DR. NEIL D KOBROSKY MD NPI 1558308205

Internal Medicine - Endocrinology, Diabetes & Metabolism in Gloucester, MA

Individual Male Years of Experience 41 Internal Medicine Endocrinology, Diabetes & Metabolism PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 84.7 Medicare Quality Reporting

About DR. NEIL D KOBROSKY MD

Neil Kobrosky is an internist established in Gloucester, Massachusetts and his medical specialization is Internal Medicine with a focus in endocrinology, diabetes & metabolism with more than 41 years of experience. He graduated from University Of Massachusetts Medical School in 1982. The NPI number of Neil Kobrosky is 1558308205 and was assigned on June 2006. The practitioner's primary taxonomy code is 207RE0101X with license number 54501 (MA). The provider is registered as an individual and his NPI record was last updated 13 years ago.

An internist like Dr. Neil D Kobrosky Md is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

NPI

1558308205

Provider NameDR. NEIL D KOBROSKY MD
Provider Location Address298 WASHINGTON ST ADDISON GILBERT HOSPITAL GLOUCESTER, MA 01930
Provider Mailing Address85 EASTERN AVE GLOUCESTER, MA 01930
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
Graduation Year1982
Is Sole Proprietor?Yes
Enumeration Date06-01-2006
Last Update Date11-17-2009



Neil Kobrosky 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.

Neil Kobrosky 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 Northeast Hospital Corporation, Anna Jaques Hospital, North Shore Medical Center -, Lahey Hospital & Medical Center, Burlington and Portsmouth Regional Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 84.7, 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: chronic care and preventative care management for empaneled patients, comprehensive eye exams, engagement of new medicaid patients and follow-up, glycemic management services, glycemic referring services, implementation of episodic care management practice improvements, implementation of improvements that contribute to more timely communication of test results, implementation of use of specialist reports back to referring clinician or group to close referral loop, practice improvements for bilateral exchange of patient information and tobacco use.

The typical physician office visit costs for Medicare beneficiaries in this area are: $35.07 for a new patient copayment and $27.15 for an established patient copayment.



Primary Taxonomy

Taxonomy Code207RE0101X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationEndocrinology, Diabetes & Metabolism
License No.54501
License StateMA
Taxonomy DescriptionAn internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Business Address

DR. NEIL D KOBROSKY MD
298 WASHINGTON ST
ADDISON GILBERT HOSPITAL
GLOUCESTER, MA
ZIP 01930
Phone: (978) 283-4000
Fax: (978) 282-0663

Get Directions


Mailing Address

DR. NEIL D KOBROSKY MD
85 EASTERN AVE
GLOUCESTER, MA
ZIP 01930
Phone: (978) 281-6890
Fax: (978) 281-0932


PECOS Enrollment and 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 ID7012934946
PECOS Enrollment IDI20051029000021
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 01930 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$61.32 $185.12 $140.28
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.33 $46.28 $35.07
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$19.31 $151.47 $108.63
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.82 $37.86 $27.15

* 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% 78.7
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% 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 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% 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.
MIPS Final Score - 84.7
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.

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
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
In order to receive credit for this activity, a MIPS eligible clinician must manage chronic and preventive care for empaneled patients (that is, patients assigned to care teams for the purpose of population health management), which could include one or more of the following actions:-   Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions;-   Use evidence based, condition-specific pathways for care of chronic conditions (for example, hypertension, diabetes, depression, asthma, and heart failure). These might include, but are not limited to, the NCQA Diabetes Recognition Program (DRP)93 and the NCQA Heart/Stroke Recognition Program (HSRP)94;-   Use pre-visit planning, that is, preparations for conversations or actions to propose with patient before an in-office visit to optimize preventive care and team management of patients with chronic conditions;-   Use panel support tools, (that is, registry functionality) or other technology that can use clinical data to identify trends or data points in patient records to identify services due;-   Use predictive analytical models to predict risk, onset and progression of chronic diseases; and/orUse reminders and outreach (e.g., phone calls, emails, postcards, patient portals, and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Comprehensive Eye ExamsYesN/A
In order to receive credit for this activity, MIPS eligible clinicians must promote the importance of a comprehensive eye exam, which may be accomplished by providing literature and/or facilitating a conversation about this topic using resources such as the "Think About Your Eyes" campaign72 and/or referring patients to resources providing no-cost eye exams, such as the American Academy of Ophthalmology's EyeCare America73 and the American Optometric Association's VISION USA74. This activity is intended for: (1) non- ophthalmologists / optometrist who refer patients to an ophthalmologist/optometrist; (2) ophthalmologists/optometrists caring for underserved patients at no cost; or (3) any clinician providing literature and/or resources on this topic. This activity must be targeted at underserved and/or high- risk populations that would benefit from engagement regarding their eye health with the aim of improving their access to comprehensive eye exams.
Engagement of New Medicaid Patients and Follow-upYesN/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
Glycemic management servicesYesN/A
For outpatient Medicare beneficiaries with diabetes and who are prescribed antidiabetic agents (e.g., insulin, sulfonylureas), MIPS eligible clinicians and groups must attest to having: For the first performance year, at least 60 percent of medical records with documentation of an individualized glycemic treatment goal that: a) Takes into account patient-specific factors, including, at least 1) age, 2) comorbidities, and 3) risk for hypoglycemia, andb) Is reassessed at least annually.The performance threshold will increase to 75 percent for the second performance year and onward.Clinician would attest that, 60 percent for first year, or 75 percent for the second year, of their medical records that document individualized glycemic treatment represent patients who are being treated for at least 90 days during the performance period.
Glycemic Referring ServicesYesN/A
For at-risk outpatient Medicare beneficiaries, individual MIPS eligible clinicians and groups must attest to implementation of systematic preventive approaches in clinical practice for at least 60 percent for the CY 2018 performance period and 75 percent in future years, of medical records with documentation of referring eligible patients with prediabetes to a CDC-recognized diabetes prevention program operating under the framework of the National Diabetes Prevention Program.
Implementation of episodic care management practice improvementsYesN/A
Provide episodic care management, including management across transitions and referrals that could include one or more of the following:Routine and timely follow-up to hospitalizations, ED visits and stays in other institutional settings, including symptom and disease management, and medication reconciliation and management; and/orManaging care intensively through new diagnoses, injuries and exacerbations of illness.
Implementation of improvements that contribute to more timely communication of test resultsYesN/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral LoopYesN/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.
Practice Improvements for Bilateral Exchange of Patient InformationYesN/A
Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: - Participate in a Health Information Exchange if available; and/or - Use structured referral notes.
Tobacco useYesN/A
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence.

