DR. RYAN WILLIAM HESS MD
NPI 1548467970
Orthopaedic Surgery - Sports Medicine in Robbinsdale, MN


Quality Rating: 15 out of 100 score

NPI Status: Active since June 29, 2007

Contact Information

3366 OAKDALE AVE N
SUITE 103
ROBBINSDALE, MN
ZIP 55422
Phone: (763) 520-7870
Fax: (763) 520-7580

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  • Individual
  • Male
  • Years of Experience 18
  • Orthopaedic Surgery
  • Sports Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About RYAN HESS

Ryan Hess is a provider established in Robbinsdale, Minnesota and his medical specialization is Orthopaedic Surgery with a focus in sports medicine with more than 18 years of experience. He graduated from Medical College Of Wisconsin in 2007. The healthcare provider is registered in the NPI registry with number 1548467970 assigned on June 2007. The practitioner's primary taxonomy code is 207XX0005X with license number 109279 (MN). The provider is registered as an individual and his NPI record was last updated 8 years ago.

NPI
1548467970
Provider Name
DR. RYAN WILLIAM HESS MD
Gender
Male
Entity Type
Individual
Location Address
3366 OAKDALE AVE N SUITE 103 ROBBINSDALE, MN 55422
Location Phone
(763) 520-7870
Location Fax
(763) 520-7580
Mailing Address
4200 DAHLBERG DR SUITE 300 GOLDEN VALLEY, MN 55422
Mailing Phone
(952) 512-5600
Mailing Fax
(763) 520-7580
Medical School Name
MEDICAL COLLEGE OF WISCONSIN
Graduation Year
2007
Is Sole Proprietor?
No
Enumeration Date
06-29-2007
Last Update Date
09-01-2016
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Ryan Hess is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 15, 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.

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

Orthopaedic Surgery Sports Medicine

Taxonomy Code
207XX0005X
Type
Allopathic & Osteopathic Physicians
License No.
109279
License State
MN
Taxonomy Description
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

Insurance Plans Accepted

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

  • HealthPartners

    • Atlas $1,000 w/Copay P-S Gold - PPO
    • Atlas $1,500 w/Copay P-S Gold - PPO
    • Atlas $3,000 w/Copay P-S Silver - PPO
    • Atlas $3,200 Plus Silver - PPO
    • Atlas $3,800 HSA Silver - PPO
    • Atlas $5,900 w/Copay P-S Silver - PPO
    • Atlas $6,350 Plus Bronze - PPO
    • Atlas $7,500 w/Copay P-S Bronze - PPO
    • Atlas $8,000 HSA Bronze - PPO
    • Atlas $9,450 Catastrophic - PPO
  • Medica

    • Medica Individual Choice Bronze Copay - EPO
    • Medica Individual Choice Bronze Copay $0 PCP - HMO
    • Medica Individual Choice Bronze HSA - EPO
    • Medica Individual Choice Bronze Share Plus - EPO
    • Medica Individual Choice Bronze Share Plus - HMO
    • Medica Individual Choice Bronze Standard - EPO
    • Medica Individual Choice Bronze Standard - HMO
    • Medica Individual Choice Catastrophic - HMO
    • Medica Individual Choice Expanded Bronze Standard - EPO
    • Medica Individual Choice Expanded Bronze Standard - HMO
    • Medica Individual Choice Gold Copay - EPO
    • Medica Individual Choice Gold Copay $0 PCP - HMO
    • Medica Individual Choice Gold Standard - EPO
    • Medica Individual Choice Gold Standard - HMO
    • Medica Individual Choice Silver Copay $0 PCP - HMO
    • Medica Individual Choice Silver Share - EPO
    • Medica Individual Choice Silver Standard - EPO
    • Medica Individual Choice Silver Standard - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

PECOS Enrollment and Medicare Participation Status

Ryan Hess 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: 4385890391

    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: I20160920000085

    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? 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 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

Overall MIPS Quality 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: 15 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: 0

    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: 0

    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: 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 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.

Clinician Services

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 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 27

    Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)

  • 25

    X-ray of shoulder, minimum of 2 views (HCPCS:73030)

  • 21

    X-ray of knee, 4 or more views (HCPCS:73564)

Hospital Affiliations

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. Ryan Hess is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
NORTH MEMORIAL HEALTH HOSPITAL3300 OAKDALE NORTH
ROBBINSDALE, MN 55422
(763) 520-5200Acute Care Hospitals

