DR. NAYYER ALI M.D. NPI 1629028048

Specialist in Long Beach, CA

Individual Male Years of Experience 34 Specialist PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 30 Medicare Quality Reporting

About DR. NAYYER ALI M.D.

Nayyer Ali is a provider established in Long Beach, California and his medical specialization is Specialist with more than 34 years of experience. He graduated from Washington University School Of Medicine in 1989. The NPI number of Nayyer Ali is 1629028048 and was assigned on May 2006. The practitioner's primary taxonomy code is 174400000X with license number G69091 (CA). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI

1629028048

Provider NameDR. NAYYER ALI M.D.
Provider Location Address701 E 28TH ST STE 400 LONG BEACH, CA 90806
Provider Mailing Address19601 DEARBORNE CIR HUNTINGTON BEACH, CA 92648
GenderMale
NPI Entity TypeIndividual
Medical School NameWASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year1989
Is Sole Proprietor?N/A
Enumeration Date05-10-2006
Last Update Date07-09-2007



Nayyer Ali 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.

Nayyer Ali 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 St Mary Medical Center and Long Beach Memorial Medical Center.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 30, 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: annual registration in the prescription drug monitoring program and security risk analysis.



Primary Taxonomy

Taxonomy Code174400000X
ClassificationSpecialist
TypeOther Service Providers
License No.G69091
License StateCA
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Business Address

DR. NAYYER ALI M.D.
701 E 28TH ST
STE 400
LONG BEACH, CA
ZIP 90806
Phone: (562) 424-6040
Fax: (562) 427-2565

Get Directions


Mailing Address

DR. NAYYER ALI M.D.
19601 DEARBORNE CIR
HUNTINGTON BEACH, CA
ZIP 92648
Phone: (562) 424-6040


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 ID9234186412
PECOS Enrollment IDI20050401000672
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

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% N/A
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% N/A
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 - 30
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
Annual registration in the Prescription Drug Monitoring ProgramYesN/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Security Risk AnalysisYesN/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.

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.

  • 30Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple (HCPCS:G0180)
  • 24Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration (HCPCS:94060)
  • 24Measurement of lung diffusing capacity (HCPCS:94729)
  • 23Insertion of central venous catheter for infusion, patient 5 years or older (HCPCS:36556)
  • 14Administration of influenza virus vaccine (HCPCS:G0008)

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. Nayyer Ali is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
ST MARY MEDICAL CENTER1050 LINDEN AVE
LONG BEACH, CA 90813
(562) 491-9000Acute Care Hospitals50191
LONG BEACH MEMORIAL MEDICAL CENTER2801 ATLANTIC AVE
LONG BEACH, CA 90806
(562) 933-2000Acute Care Hospitals50485

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
WG69091GMEDICARE ID-TYPE UNSPECIFIED (04)CAMCARE PROVIDER NO
00G690910MEDICAID (05)CA
E94632MEDICARE UPIN (02)CA
G69091OTHER (01)CAB/S PROVIDER NO

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.
1629028048
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2649021608
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 4 + 9 + 0 + 2 + 1 + 6 + 0 + 8 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 88

The NPI number 1629028048 is valid because the calculated check digit 8 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
1144201138MS. PATRICIA J GAMBOL APNG
Individual
Clinical Nurse Specialist701 E 28TH ST SUITE 412
LONG BEACH, CA 90806
(562) 933-7874
1700837457 MICHAEL B. STRAUSS MD
Individual
Orthopaedic Surgery701 E 28TH ST SUITE 416
LONG BEACH, CA 90806
(562) 427-5823
1851343081 GRETCHEN STIPEC M.D.
Individual
Radiology (Diagnostic Radiology)701 E 28TH ST STE 200
LONG BEACH, CA 90806
(562) 933-7880
1770538373 MATTHEW HIEU NGUYEN D.P.M.
Individual
Podiatrist701 E 28TH ST SUITE 111
LONG BEACH, CA 90806
(562) 426-2551
1104871227DR. TOMI EVANS M.D.
Individual
Specialist701 E 28TH ST SUITE 411
LONG BEACH, CA 90806
(562) 426-0338
1588610786DR. S.DON KIM D.P.M.
Individual
Podiatrist701 E 28TH ST SUITE 111
LONG BEACH, CA 90806
(562) 426-2551
1104872605BREAST IMAGING RADIOLOGISTS A MEDICAL GROUP INC
Organization
Radiology (Diagnostic Radiology)701 E 28TH ST STE 200
LONG BEACH, CA 90806
(562) 933-7880
1467482133 VIKEN RAZMIG KONYALIAN MD
Individual
Surgery701 E 28TH ST #314
LONG BEACH, CA 90806
(714) 615-1870
1003840018 JEFFREY BRUCE RIKER M.D.
Individual
Specialist701 E 28TH ST STE 318
LONG BEACH, CA 90806
(562) 290-8888
1225062698 BARRY JOHN FREEMAN M.D.
Individual
Anesthesiology701 E 28TH ST SUITE # 301
LONG BEACH, CA 90806
(562) 997-7864
1194822262DR. LESLIE HOWARD EDRICH MD
Individual
Specialist701 E 28TH ST SUITE 400
LONG BEACH, CA 90806
(562) 427-9929
1992893408DR. JAMES JEROME KRUEGER M.D.
Individual
Internal Medicine (Pulmonary Disease)701 E 28TH ST SUITE 400
LONG BEACH, CA 90806
(562) 424-6040
1508997966LESLIE H EDRICH, M.D., INC
Organization
Specialist701 E 28TH ST SUITE 400
LONG BEACH, CA 90806
(562) 427-9929
1023135464JAMES J KRUEGER, MD, INC
Organization
Specialist701 E 28TH ST 400
LONG BEACH, CA 90806
(562) 424-6040
1649392432WOMENS SURGICAL ASSOCIATES BREAST SPECIALISTS MEDICAL GROUP, INC.
Organization
Specialist701 E 28TH ST SUITE 411
LONG BEACH, CA 90806
(562) 426-0338
1306040670 BRIAN R WEST MD
Individual
Surgery701 E 28TH ST SUITE 300
LONG BEACH, CA 90806
(562) 426-7111
1518164094 DANNY PHU M.D.
Individual
Internal Medicine701 E 28TH ST SUITE 415
LONG BEACH, CA 90806
(562) 988-2777
1003003187FREDERICK L.STAFFORD M.D., INC.
Organization
Personal Emergency Response Attendant701 E 28TH ST 411
LONG BEACH, CA 90806
(562) 427-1322
1588851505ORTHOPAEDIC SPECIALTIES ASSOCIATES
Organization
Specialist701 E 28TH ST SUITE 117
LONG BEACH, CA 90806
(310) 543-2521
1326236670BEVERLY HILLS PLASTIC SURGERY PHYSICIANS, INC.
Organization
Clinic/Center (Ambulatory Surgical)701 E 28TH ST SUITE 301
LONG BEACH, CA 90806
(714) 566-5240

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. Nayyer Ali M.d. 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.