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. Neil Kobrosky is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
NORTHEAST HOSPITAL CORPORATION85 HERRICK STREET
BEVERLY, MA 1915
(978) 922-3000Acute Care Hospitals220033
ANNA JAQUES HOSPITAL25 HIGHLAND AVENUE
NEWBURYPORT, MA 1950
(978) 463-1000Acute Care Hospitals220029
NORTH SHORE MEDICAL CENTER -81 HIGHLAND AVENUE
SALEM, MA 1970
(978) 741-1215Acute Care Hospitals220035
LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON41 & 45 MALL ROAD
BURLINGTON, MA 1803
(781) 744-5100Acute Care Hospitals220171
PORTSMOUTH REGIONAL HOSPITAL333 BORTHWICK AVE
PORTSMOUTH, NH 3801
(603) 436-5110Acute Care Hospitals300029

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 Identifier Issuer
E10134MEDICARE UPIN (02)
110029028OTHER (01)PALMETTO
51998OTHER (01)AETNA
31979OTHER (01)FALLON
3050122MEDICAID (05)MA
61683OTHER (01)MAPILGRIM
5015917OTHER (01)CHAMPUS
713905OTHER (01)MATUFTS
J08423MEDICARE ID-TYPE UNSPECIFIED (04)MA

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.
1558308205
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
25108601620
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 1 + 0 + 8 + 6 + 0 + 1 + 6 + 2 + 0 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1558308205 is valid because the calculated check digit 5 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
1235196759 EMILY B REULET NP
Individual
Nurse Practitioner (Pediatrics)298 WASHINGTON ST BABSON PROFESSIONAL BUILDING
GLOUCESTER, MA 01930
(978) 283-5079
1255374518 ZAVEN E JOUHOURIAN MD
Individual
Internal Medicine298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 281-4550
1649299132MR. RODERICK FORBES MCKENZIE II LPN, LADCII, CCDN
Individual
Counselor (Addiction (Substance Use Disorder))298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-4001
1962516369 CAROL SUE YENAWINE MSW
Individual
Social Worker (Clinical)298 WASHINGTON ST C/O HEALTH & EDUCATION SERVICES, INC.
GLOUCESTER, MA 01930
(978) 283-0296
1417064692MS. MARGARET O'NEILL LCSW
Individual
Social Worker (Clinical)298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-0296
1144337080MS. ESTHER MEADER SCANLAN I LICSW
Individual
Social Worker (Clinical)298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-0296
1518074269MS. GERI DAVIS LMHC
Individual
Counselor (Mental Health)298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-0296
1336256049MRS. JOAN NELSON LOW CADACII & LADC I
Individual
Counselor (Addiction (Substance Use Disorder))298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-0296
1396854287 DAVID J. BOOKBINDER M.ED.
Individual
Counselor298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-0296
1497842793DR. DANIEL HUGH SHEA M.D.
Individual
Internal Medicine298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 282-0676
1538256532DR. AMY BONNER ESDALE MD
Individual
Family Medicine298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-2726
1639269848MISS JENNIE H. ALBERTSON LICSW
Individual
Social Worker (Clinical)298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 281-2400
1770665770MR. DENNIS JAY EIGEN LMHC, LADC
Individual
Counselor (Addiction (Substance Use Disorder))298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 298-4001
1982767075 BRENDA E RICHARDSON M.D.
Individual
Internal Medicine298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-4000
1962558825MRS. NORMA A COONEY LICSW
Individual
Counselor (Mental Health)298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-0296
1912048901 WENDY D STEVENSON P.T.
Individual
Physical Therapist298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-4001
1265560478MS. SALLY SMITHWICK MA
Individual
Counselor (Mental Health)298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-0296
1639209265MR. MARC ANDRE MESSIER MSW,LICSW
Individual
Counselor (Mental Health)298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-0296
1992925002MS. JODI W. SMITH MED
Individual
Counselor (Mental Health)298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-0296
1376764225 KIM GRAHAM NP-C
Individual
Nurse Practitioner298 WASHINGTON ST
GLOUCESTER, MA 01930
(978) 283-7580

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
Dr. Neil D Kobrosky Md is registered as an entity type code: 1. The entity type code describes 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.