DAVID W GREGG PA C NPI 1538152053

Physician Assistant in River Falls, WI

NPI 1538152053 Individual Male Years of Experience 24 Physician Assistant PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 91.5

About DAVID GREGG

David Gregg is a primary care provider established in River Falls, Wisconsin and his medical specialization is physician assistant with more than 24 years of experience. He graduated from University Of Wisconsin School Of Medicine in 1998. The NPI number of David Gregg is 1538152053 and was assigned on August 2005. The practitioner's primary taxonomy code is 363A00000X with license number 1032 (WI). The provider is registered as an individual and his NPI record was last updated 12 years ago.

A primary care provider (PCP) like David W Gregg Pa C 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

David Gregg is enrolled in PECOS and is eligible to order or refer healthcare 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

David Gregg 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 he has hospital affiliations with University Of Minnesota Medical Center, Fairview, River Falls Area Hospital and Western Wisconsin Health.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 91.5, 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: $21.4 for a new patient copayment and $17.49 for an established patient copayment.

NPI

1538152053

Provider Name DAVID W GREGG PA C
Provider Location Address1687 E DIVISION ST RIVER FALLS, WI 54022
Provider Mailing Address1687 E DIVISION ST RIVER FALLS, WI 54022
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduation Year1998
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date08-30-2005
Last Update Date02-09-2010


Primary Taxonomy

Taxonomy Code363A00000X
ClassificationPhysician Assistant
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.1032
License StateWI
Taxonomy DescriptionA 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

DAVID W GREGG PA C
1687 E DIVISION ST
RIVER FALLS, WI
ZIP 54022
Phone: (715) 425-6701
Fax: (715) 425-7075

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Mailing Address

DAVID W GREGG PA C
1687 E DIVISION ST
RIVER FALLS, WI
ZIP 54022
Phone: (715) 425-6701
Fax: (715) 425-7075



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
PECOS PAC ID7719968155
PECOS Enrollment IDI20040601000327
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 ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

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 54022 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
$55.63 $169.16 $85.6
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.9 $42.29 $21.4
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
$17.46 $138.8 $69.98
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.36 $34.7 $17.49

* 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% 98.8
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% 76
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% 72.8
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 - 91.5
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.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. David Gregg is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
UNIVERSITY OF MINNESOTA MEDICAL CENTER, FAIRVIEW2450 RIVERSIDE AVENUE
MINNEAPOLIS, MN 55454
(612) 672-6455Acute Care Hospitals240080
RIVER FALLS AREA HOSPITAL1629 E DIVISION ST
RIVER FALLS, WI 54022
(715) 307-6000Critical Access Hospitals521349
WESTERN WISCONSIN HEALTH1100 BERGSLIEN ST
BALDWIN, WI 54002
(715) 684-1111Critical Access Hospitals521347

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
41928200MEDICAID (05)WI
0024MEDICARE ID-TYPE UNSPECIFIED (04)WI
S86032MEDICARE UPIN (02)

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1821081316 GREGORY T GOBLIRSCH MD
Individual
Family Medicine1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1093708588 KERITH W LIJEWSKI MD
Individual
Family Medicine1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1104819622 JEFF D LARSEN MD
Individual
Internal Medicine1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1275526774 CATHERINE E SHOCKEY-WOLL NP
Individual
Nurse Practitioner (Obstetrics & Gynecology)1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1790778215 ROBERT B JOHNSON JR. MD
Individual
Family Medicine1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1114901915DR. THOMAS FRANCIS MONAHAN M.D.
Individual
Emergency Medicine1687 E DIVISION ST
RIVER FALLS, WI 54022
(800) 514-9204
1770696668 DEBRA M SANDERS RD CD
Individual
Dietitian, Registered1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1144507740ST. CROIX ORTHOPAEDICS, P.A.
Organization
Durable Medical Equipment & Medical Supplies1687 E DIVISION ST UNIT 2
RIVER FALLS, WI 54022
(651) 439-8807
1255324752WESTERN WISCONSIN MEDICAL ASSOCIATES
Organization
Clinic/Center (Primary Care)1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1750505913 BENJAMIN REID MORGAN MD
Individual
Internal Medicine1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1205892098 KARLYN M PETERSON CNM
Individual
Advanced Practice Midwife1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1386637882 DAVID M WILHELM MD
Individual
Family Medicine1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1144542465QUEST DIAGNOSTICS LLC IL
Organization
Clinical Medical Laboratory1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 426-3752
1063405561 DANIEL W ZIMMERMAN MD
Individual
Family Medicine1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1043203540 TIMOTHY F. STEINMETZ M.D.
Individual
Family Medicine1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1972596476 KURT A HELMRICK PA
Individual
Physician Assistant1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1093708505 KELLE O ANDERSON MD
Individual
Family Medicine1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1295700524 BRITTNEY A MATHESON PAC
Individual
Physician Assistant1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701
1144608589INFINITE HEALTH COLLABORATIVE, PA
Organization
Durable Medical Equipment & Medical Supplies1687 E DIVISION ST
RIVER FALLS, WI 54022
(651) 439-8807
1467453597 JON V. THOMAS M.D.
Individual
Otolaryngology1687 E DIVISION ST
RIVER FALLS, WI 54022
(715) 425-6701

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
The code describing 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.