DR. PAUL W LENKOWSKI JR. M.D.PH.D.
NPI 1497964886
Otolaryngology in Roanoke, VA

Quality Rating: 75 out of 100 score

NPI Status: Active since May 22, 2007

Contact Information

4633 BRAMBLETON AVE STE 100
ROANOKE, VA
ZIP 24018
Phone: (540) 968-7368
Fax: (844) 212-0402

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Table of Contents

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Overall Quality Performance
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 16
Otolaryngology
May Accept Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About PAUL LENKOWSKI

This page provides the complete NPI Profile along with additional information for Paul Lenkowski, a provider established in Roanoke, Virginia with a medical specialization in Otolaryngology and more than 16 years of experience. He graduated from University Of Virginia School Of Medicine in 2010. The healthcare provider is registered in the NPI registry with number 1497964886 assigned on May 2007. The practitioner's primary taxonomy code is 207Y00000X with license number 0101247485 (VA). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI: 1497964886
Provider Name: DR. PAUL W LENKOWSKI JR. M.D.PH.D.
Gender: Male
Entity Type: Individual
Location Address: 4633 BRAMBLETON AVE STE 100 ROANOKE, VA 24018
Location Phone: (540) 968-7368
Location Fax: (844) 212-0402
Mailing Address: PO BOX 8310 ROANOKE, VA 24014
Mailing Phone: (540) 345-3556
Mailing Fax: (844) 212-0402
Medical School Name: UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Graduation Year: 2010
Is Sole Proprietor?: No
Enumeration Date: 05-22-2007
Last Update Date: 04-27-2023
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Location Map

Secondary Locations

1902 Braeburn Dr Ste 130
Salem, VA 24153
(540) 444-8100
2154 McVitty Rd SW Fl 2
Roanoke, VA 24018
(540) 968-7368

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: Otolaryngology
Taxonomy Code: 207Y00000X
Type: Allopathic & Osteopathic Physicians
License No.: 0101247485
License State: VA
Taxonomy Description: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Insurance Plans Accepted

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

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

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
1497964886	MEDICAID (05)	VA

Medicare Participation & PECOS Enrollment Status

Paul Lenkowski 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.

Paul Lenkowski 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: 9739203399
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: I20100902001006
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.
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

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Biopsy or removal of nasal polyp or tissue using an endoscope
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month
Computer-assisted procedure outside membrane covering brain
Diagnostic exam of nasal passages using an endoscope
Diagnostic exam of voice box using a flexible endoscope
Dilation of canal between middle ear and throat (eustachian tube) on both sides of body, using endoscope inserted through nose
Dilation of frontal nasal sinus using an endoscope
Dilation of nasal sinus using an endoscope
Dilation of sphenoid and frontal nasal sinus using an endoscope
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Partial removal of nasal sinus using an endoscope
Professional service for multiple injections of allergen
Professional service for preparation and provision of 1 or more antigens
Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days
Removal of impacted ear wax
Removal of nasal air passage under lining tissue
Test for allergy using allergenic extract
Test for allergy using allergenic extract injected into skin
Therapeutic fracture of nasal passages

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 24018 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $129.04
Minimum New Patient Price $56.19
Maximum New Patient Price $170.3

Average New Patient Copayment $32.26
Minimum New Patient Copayment $14.04
Maximum New Patient Copayment $42.57

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $70.08
Minimum Established Patient Price $18.07
Maximum Established Patient Price $138.91

Average Established Patient Copayment $17.52
Minimum Established Patient Copayment $4.51
Maximum Established Patient Copayment $34.72

* 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 provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 75, 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: 75 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: N/A

