DR. CRAIG D KESACK M.D. NPI 1558355065
Radiology - Diagnostic Radiology in Doylestown, PA
About DR. CRAIG D KESACK M.D.
Craig Kesack is a provider established in Doylestown, Pennsylvania and his medical specialization is Radiology with a focus in diagnostic radiology with more than 34 years of experience. He graduated from Pennsylvania State University College Of Medicine in 1989. The NPI number of this provider is 1558355065 and was assigned on September 2005. The practitioner's primary taxonomy code is 2085R0202X with license number MD046425L (PA). The provider is registered as an individual and his NPI record was last updated 14 years ago.
| NPI | 1558355065 |
| Provider Name | DR. CRAIG D KESACK M.D. |
| Location Address | 595 W STATE ST DOYLESTOWN, PA 18901 |
| Location Phone | (215) 345-2290 |
| Mailing Address | PO BOX 892 CONCORDVILLE, PA 19331 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 1989 |
| Is Sole Proprietor? | No |
| Enumeration Date | 09-12-2005 |
| Last Update Date | 06-19-2009 |
Craig Kesack 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.
Craig Kesack 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 Doylestown 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 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 following quality measures were reported for this provider: .
The typical physician office visit costs for Medicare beneficiaries in this area are: $24.07 for a new patient copayment and $19.55 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 | 2085R0202X |
| Classification | Radiology |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | Diagnostic Radiology |
| License No. | MD046425L |
| License State | PA |
| Taxonomy Description | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
595 W STATE ST
DOYLESTOWN, PA
ZIP 18901
Phone: (215) 345-2290
Fax: (215) 345-2596
Mailing Address
PO BOX 892
CONCORDVILLE, PA
ZIP 19331
Phone: (610) 372-4957
Fax: (610) 372-3117
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 | 9638158868 |
| PECOS Enrollment ID | I20040720000480 |
| 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 18901 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 |
| $62.8 | $189.43 | $96.31 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $15.7 | $47.35 | $24.07 |
| 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 |
| $19.68 | $154.62 | $78.22 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.92 | $38.65 | $19.55 |
* 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% | 90 | |
|
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% | 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. |
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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 | - | 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. | |||
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 |
|---|
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.
- 408X-ray of chest, 1 view (HCPCS:71045)
- 318X-ray of chest, 2 views (HCPCS:71046)
- 226Ct scan head or brain (HCPCS:70450)
- 86Ct scan of abdomen and pelvis (HCPCS:74176)
- 80Ct scan of abdomen and pelvis with contrast (HCPCS:74177)
- 57X-ray of hip with pelvis, 2-3 views (HCPCS:73502)
- 52Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers (HCPCS:93971)
- 43Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)
- 40Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers (HCPCS:93970)
- 26X-ray of shoulder, minimum of 2 views (HCPCS:73030)
- 23Ct scan chest (HCPCS:71250)
- 20X-ray of knee, 4 or more views (HCPCS:73564)
- 20X-ray of foot, minimum of 3 views (HCPCS:73630)
- 14Ultrasound of head and neck (HCPCS:76536)
- 14X-ray of wrist, minimum of 3 views (HCPCS:73110)
- 12X-ray of hand, minimum of 3 views (HCPCS:73130)
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. Craig Kesack is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| DOYLESTOWN HOSPITAL | 595 WEST STATE ST DOYLESTOWN, PA 18901 | (215) 345-2200 | Acute Care Hospitals | 390203 |
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 |
|---|---|---|
| 759191SU0 | MEDICARE PIN (08) | PA |
| 300083541 | MEDICARE PIN (08) | PA |
| 759191GG5 | MEDICARE PIN (08) | PA |
| F63362 | MEDICARE UPIN (02) |
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 | 5 | 5 | 0 | 6 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 10 | 8 | 6 | 5 | 10 | 0 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 0 + 8 + 6 + 5 + 1 + 0 + 0 + 1 + 2 + 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 = 5 | 5 | ||||||||
The NPI number 1558355065 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 |
|---|---|---|---|
| 1306830815 | DR. EUGENE H HUNT M.D. Individual | Radiology (Diagnostic Radiology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2290 |
