DR. LUIS ALBERTO DE LA CRUZ ABRAMO M.D.
NPI 1558346494
Anesthesiology - Critical Care Medicine in Miami, FL
Quality Rating: 94.68 out of 100 score
NPI Status: Active since December 14, 2005
Contact Information
9370 SUNSET DR
SUITE A-250
MIAMI, FL
ZIP 33173
Phone: (305) 595-4510
- Individual
- Male
- Years of Experience 31
- Anesthesiology
- Critical Care Medicine
- PECOS Enrolled
- Accepts Medicare Approved Payment
- Medicare Quality Reporting
About LUIS DE LA CRUZ ABRAMO
Luis De La Cruz Abramo is a provider established in Miami, Florida and his medical specialization is Anesthesiology with a focus in critical care medicine with more than 31 years of experience. The healthcare provider is registered in the NPI registry with number 1558346494 assigned on December 2005. The practitioner's primary taxonomy code is 207LC0200X with license number ME76569 (FL). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1558346494
- Provider Name
- DR. LUIS ALBERTO DE LA CRUZ ABRAMO M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173
- Location Phone
- (305) 595-4510
- Mailing Address
- PO BOX 840207 PEMBROKE PINES, FL 33084
- Mailing Phone
- (305) 595-4510
- Medical School Name
- OTHER
- Graduation Year
- 1993
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-14-2005
- Last Update Date
- 10-05-2020
- Code Navigator
Luis De La Cruz Abramo 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 94.68, 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 following quality measures were reported for this provider: implementation of formal quality improvement methods, practice changes, or other practice improvement processes, participation in an ahrq-listed patient safety organization., participation in joint commission evaluation initiative, post-anesthetic transfer of care measure: procedure room to a post anesthesia care unit (pacu), pre-operative osa assessment, use of qcdr data for ongoing practice assessment and improvements and use of qcdr to promote standard practices, tools and processes in practice for improvement in care coordination.
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
Anesthesiology Critical Care Medicine
- Taxonomy Code
- 207LC0200X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- ME76569
- License State
- FL
- Taxonomy Description
- An anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Location Map
Secondary Locations
- 601 E Rollins St
Orlando, FL 32803
(407) 303-7283
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | ME76569 (FL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Cigna Healthcare
- Connect Bronze 0 Indiv Med Deductible - EPO
- Connect Bronze 5500 Indiv Med Deductible - EPO
- Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - EPO
- Connect Bronze 8500 Indiv Med Deductible - EPO
- Connect Bronze CMS Standard - EPO
- Connect Gold 2500 Indiv Med Deductible - EPO
- Connect Gold 500 Indiv Med Deductible - EPO
- Connect Gold CMS Standard - EPO
- Connect Silver 3000 Indiv Med Deductible - EPO
- Connect Silver 4000 Indiv Med Deductible - EPO
Molina Healthcare
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Silver 9 - HMO
Oscar Health Plan, Inc.
- Bronze Classic (Choice) - HMO
- Bronze Classic 4700 (Choice) - HMO
- Bronze Classic 4700 (Select) - HMO
- Bronze Classic PCP Saver Plus Rx Copay (Choice) - HMO
- Bronze Classic PCP Saver Plus Rx Copay (Select) - HMO
- Bronze Classic Standard (Choice) - HMO
- Bronze Classic Standard (Select) - HMO
- Bronze Elite + PCP Saver Plus (Choice) - HMO
- Bronze Elite + PCP Saver Plus (Select) - HMO
- Gold Classic Standard (Choice) - HMO
Oscar Insurance Company
- Bronze Classic - EPO
- Bronze Classic | MercyOne - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic 4700 | MercyOne - EPO
- Bronze Classic PCP Saver Plus - EPO
- Bronze Classic PCP Saver Plus | MercyOne - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard | MercyOne - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus | MercyOne - EPO
Oscar Insurance Company of Florida
- Bronze Classic - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + Specialist Saver Plus - EPO
- Bronze Elite Saver Plus - EPO
- Gold Classic - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Gold Elite Saver Plus - EPO
Blue Cross Blue Shield
Medicare
Medicaid
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State | Identifier Issuer |
---|---|---|---|
44658 | OTHER (01) | FL | BCBS |
269231700 | MEDICAID (05) | FL |
PECOS Enrollment and Medicare Participation Status
Luis De La Cruz Abramo 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: 5890777841
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: I20040603000275
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: 94.68 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: 91.42
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: 98
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.