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: N/A

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
Colorectal Cancer Screening	37%	764
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Diabetes: Medical Attention for Nephropathy	76%	116
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Documentation of Current Medications in the Medical Record	96%	2076
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing	94%	854
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Falls: Screening for Future Fall Risk	55%	709
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Health Information Exchange	10%	29
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Implementation of fall screening and assessment programs	Yes	N/A
Implementation of fall screening and assessment programs to identify patients at risk for falls and address modifiable risk factors (e.g., Clinical decision support/prompts in the electronic health record that help manage the use of medications, such as benzodiazepines, that increase fall risk).
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop	Yes	N/A
Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology.
Medication Reconciliation	99%	542
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	15%	978
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Pneumococcal Vaccination Status for Older Adults	41%	709
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	45%	1442
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
Preventive Care and Screening: Influenza Immunization	31%	1369
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Provide Patient Access	100%	978
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	11%	978
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Use of decision support and standardized treatment protocols	Yes	N/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.
Use of High-Risk Medications in the Elderly	1% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	668
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication

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 1497964886, we treat the final digit (6) 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 84. The final step is to find the difference between that total and the next multiple of ten (90 - 84 = 6).

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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 18 → 1 + 8

Pos 6

Unchanged

Pos 7

Doubled → 8

Pos 8

Unchanged

Pos 9

Doubled → 16 → 1 + 6

Check

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 9 → 18 → 9 9 → 18 → 9 4 → 8 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

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

2 + 4 + 1 + 8 + 7 + 1 + 8 + 6 + 8 + 8 + 1 + 6 + 24 = 84

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

The next multiple of ten after 84 is 90. The difference is the calculated check digit.

90 - 84 = 6

This NPI is valid

The calculated check digit is 6, which matches the last digit of 1497964886.

Other Providers at the Same Location

The following 2 providers are registered at the same or a nearby location.

ROANOKE VALLEY ENT & ALLERGY PC

Otolaryngology

4633 BRAMBLETON AVE STE 100
ROANOKE, VA 24018

Roanoke County (540) 968-7368

HANNAH SELDOMRIDGE PA-C

Physician Assistant (Medical)

4633 BRAMBLETON AVE STE 100
ROANOKE, VA 24018

Roanoke County (540) 968-7368

About PAUL LENKOWSKI

Location Map

Secondary Locations

Specialty - Primary Taxonomy

Otolaryngology

Insurance Plans Accepted

Medicare

Medicaid

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 9739203399

PECOS Enrollment ID: I20100902001006

Accepts Medicare Assignment? Maybe

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

Areas of Expertise

Biopsy or removal of nasal polyp or tissue using an endoscope

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month

Computer-assisted procedure outside membrane covering brain

Diagnostic exam of nasal passages using an endoscope

Diagnostic exam of voice box using a flexible endoscope

Dilation of canal between middle ear and throat (eustachian tube) on both sides of body, using endoscope inserted through nose

Dilation of frontal nasal sinus using an endoscope

Dilation of nasal sinus using an endoscope

Dilation of sphenoid and frontal nasal sinus using an endoscope

Established patient office or other outpatient visit, 20-29 minutes

Established patient office or other outpatient visit, 30-39 minutes

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes

New patient office or other outpatient visit, 30-44 minutes

New patient office or other outpatient visit, 45-59 minutes

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

Partial removal of nasal sinus using an endoscope

Professional service for multiple injections of allergen

Professional service for preparation and provision of 1 or more antigens

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days

Removal of impacted ear wax

Removal of nasal air passage under lining tissue

Test for allergy using allergenic extract

Test for allergy using allergenic extract injected into skin

Therapeutic fracture of nasal passages

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Overall MIPS Quality Performance

Final Score: 75 out of 100

Quality Score: N/A

Promoting Interoperability Score: N/A

Improvement Activities Score: N/A

Cost Score: N/A

Cost Score: N/A

Quality Reporting

Reviews for DR. PAUL W LENKOWSKI JR. M.D.PH.D.

NPI NPI Number Validation

How NPI Validation Works

Digit-by-digit view

Step 1: Double every other digit from the right

Step 2: Add all digits plus the NPI constant

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

Other Providers at the Same Location

Frequently Asked Questions

What is Paul Lenkowski's NPI number?

Where is the provider located?

What is the provider's specialty?

What insurance does Paul Lenkowski accept?