| 1598750028 | DR. MARK S SILIDKER M.D. Individual | Radiology (Diagnostic Radiology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2290 |
| 1093709503 | DR. PAUL J ADELIZZI M.D. Individual | Radiology (Diagnostic Radiology) | 595 W STATE ST RADIOLOGY DEPT DOYLESTOWN, PA 18901 (215) 345-2290 |
| 1205824026 | DR. ANDREA CANDIA M.D. Individual | Radiology (Diagnostic Radiology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2290 |
| 1053309773 | DR. BRIAN S POLESUK MD Individual | Radiology (Diagnostic Radiology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2290 |
| 1679561336 | DR. PRAMOD DIGAMBER M.D. Individual | Radiology (Diagnostic Radiology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2290 |
| 1093703753 | DR. RONALD J COSTANZO M.D. Individual | Radiology (Diagnostic Radiology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2290 |
| 1093703787 | DR. SCOTT K PRICE M.D. Individual | Radiology (Diagnostic Radiology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2290 |
| 1811985500 | DR. GEORGE G BRACKIN M.D. Individual | Radiology (Diagnostic Radiology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2290 |
| 1861480311 | DR. RAJESH RAI M.D. Individual | Radiology (Diagnostic Radiology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2290 |
| 1437149879 | DR. DONALD E PARLEE M.D. Individual | Radiology (Diagnostic Radiology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2290 |
| 1700858867 | JOSEPH J MCHUGH MD Individual | Emergency Medicine | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2362 |
| 1174595227 | ROBERT W LINKENHEIMER DO Individual | Emergency Medicine | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2673 |
| 1083686133 | EDWARD G KUBOVSAK MD Individual | Emergency Medicine | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2362 |
| 1932171717 | STEPHEN J GAZAK MD Individual | Emergency Medicine | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2362 |
| 1568434165 | MARK CHOI MD Individual | Emergency Medicine | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2362 |
| 1225091697 | DOYLESTOWN HOSPITAL Organization | General Acute Care Hospital | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2321 |
| 1649210220 | ROBERT J TROTTA MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2250 |
| 1477596195 | ROSE M KENNY MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2250 |
| 1760427728 | TODD H BROAD MD Individual | Anesthesiology | 595 W STATE ST DOYLESTOWN, PA 18901 (215) 345-2200 |
Frequently Asked Questions
What is Dr. Craig Kesack M.D. NPI number?
The NPI number assigned to this healthcare provider is 1558355065, registered as an "individual" on September 12, 2005
Where is Dr. Craig Kesack M.D. located?
The provider is located at 595 W State St Doylestown, Pa 18901 and the phone number is (215) 345-2290
Which is Dr. Craig Kesack M.D. specialty?
The provider's speciality is Radiology with a focus in Diagnostic Radiology
How many years of experience does Dr. Craig Kesack M.D. have?
The provider has more than 34 years of experience. He graduated from Pennsylvania State University College Of Medicine in 1989.
What insurance does Dr. Craig Kesack M.D. accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Dr. Craig Kesack M.D. registered in PECOS?
Yes, as of May 11, 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 Dr. Craig Kesack M.D. 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 Dr. Craig Kesack M.D.?
Medicare beneficiaries should expect a typical cost of $96.31 with an average copayment of $24.07 for new patient appointments. Established patients should expect a typical charge of $78.22 and an average copayment of 19.55. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Dr. Craig Kesack M.D.?
The most common procedures or services performed by this practitioner are: X-ray of chest, 1 view, X-ray of chest, 2 views, Ct scan head or brain, Ct scan of abdomen and pelvis, Ct scan of abdomen and pelvis with contrast, X-ray of hip with pelvis, 2-3 views, Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers, Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck, Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers, X-ray of shoulder, minimum of 2 views, Ct scan chest, X-ray of knee, 4 or more views, X-ray of foot, minimum of 3 views, Ultrasound of head and neck, X-ray of wrist, minimum of 3 views and X-ray of hand, minimum of 3 views.
Is Dr. Craig Kesack M.D. affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: DOYLESTOWN HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
The NPI record of Dr. Craig Kesack M.D. was last updated on September 12, 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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