DR. ARA S. MAKDESSIAN M.D.
NPI 1598752248
Otolaryngology in Winchester, KY

Quality Rating: 53.1 out of 100 score

NPI Status: Active since September 27, 2005

Contact Information

225 HOSPITAL DRIVE
SUITE 265, CLARK CLINIC B
WINCHESTER, KY
ZIP 40391
Phone: (859) 745-1010

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Table of Contents

NPI Profile Information
Primary Taxonomy
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
Overall Quality Performance
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Otolaryngology
PECOS Enrolled
Medicare Quality Reporting

About ARA MAKDESSIAN

This page provides the complete NPI Profile along with additional information for Ara Makdessian, a provider established in Winchester, Kentucky with a medical specialization in Otolaryngology. The healthcare provider is registered in the NPI registry with number 1598752248 assigned on September 2005. The practitioner's primary taxonomy code is 207Y00000X with license number 39412 (KY). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI: 1598752248
Provider Name: DR. ARA S. MAKDESSIAN M.D.
Gender: Male
Entity Type: Individual
Location Address: 225 HOSPITAL DRIVE SUITE 265, CLARK CLINIC B WINCHESTER, KY 40391
Location Phone: (859) 745-1010
Mailing Address: 225 HOSPITAL DRIVE SUITE 265, CLARK CLINIC B WINCHESTER, KY 40391
Mailing Phone: (859) 745-1010
Is Sole Proprietor?: No
Enumeration Date: 09-27-2005
Last Update Date: 06-11-2024
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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: Otolaryngology
Taxonomy Code: 207Y00000X
Type: Allopathic & Osteopathic Physicians
License No.: 39412
License State: KY
Taxonomy Description: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Medicare Participation & PECOS Enrollment Status

Ara Makdessian 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: Durable Medical Equipment (DME) 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
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

DME-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
9 DME suppliers used 70 Medicare Claims 70 Services Paid
DME-Other DME (DE001N)
Full face mask used with positive airway pressure device, each (HCPCS:A7030)
10 DME suppliers used 59 Medicare Claims 59 Services Paid
DME-Other DME (DE001N)
Face mask interface, replacement for full face mask, each (HCPCS:A7031)
9 DME suppliers used 60 Medicare Claims 176 Services Paid
DME-Other DME (DE001N)
Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)
4 DME suppliers used 11 Medicare Claims 60 Services Paid
DME-Other DME (DE001N)
Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)
6 DME suppliers used 16 Medicare Claims 95 Services Paid
DME-Other DME (DE001N)
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)
8 DME suppliers used 29 Medicare Claims 29 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
11 DME suppliers used 47 Medicare Claims 47 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
12 DME suppliers used 82 Medicare Claims 476 Services Paid
DME-Other DME (DE001N)
Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)
9 DME suppliers used 35 Medicare Claims 35 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
4 DME suppliers used 71 Medicare Claims 71 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Comprehensive hearing and speech recognition test
Diagnostic exam of nasal passages using an endoscope
Diagnostic exam of voice box using a flexible endoscope
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Incision of eardrum with insertion of eardrum tube under local or topical anesthesia
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Professional service for multiple injections of allergen
Professional service for preparation and provision of 1 or more antigens
Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing
Removal of impacted ear wax
Test for allergy using allergenic extract
Test for allergy using allergenic extract injected into skin
Test to assess middle ear function

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 40391 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $122.77
Minimum New Patient Price $52.76
Maximum New Patient Price $162.27

Average New Patient Copayment $30.69
Minimum New Patient Copayment $13.19
Maximum New Patient Copayment $40.56

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $66.24
Minimum Established Patient Price $16.53
Maximum Established Patient Price $131.99

Average Established Patient Copayment $16.56
Minimum Established Patient Copayment $4.13
Maximum Established Patient Copayment $32.99

* The physician office visit costs information is generated by 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 provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 53.1, 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 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: 53.1 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: 57.82

