DR. THOMAS HAYS RAETZSCH M.D.
NPI 1629156765
Family Medicine in Seguin, TX
NPI Status: Active since November 02, 2006
Contact Information
1025 N AUSTIN ST
SEGUIN, TX
ZIP 78155
Phone: (830) 379-1184
Fax: (830) 303-2314
- Individual
- Male
- Years of Experience 43
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About THOMAS RAETZSCH
This page provides the complete NPI Profile along with additional information for Thomas Raetzsch, a primary care provider established in Seguin, Texas with a medical specialization in Family Medicine and more than 43 years of experience. He graduated from Texas Tech University Health Science Center School Of Medicine in 1983. The healthcare provider is registered in the NPI registry with number 1629156765 assigned on November 2006. The practitioner's primary taxonomy code is 207Q00000X with license number G5508 (TX). The provider is registered as an individual and his NPI record was last updated 14 years ago.
- NPI
- 1629156765
- Provider Name
- DR. THOMAS HAYS RAETZSCH M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1025 N AUSTIN ST SEGUIN, TX 78155
- Location Phone
- (830) 379-1184
- Location Fax
- (830) 303-2314
- Mailing Address
- 1025 N AUSTIN ST SEGUIN, TX 78155
- Mailing Phone
- (830) 305-1595
- Mailing Fax
- (830) 303-2314
- Medical School Name
- TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
- Graduation Year
- 1983
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-02-2006
- Last Update Date
- 09-15-2011
- Code Navigator
A primary care provider (PCP) like Thomas Raetzsch sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- G5508
- License State
- TX
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- CHRISTUS Bronze - HMO
- CHRISTUS Bronze Essential - HMO
- CHRISTUS Bronze Essential Plus - HMO
- CHRISTUS Bronze Plus - HMO
- CHRISTUS Catastrophic - HMO
- CHRISTUS Gold - HMO
- CHRISTUS Gold Essential - HMO
- CHRISTUS Gold Essential Plus - HMO
- CHRISTUS Gold Plus - HMO
- CHRISTUS Silver - HMO
- CHRISTUS Silver Essential - HMO
- CHRISTUS Silver Essential Plus - HMO
- CHRISTUS Silver Plus - HMO
- CHRISTUS Standard Expanded Bronze - HMO
- CHRISTUS Standard Gold - HMO
- CHRISTUS Standard Silver - HMO
- Wellpoint Essential Bronze 4000 HSA ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 6000 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs) - HMO
- Wellpoint Essential Bronze 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze POS 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Bronze POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Bronze POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Catastrophic 9200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold POS 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Gold POS 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Gold POS 700 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver POS 2500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Silver POS 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*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 |
---|---|---|---|
B25736 | MEDICARE UPIN (02) | TX | |
110614801 | MEDICAID (05) | TX | |
080093500 | MEDICARE PIN (08) | TX |
Medicare Participation & PECOS Enrollment Status
Thomas Raetzsch 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.
Thomas Raetzsch 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: 4082740113
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: I20100329000514
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
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 (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
8 DME suppliers used 73 Medicare Claims 147 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
6 DME suppliers used 31 Medicare Claims 31 Services Paid
DME-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
3 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
4 DME suppliers used 18 Medicare Claims 80 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
1 DME suppliers used 17 Medicare Claims 17 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 26 Medicare Claims 26 Services Paid
DME-Wheelchairs (DD000N)
Lightweight wheelchair (HCPCS:K0003)
1 DME suppliers used 25 Medicare Claims 25 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
3 DME suppliers used 24 Medicare Claims 24 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.
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza
Detection test by immunoassay with direct visual observation for influenza virus
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Transitional care management services for problem of moderate complexity
Urinalysis, manual test
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 49 times for 49 patientsAn immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
This service was performed 89 times for 71 patientsThis test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.
This service was performed 14 times for 14 patientsThis is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
This service was performed 60 times for 28 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 127 times for 96 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 531 times for 259 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 339 times for 206 patientsTransitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
This service was performed 13 times for 11 patientsA urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
This service was performed 55 times for 41 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.23 for a new patient copayment and $24.26 for an established patient copayment.
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 78155 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.92
- Minimum New Patient Price $54.84
- Maximum New Patient Price $166.88
- Average New Patient Copayment $21.23
- Minimum New Patient Copayment $13.71
- Maximum New Patient Copayment $41.72
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.05
- Minimum Established Patient Price $17.52
- Maximum Established Patient Price $136.11
- Average Established Patient Copayment $24.26
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.02
* 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.
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 |
---|---|---|
Breast Cancer Screening | 62% | 322 |
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
Care Plan | 61% | 589 |
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
Colorectal Cancer Screening | 60% | 660 |
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
Diabetes: Eye Exam | 27% | 200 |
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
Documentation of Current Medications in the Medical Record | 99% | 3634 |
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 | ||
e-Prescribing | 77% | 3388 |
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
Health Information Exchange | 72% | 259 |
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
Implementation of medication management practice improvements | Yes | N/A |
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
Medication Reconciliation | 98% | 198 |
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 | 68% | 1431 |
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. | ||
Preventive Care and Screening: Influenza Immunization | 23% | 854 |
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
Provide Patient Access | 67% | 1431 |
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. | ||
Secure Messaging | 13% | 1431 |
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
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 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. |
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
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. Thomas Raetzsch is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
GUADALUPE REGIONAL MEDICAL CENTER | 1215 E COURT ST SEGUIN, TX 78155 | (830) 379-2411 | 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 | 6 | 2 | 9 | 1 | 5 | 6 | 7 | 6 | 5 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 6 | 4 | 9 | 2 | 5 | 12 | 7 | 12 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 6 + 4 + 9 + 2 + 5 + 1 + 2 + 7 + 1 + 2 + 24 = 65 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 65 = 5 | 5 |
The NPI number 1629156765 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 4 providers are registered at the same or nearby location.
MARILYNN WOMACK APRN,FNP-C
Nurse Practitioner
(Family)
1025 N AUSTIN ST
SEGUIN, TX
ZIP 78155
CCCST - SEGUIN
Internal Medicine
(Hematology & Oncology)
1025 N AUSTIN ST
SEGUIN, TX
ZIP 78155
EYE SPECIALISTS OF AUSTIN, PA
Ophthalmology
(Glaucoma Specialist)
1025 N AUSTIN ST
SEGUIN, TX
ZIP 78155
ERIN MICHELLE WITTE FUDGE
Nurse Practitioner
(Family)
1025 N AUSTIN ST
SEGUIN, TX
ZIP 78155
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629156765, enumerated as an "individual" on November 02, 2006.
The provider is located at 1025 N AUSTIN ST SEGUIN, TX 78155 and the phone number is (830) 379-1184.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: CHRISTUS Health Plan, WellPoint, Medicare and. Please consult your insurance carrier or call the provider to verify.
Thomas Raetzsch is affiliated with: GUADALUPE REGIONAL MEDICAL CENTER.