Quality Reporting
The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
Quality Measure | Performance | Number of Patients |
---|---|---|
Implementation of formal quality improvement methods, practice changes, or other practice improvement processes | Yes | N/A |
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data. | ||
Participation in an AHRQ-listed patient safety organization. | Yes | N/A |
Participation in an AHRQ-listed patient safety organization. | ||
Participation in Joint Commission Evaluation Initiative | Yes | N/A |
Participation in Joint Commission Ongoing Professional Practice Evaluation initiative | ||
Post-Anesthetic Transfer of Care Measure: Procedure Room to a Post Anesthesia Care Unit (PACU) | 84% | 439 |
Percentage of patients, regardless of age, who are under the care of an anesthesia practitioner and are admitted to a PACU or other non-ICU location in which a post-anesthetic formal transfer of care protocol or checklist which includes the key transfer of care elements is utilized | ||
Pre-operative OSA assessment | 92% | 826 |
Percentage of patients who undergo a surgical procedure in the operating room/procedure room that have a pre-operative assessment for Obstructive Sleep Apnea (OSA) | ||
Use of QCDR data for ongoing practice assessment and improvements | Yes | N/A |
Use of QCDR data, for ongoing practice assessment and improvements in patient safety. | ||
Use of QCDR to promote standard practices, tools and processes in practice for improvement in care coordination | Yes | N/A |
Participation in a Qualified Clinical Data Registry, demonstrating performance of activities that promote use of standard practices, tools and processes for quality improvement (e.g., documented preventative screening and vaccinations that can be shared across MIPS eligible clinician or groups). |
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. Luis De La Cruz Abramo is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
BAPTIST HOSPITAL OF MIAMI | 8900 N KENDALL DR MIAMI, FL 33176 | (786) 596-1960 | Acute 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. | |||||||||
1 | 5 | 5 | 8 | 3 | 4 | 6 | 4 | 9 | 4 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 5 | 10 | 8 | 6 | 4 | 12 | 4 | 18 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 5 + 1 + 0 + 8 + 6 + 4 + 1 + 2 + 4 + 1 + 8 + 24 = 66 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 66 = 4 | 4 |
The NPI number 1558346494 is valid because the calculated check digit 4 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 |
---|---|---|---|
1831174283 | DR. STEVEN J BUKOWSKI M.D. Individual | Anesthesiology | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1265417638 | DR. HOWARD S GOLD M.D. Individual | Anesthesiology | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1760467138 | DR. PIOTR KRASUSKI M.D. Individual | Anesthesiology | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1477538841 | DR. KEVIN ANDREW KUESER M.D. Individual | Anesthesiology | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1811972136 | DR. RAFAEL MACHADO JR. M.D. Individual | Anesthesiology | 9370 SUNSET DR MIAMI, FL 33173 (305) 595-4510 |
1265417588 | DR. THOMAS FERGUS MACMAHON M.D. Individual | Anesthesiology | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1770568008 | DR. JAMAL OJI KAMAU SAMPSON M.D. Individual | Anesthesiology | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1912982265 | ALEXANDRE P BARCELLOS CRNA Individual | Nurse Anesthetist, Certified Registered | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1891770160 | JUSTIN M GILMORE CRNA Individual | Nurse Anesthetist, Certified Registered | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1417932781 | ALEXANDER GILSON CRNA Individual | Nurse Anesthetist, Certified Registered | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1518942747 | EDWARD M SALKIND CRNA Individual | Nurse Anesthetist, Certified Registered | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1083699367 | RICHARD GONZALEZ CRNA Individual | Nurse Anesthetist, Certified Registered | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1255316451 | HELEN A MANY CRNA Individual | Nurse Anesthetist, Certified Registered | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1912982133 | CAROLIN MARGIT MARIE CRNA Individual | Nurse Anesthetist, Certified Registered | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1689659815 | DORREL SMALL CRNA Individual | Nurse Anesthetist, Certified Registered | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1083699326 | DR. DANIEL ZAITMAN M.D. Individual | Anesthesiology | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1396720330 | DR. EDWARD C ABRAHAM M.D. Individual | Anesthesiology | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1437134343 | DR. GABRIEL G ALVAREZ M.D. Individual | Anesthesiology | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1275518193 | DR. JOSEPH J BOOLBOL M.D. Individual | Anesthesiology | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
1104801042 | DR. ALFREDO RICARDO FERNANDEZ M.D. Individual | Anesthesiology | 9370 SUNSET DR SUITE A-250 MIAMI, FL 33173 (305) 595-4510 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1558346494, enumerated in the NPI registry as an "individual" on December 14, 2005
The provider is located at 9370 Sunset Dr Suite A-250 Miami, Fl 33173 and the phone number is (305) 595-4510
The provider's speciality is Anesthesiology with taxonomy code 207LC0200X with a focus in Critical Care Medicine
The provider has more than 31 years of experience.
The provider might be accepting Accepts: Cigna Healthcare, Molina Healthcare, Oscar Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 10, 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 provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.
The practitioner is affiliated to the following hospital(s): BAPTIST HOSPITAL OF MIAMI. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on December 14, 2005. 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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