DR. CAROLYN MARY LOBO M.D., NPI 1588711709
Surgery in Pinole, CA

About DR. CAROLYN MARY LOBO M.D.,

Carolyn Lobo is a provider established in Pinole, California and her medical specialization is Surgery with more than 35 years of experience. The NPI number of Carolyn Lobo is 1588711709 and was assigned on January 2007. The practitioner's primary taxonomy code is 208600000X with license number A63239 (CA). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI
1588711709
Provider NameDR. CAROLYN MARY LOBO M.D.,
Location Address1430 TARA HILLS DR PINOLE, CA 94564
Location Phone(510) 724-3768
Mailing AddressPO BOX 5068 GLENDALE, CA 91221
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1988
Is Sole Proprietor?No
Enumeration Date01-03-2007
Last Update Date05-06-2022

A surgeon like Dr. Carolyn Mary Lobo M.d., treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.Carolyn Lobo 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.

Carolyn Lobo 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.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 96.9, 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: preventive care and screening: body mass index (bmi) screening and follow-up plan.

The typical physician office visit costs for Medicare beneficiaries in this area are: $26.51 for a new patient copayment and $21.68 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 Code208600000X
ClassificationSurgery
TypeAllopathic & Osteopathic Physicians
License No.A63239
License StateCA
Taxonomy DescriptionA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

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

Business Address

DR. CAROLYN MARY LOBO M.D.,
1430 TARA HILLS DR
PINOLE, CA
ZIP 94564
Phone: (510) 724-3768
Fax: (435) 578-7062

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Mailing Address

DR. CAROLYN MARY LOBO M.D.,
PO BOX 5068
GLENDALE, CA
ZIP 91221
Phone: (818) 242-3333
Fax: (818) 552-2722


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 ID749362937
PECOS Enrollment IDI20080126000168
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 94564 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
$69.92 $206.38 $106.04
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$17.48 $51.59 $26.51
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
$22.97 $169.96 $86.73
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.74 $42.49 $21.68

* 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% 96.4
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 - 96.9
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
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 73% 240
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2

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
00A632390MEDICAID (05)CA

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.
1588711709
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
25168141270
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 1 + 6 + 8 + 1 + 4 + 1 + 2 + 7 + 0 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 99

The NPI number 1588711709 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 8 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1265517734DR. MICHAEL J.H. MCDONALD D.M.D.
Individual
Dentist (Oral and Maxillofacial Surgery)1430 TARA HILLS DR SUITE B
PINOLE, CA 94564
(510) 724-5064
1346374378 STUART J GOURLAY MD
Individual
Surgery1430 TARA HILLS DR STE. D
PINOLE, CA 94564
(510) 724-5714
1235357450CAROLYN M. LOBO, M.D., INC.
Organization
Surgery1430 TARA HILLS DR SUITE A
PINOLE, CA 94564
(510) 724-3768
1104093897DR. CAROLYN L. YU DDS
Individual
Dentist (General Practice)1430 TARA HILLS DR SUITE C
PINOLE, CA 94564
(510) 724-8001
1306274980CAROLYN L. YU, DDS, INC
Organization
Clinic/Center (Dental)1430 TARA HILLS DR SUITE C
PINOLE, CA 94564
(510) 724-8001
1902262710GARY B. MARCUS, M.D. - A PROFESSIONAL CORPORATION
Organization
Specialist1430 TARA HILLS DR SUITE A
PINOLE, CA 94564
(510) 640-0019
1013092584MICHAEL J.H. MCDONALD DMD,INC
Organization
Dentist (Oral and Maxillofacial Surgery)1430 TARA HILLS DR SUITE B
PINOLE, CA 94564
(510) 724-5064
1639203672EAST BAY SURGICAL ASSOCIATES MEDICAL GROUP
Organization
Surgery1430 TARA HILLS DR STE D
PINOLE, CA 94564
(510) 724-5714

Frequently Asked Questions

What is Dr. Carolyn Lobo M.D., NPI number?

The NPI number assigned to Dr. Carolyn Lobo M.D., is 1588711709, registered as an "individual" on January 03, 2007

Where is Dr. Carolyn Lobo M.D., located?

The provider is located at 1430 Tara Hills Dr Pinole, Ca 94564 and the phone number is (510) 724-3768

Which is Dr. Carolyn Lobo M.D., specialty?

The provider's speciality is Surgery

How many years of experience does Dr. Carolyn Lobo M.D., have?

The provider has more than 35 years of experience.

What insurance does Dr. Carolyn Lobo M.D., accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Dr. Carolyn Lobo M.D., registered in PECOS?

Yes, as of January 10, 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. Carolyn Lobo 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. Carolyn Lobo M.D.,?

Medicare beneficiaries should expect a typical cost of $106.04 with an average copayment of $26.51 for new patient appointments. Established patients should expect a typical charge of $86.73 and an average copayment of 21.68. Please review your insurance plan or contact the provider directly to determine your specific costs.

How do I update my NPI information?

The NPI record of Dr. Carolyn Lobo M.D., was last updated on January 03, 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]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]