digit Calculation


The following table explains step by step the 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.
1497781421
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
24187148244
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 8 + 7 + 1 + 4 + 8 + 2 + 4 + 4 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1497781421 is valid because the calculated check digit 1 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
1972504827 PETER A ACCETTA M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-4945
1215938311 MELINDA C DOLOR MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-4945
1366444309 RONALD E PYKA MD
Individual
Pathology (Anatomic Pathology)3535 OLENTANGY RIVER RD RMH PATHOLOGY DEPT
COLUMBUS, OH 43214
(614) 566-4945
1659373389 RICHARD B ZELLMER MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-4943
1265424592 SOUHAIR A GARAS MD
Individual
Psychiatry & Neurology (Psychiatry)3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 785-1115
1447243910CORPATH LTD
Organization
Pathology (Anatomic Pathology & Clinical Pathology)3535 OLENTANGY RIVER RD RIVERSIDE METHODIST HOSP PATHOLOGY DEPT
COLUMBUS, OH 43214
(614) 566-4945
1841274305DR. MELISSA M BRASCO D.O.
Individual
Internal Medicine3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 255-6900
1356319206MS. DEANIA MARIE TOWNS PA-C
Individual
Physician Assistant3535 OLENTANGY RIVER RD EMERGENCY DEPARTMENT
COLUMBUS, OH 43214
(614) 566-5070
1669427159DR. GREGORY H DECKER MD
Individual
Emergency Medicine3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-5000
1750328266 VANITHA SUNDARARAJAN MD
Individual
Pathology (Anatomic Pathology)3535 OLENTANGY RIVER RD RIVERSIDE METHODIST HOSPITAL PATH DEPT
COLUMBUS, OH 43214
(614) 566-4945
1710926969DR. JOEL I FISHER MD
Individual
Emergency Medicine3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-5000
1578506309DR. NEIL R FOSNAUGH MD
Individual
Emergency Medicine3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-5000
1386686194DR. STEVEN J ESKIN MD
Individual
Emergency Medicine3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-5000
1154363935DR. RONALD A RIMER DO
Individual
Emergency Medicine3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-5000
1619903663MISS MARICHELLE T UY PA-C
Individual
Physician Assistant (Medical)3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-5000
1659307676DR. PATRICK R HAYES MD
Individual
Emergency Medicine3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(800) 424-3972
1437186301DR. WARREN K YAMARICK MD
Individual
Emergency Medicine3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-5000
1578592028DR. RICHARD B ESLER DO
Individual
Emergency Medicine3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-5000
1518068048 PHILIP E HINKLE MD
Individual
Psychiatry & Neurology (Psychiatry)3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 235-2326
1952459968 MEGAN L. DEHAAN MD
Individual
Radiology (Radiation Oncology)3535 OLENTANGY RIVER RD
COLUMBUS, OH 43214
(614) 566-5560

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Brain J Marshall Md is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
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.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.