DR. DONALD A MAHLER M.D.
NPI 1518075159
Internal Medicine - Pulmonary Disease in Lebanon, NH
About Dr. Donald A Mahler M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DONALD A MAHLER M.D. (NPI 1518075159) is an individual pulmonary disease provider in Lebanon, New Hampshire, licensed in New Hampshire (6535) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Valley Regional Hospital, and is a graduate of Loyola University Of Chicago, Stritch School Of Medicine (1972).
NPPES Registry Identity
Specialties & Licenses
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Other Identifiers 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Donald A Mahler M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE000N)
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)
5 DME suppliers used 45 Medicare Claims 90 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
2 DME suppliers used 37 Medicare Claims 37 Services Paid
DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
1 DME suppliers used 31 Medicare Claims 31 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
4 DME suppliers used 103 Medicare Claims 107 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
3 DME suppliers used 30 Medicare Claims 38 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:K0738)
1 DME suppliers used 22 Medicare Claims 22 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
9 DME suppliers used 203 Medicare Claims 203 Services Paid
Drugs Administered Through DME
DME-Drugs Administered Through DME (DG006N)
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms (HCPCS:J7605)
1 DME suppliers used 18 Medicare Claims 1080 Services Paid
DME-Drugs Administered Through DME (DG006N)
Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms (HCPCS:J7606)
6 DME suppliers used 140 Medicare Claims 8250 Services Paid
DME-Drugs Administered Through DME (DG006N)
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)
4 DME suppliers used 20 Medicare Claims 2237 Services Paid
DME-Drugs Administered Through DME (DG006N)
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)
6 DME suppliers used 19 Medicare Claims 2040 Services Paid
DME-Drugs Administered Through DME (DG000N)
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)
7 DME suppliers used 111 Medicare Claims 6638 Services Paid
DME-Drugs Administered Through DME (DG006N)
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram (HCPCS:J7644)
2 DME suppliers used 22 Medicare Claims 620 Services Paid
DME-Drugs Administered Through DME (DG006N)
Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram (HCPCS:J7677)
4 DME suppliers used 114 Medicare Claims 598500 Services Paid
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $33.02 for a new patient copayment and $25.38 for an established patient copayment.
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 03756 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $132.09
- Minimum New Patient Price $57.75
- Maximum New Patient Price $174.26
- Average New Patient Copayment $33.02
- Minimum New Patient Copayment $14.43
- Maximum New Patient Copayment $43.56
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $101.54
- Minimum Established Patient Price $18.7
- Maximum Established Patient Price $142.15
- Average Established Patient Copayment $25.38
- Minimum Established Patient Copayment $4.67
- Maximum Established Patient Copayment $35.53
* 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 73.11, 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: .
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.
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Final Score: 73.11 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.
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Quality Score: 60.04
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 comprises 40% of a provider's final MIPS score.
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.
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Promoting Interoperability Score: 91
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 comprises 25% of a provider's final MIPS score.
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 comprises 15% of a provider's final MIPS score.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score. -
Cost Score: 47.04
The Cost performance category assesses 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 comprises 20% of a provider's final MIPS score.
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 |
|---|---|---|
| Colorectal Cancer Screening | 32% | 191 |
| Controlling High Blood Pressure | 56% | 96 |
| Diabetes: Eye Exam | 14% | 35 |
| Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) | 49% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 35 |
| e-Prescribing | 96% | 137 |
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 30% | 293 |
| Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented | 21% | 233 |
| Provide Patients Electronic Access to Their Health Information | 41% | 105 |
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
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. Donald Mahler is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| VALLEY REGIONAL HOSPITAL | 243 ELM STREET CLAREMONT, NH 03743 | (603) 542-7771 | Critical Access Hospitals |
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1518075159, enumerated as an "individual" on August 25, 2006.
The provider is located at 1 MEDICAL CENTER DR DHMC PULMONARY LEBANON, NH 03756 and the phone number is (603) 650-5533.
Internal Medicine with taxonomy code 207RP1001X and a focus in Pulmonary Disease.
The provider might be accepting Accepts: Ambetter from NH Healthy Families, Anthem Blue. Please consult your insurance carrier or call the provider to verify.
Donald Mahler is affiliated with: VALLEY REGIONAL HOSPITAL.