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: 21

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 provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. 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
Care coordination agreements that promote improvements in patient tracking across settings	Yes	N/A
Establish effective care coordination and active referral management that could include one or more of the following: Establish care coordination agreements with frequently used consultants that set expectations for documented flow of information and MIPS eligible clinician or MIPS eligible clinician group expectations between settings. Provide patients with information that sets their expectations consistently with the care coordination agreements; Track patients referred to specialist through the entire process; and/or Systematically integrate information from referrals into the plan of care.
Care transition standard operational improvements	Yes	N/A
Establish standard operations to manage transitions of care that could include one or more of the following: Establish formalized lines of communication with local settings in which empaneled patients receive care to ensure documented flow of information and seamless transitions in care; and/or Partner with community or hospital-based transitional care services.
Consultation of the Prescription Drug Monitoring Program	Yes	N/A
Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance.
Documentation of Current Medications in the Medical Record	82%	3657
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Engagement of New Medicaid Patients and Follow-up	Yes	N/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.
e-Prescribing	96%	6551
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Implementation of improvements that contribute to more timely communication of test results	Yes	N/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 Loop	Yes	N/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.
Integration of patient coaching practices between visits	Yes	N/A
Provide coaching between visits with follow-up on care plan and goals.
Medication Reconciliation	87%	1688
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	52%	3450
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Practice Improvements for Bilateral Exchange of Patient Information	Yes	N/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.
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	11%	1068
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Provide Patient Access	2%	3450
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Use of certified EHR to capture patient reported outcomes	Yes	N/A
In support of improving patient access, performing additional activities that enable capture of patient reported outcomes (e.g., home blood pressure, blood glucose logs, food diaries, at-risk health factors such as tobacco or alcohol use, etc.) or patient activation measures through use of certified EHR technology, containing this data in a separate queue for clinician recognition and review.
Use of decision support and standardized treatment protocols	Yes	N/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1598752248, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 14 → 1 + 4

Pos 6

Unchanged

Pos 7

Doubled → 4

Pos 8

Unchanged

Pos 9

Doubled → 8

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 7 → 14 → 5 2 → 4 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 8 + 8 + 1 + 4 + 5 + 4 + 2 + 8 + 24 = 72

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 72 is 80. The difference is the calculated check digit.

80 - 72 = 8

This NPI is valid

The calculated check digit is 8, which matches the last digit of 1598752248.

Other Providers at the Same Location

The following 2 providers are registered at the same or a nearby location.

KENTUCKY HOSPITAL, LLC

Clinic/Center (Physical Therapy)

225 HOSPITAL DRIVE
WINCHESTER, KY 40391

Clark County (859) 737-8454

JOHN F. GREENE III M.D.

Obstetrics & Gynecology

225 HOSPITAL DRIVE, BLDG B, STE 255
WINCHESTER, KY 40391

Clark County (859) 744-2623

About ARA MAKDESSIAN

Location Map

Specialty - Primary Taxonomy

Otolaryngology

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): No

Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

Durable Medical Equipment

Areas of Expertise

Comprehensive hearing and speech recognition test

Diagnostic exam of nasal passages using an endoscope

Diagnostic exam of voice box using a flexible endoscope

Established patient office or other outpatient visit, 20-29 minutes

Established patient office or other outpatient visit, 30-39 minutes

Incision of eardrum with insertion of eardrum tube under local or topical anesthesia

New patient office or other outpatient visit, 30-44 minutes

New patient office or other outpatient visit, 45-59 minutes

Professional service for multiple injections of allergen

Professional service for preparation and provision of 1 or more antigens

Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing

Removal of impacted ear wax

Test for allergy using allergenic extract

Test for allergy using allergenic extract injected into skin

Test to assess middle ear function

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Overall MIPS Quality Performance

Final Score: 53.1 out of 100

Quality Score: 57.82

Promoting Interoperability Score: 21

Improvement Activities Score: 40

Cost Score: N/A

Cost Score: N/A

Quality Reporting

Reviews for DR. ARA S. MAKDESSIAN M.D.

NPI NPI Number Validation

How NPI Validation Works

Digit-by-digit view

Step 1: Double every other digit from the right

Step 2: Add all digits plus the NPI constant

Step 3: Find the amount needed to reach the next multiple of 10

Other Providers at the Same Location

Frequently Asked Questions

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