MRS. GABRIELLE EDEN PIERCE PA-C NPI 1528236932
Physician Assistant in Mystic, CT
About MRS. GABRIELLE EDEN PIERCE PA-C
Gabrielle Pierce is a primary care provider established in Mystic, Connecticut and her medical specialization is Physician Assistant with more than 16 years of experience. The NPI number of this provider is 1528236932 and was assigned on February 2008. The practitioner's primary taxonomy code is 363A00000X with license number 002016 (CT). The provider is registered as an individual and her NPI record was last updated 12 years ago.
| NPI | 1528236932 |
| Provider Name | MRS. GABRIELLE EDEN PIERCE PA-C |
| Location Address | 23 CLARA DR SUITE 201 MYSTIC, CT 06355 |
| Location Phone | (860) 536-1666 |
| Mailing Address | 23 CLARA DR SUITE 201 MYSTIC, CT 06355 |
| Gender | Female |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 2007 |
| Is Sole Proprietor? | No |
| Enumeration Date | 02-19-2008 |
| Last Update Date | 11-15-2010 |
A primary care provider (PCP) like Gabrielle Pierce 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 Gabrielle Pierce 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.
Gabrielle Pierce is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with .
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 93.5, 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: $24.29 for a new patient copayment and $19.77 for an established patient copayment.
Primary Taxonomy
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.
| Taxonomy Code | 363A00000X |
| Classification | Physician Assistant |
| Type | Physician Assistants & Advanced Practice Nursing Providers |
| License No. | 002016 |
| License State | CT |
| Taxonomy Description | A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
Business Address
23 CLARA DR
SUITE 201
MYSTIC, CT
ZIP 06355
Phone: (860) 536-1666
Mailing Address
23 CLARA DR
SUITE 201
MYSTIC, CT
ZIP 06355
Phone: (860) 536-1666
Location Map
PECOS Enrollment and Medicare Participation Status
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 |
| PECOS PAC ID | 3678714821 |
| PECOS Enrollment ID | I20150425000232 |
| 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 order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 06355 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99203 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $63.47 | $190.87 | $97.18 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $15.86 | $47.71 | $24.29 |
| Established Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for established patients office visits: 99213 | ||
| Minimum Established Patient Pricing | Maximum Established Patient Pricing | Typical Established Patient Pricing |
| $20.08 | $156.18 | $79.11 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $5.02 | $39.04 | $19.77 |
* The physician office visit costs information is obtained by Medicare's 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 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% | 100 | |
|
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. |
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| Promoting Interoperability (PI) | 25% | 78.2 | |
|
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. |
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| 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. |
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| Cost | 20% | 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. |
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| MIPS Final Score | - | 93.5 | |
| 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. | |||
Clinician Utilization
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 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 14Administration of influenza virus vaccine (HCPCS:G0008)
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. | |||||||||
| 1 | 5 | 2 | 8 | 2 | 3 | 6 | 9 | 3 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 4 | 8 | 4 | 3 | 12 | 9 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 4 + 8 + 4 + 3 + 1 + 2 + 9 + 6 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1528236932 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 9 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1720065154 | BRUCE A. BERLOW M.D. Individual | Specialist | 23 CLARA DR SUITE 204 MYSTIC, CT 06355 (860) 536-2995 |
| 1265656946 | JENNIFER FELICELLI PA-C Individual | Physician Assistant | 23 CLARA DR MYSTIC, CT 06355 (860) 536-1666 |
| 1003001850 | MAIN MEDICAL-MYSTIC, LLC Organization | Internal Medicine | 23 CLARA DR SUITE 201 MYSTIC, CT 06355 (860) 536-1666 |
| 1013195064 | MRS. LAURA ANN WHITE OTRL Individual | Occupational Therapist | 23 CLARA DR VISIONS SIGHT AND LEARNING CENTER MYSTIC, CT 06355 (860) 572-4805 |
| 1467659227 | DR. ADRIENNE LYNNE MAROLD PARAD M.D. Individual | Family Medicine | 23 CLARA DR SUITE 203 MYSTIC, CT 06355 (860) 464-2028 |
| 1558406066 | DANIEL LEROY WAGGONER M.D. Individual | Allergy & Immunology | 23 CLARA DR SUITE 204 MYSTIC, CT 06355 (860) 536-2995 |
| 1811109259 | COASTAL CHIROPRACTIC & FAMILY WELLNESS CENTRE Organization | Chiropractor (Rehabilitation) | 23 CLARA DR SUITE 105 MYSTIC, CT 06355 (860) 572-7711 |
| 1891417242 | DANIELLE PETROWSKI Individual | Nurse Practitioner (Family) | 23 CLARA DR MYSTIC, CT 06355 (860) 572-5782 |
| 1437611696 | DR. SUNGSIL CHO MD Individual | Family Medicine | 23 CLARA DR MYSTIC, CT 06355 (860) 572-5782 |
Frequently Asked Questions
What is Mrs. Gabrielle Pierce PA-C NPI number?
The NPI number assigned to this healthcare provider is 1528236932, registered as an "individual" on February 19, 2008
Where is Mrs. Gabrielle Pierce PA-C located?
The provider is located at 23 Clara Dr Suite 201 Mystic, Ct 06355 and the phone number is (860) 536-1666
Which is Mrs. Gabrielle Pierce PA-C specialty?
The provider's speciality is Physician Assistant
How many years of experience does Mrs. Gabrielle Pierce PA-C have?
The provider has more than 16 years of experience.
Is Mrs. Gabrielle Pierce PA-C registered in PECOS?
Yes, as of March 13, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare 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.
What are Mrs. Gabrielle Pierce PA-C Quality Ratings?
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.
How much is a visit to Mrs. Gabrielle Pierce PA-C?
Medicare beneficiaries should expect a typical cost of $97.18 with an average copayment of $24.29 for new patient appointments. Established patients should expect a typical charge of $79.11 and an average copayment of 19.77. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Mrs. Gabrielle Pierce PA-C?
The most common procedures or services performed by this practitioner are: Administration of influenza virus vaccine.
How do I update my NPI information?
The NPI record of Mrs. Gabrielle Pierce PA-C was last updated on February 19, 2008. 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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