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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.
1548467970
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
25888614914
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 8 + 8 + 8 + 6 + 1 + 4 + 9 + 1 + 4 + 24 = 80
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1548467970 is valid because the calculated check digit 0 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
1720066582 DEAN W STENSRUD OD
Individual
Optometrist3366 OAKDALE AVE N SUITE 402
ROBBINSDALE, MN 55422
(763) 416-7600
1396712022DR. STELLA K. EVANS M.D.
Individual
Pediatrics3366 OAKDALE AVE N #501
ROBBINSDALE, MN 55422
(763) 588-0758
1265409940DR. FATIMA R. JIWA MBCHB
Individual
Pediatrics3366 OAKDALE AVE N #501
ROBBINSDALE, MN 55422
(763) 588-0758
1649249764 MARY ANN ELIZABETH KISH MD
Individual
Internal Medicine (Infectious Disease)3366 OAKDALE AVE N SUITE 200 MAIL STOP 33500A
ROBBINSDALE, MN 55422
(763) 287-5000
1063481133 STEVEN T MESTITZ MD
Individual
Surgery3366 OAKDALE AVE N SUITE 200 MAIL STOP 33500A
ROBBINSDALE, MN 55422
(763) 287-5000
1245209386 JANE D. SPENCER PNP
Individual
Nurse Practitioner (Pediatrics)3366 OAKDALE AVE N #501
ROBBINSDALE, MN 55422
(763) 588-0758
1942279492MRS. TERRI ANN PETERSON OTR, CMLDT
Individual
Occupational Therapist3366 OAKDALE AVE N SUITE 312
ROBBINSDALE, MN 55422
(763) 521-3256
1518927326MRS. JACALYN JEANNE BEILER PA-C
Individual
Physician Assistant3366 OAKDALE AVE N SUITE 200 MAIL STOP 33500A
ROBBINSDALE, MN 55422
(763) 287-5000
1316998834DR. JOSEPH CHARLES CERNY JR. M.D.
Individual
Urology3366 OAKDALE AVE N SUITE 409
ROBBINSDALE, MN 55422
(763) 520-7700
1396785002DR. LISA ERHARD M.D.
Individual
Obstetrics & Gynecology3366 OAKDALE AVE N SUITE 450
ROBBINSDALE, MN 55422
(763) 587-7000
1912942525 KAREN ELAINE RILEY PA
Individual
Physician Assistant3366 OAKDALE AVE N SUITE 315
ROBBINSDALE, MN 55422
(763) 520-7900
1922044809 KAREN LOUISE LADIN NP
Individual
Nurse Practitioner (Women's Health)3366 OAKDALE AVE N SUITE 315
ROBBINSDALE, MN 55422
(763) 587-7900
1699711234 ERIC J GILSTER MD
Individual
Obstetrics & Gynecology3366 OAKDALE AVE N SUITE 315
ROBBINSDALE, MN 55422
(763) 520-7900
1669408886 KELLEY RAE SALO MD
Individual
Internal Medicine3366 OAKDALE AVE N SUITE 315
ROBBINSDALE, MN 55422
(763) 587-7900
1063448330 JERROLD MARTIN STEMPEL MD
Individual
Internal Medicine (Gastroenterology)3366 OAKDALE AVE N SUITE 315
ROBBINSDALE, MN 55422
(763) 520-7900
1023044484 RENEE K DOERING G.N.P
Individual
Nurse Practitioner (Gerontology)3366 OAKDALE AVE N SUITE 315
ROBBINSDALE, MN 55422
(763) 587-7900
1760419741 THOMAS B KOENIG M.D.
Individual
Internal Medicine (Gastroenterology)3366 OAKDALE AVE N SUITE 315
ROBBINSDALE, MN 55422
(763) 520-7900
1750319455 MARK R HAGSTROM MD
Individual
Family Medicine3366 OAKDALE AVE N SUITE 315
ROBBINSDALE, MN 55422
(763) 520-7900
1962430694 BARBARA MARIE MCGLENNEN GNP
Individual
Nurse Practitioner (Gerontology)3366 OAKDALE AVE N SUITE 315
ROBBINSDALE, MN 55422
(763) 587-7900
1679501696 BEN R BACHE-WIIG M.D.
Individual
Internal Medicine3366 OAKDALE AVE N SUITE 315
ROBBINSDALE, MN 55422
(763) 520-7900

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1548467970, enumerated in the NPI registry as an "individual" on June 29, 2007

The provider is located at 3366 Oakdale Ave N Suite 103 Robbinsdale, Mn 55422 and the phone number is (763) 520-7870

The provider's speciality is Orthopaedic Surgery with taxonomy code 207XX0005X with a focus in Sports Medicine

The provider has more than 18 years of experience. He graduated from Medical College Of Wisconsin in 2007.

The provider might be accepting Accepts: HealthPartners and Medica. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of July 16, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a 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.

The most common procedures or services performed by this practitioner are: Aspiration and/or injection of large joint or joint capsule, X-ray of shoulder, minimum of 2 views and X-ray of knee, 4 or more views.

The practitioner is affiliated to the following hospital(s): NORTH MEMORIAL HEALTH HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 29, 2007. 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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