ARDEN LEROY AYLOR MD NPI 1629267141
Family Medicine - Geriatric Medicine in Talladega, AL

About ARDEN LEROY AYLOR MD

Arden Aylor is a primary care provider established in Talladega, Alabama and his medical specialization is Family Medicine with a focus in geriatric medicine with more than 19 years of experience. The NPI number of Arden Aylor is 1629267141 and was assigned on October 2007. The practitioner's primary taxonomy code is 207QG0300X with license number 42258 (TX). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1629267141
Provider Name ARDEN LEROY AYLOR MD
Location Address803 NORTH ST E TALLADEGA, AL 35160
Location Phone(256) 362-1600
Mailing Address803 NORTH ST E TALLADEGA, AL 35160
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2004
Is Sole Proprietor?No
Enumeration Date10-22-2007
Last Update Date09-18-2013

A primary care provider (PCP) like Arden Leroy Aylor Md 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 Arden Aylor 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.

Arden Aylor 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 Northeast Alabama Regional 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 91.7, 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 provider also has detailed performance information the following quality measures: closing the referral loop: receipt of specialist report, consultation of the prescription drug monitoring program, documentation of current medications in the medical record, electronic case reporting, e-prescribing, immunization registry reporting, pneumococcal vaccination status for older adults, practice improvements for bilateral exchange of patient information, preventive care and screening: body mass index (bmi) screening and follow-up plan, preventive care and screening: tobacco use: screening and cessation intervention, provide patients electronic access to their health information, public health registry reporting, security risk analysis, support electronic referral loops by sending health information, use of certified ehr to capture patient reported outcomes and use of high-risk medications in the elderly.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.48 for a new patient copayment and $24.83 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 Code207QG0300X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationGeriatric Medicine
License No.42258
License StateTX
Taxonomy DescriptionA family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

Accepted Insurance

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

  • Blue Cross Blue Shield
  • Medicaid
  • Medicare
  • Tricare

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

Business Address

ARDEN LEROY AYLOR MD
803 NORTH ST E
TALLADEGA, AL
ZIP 35160
Phone: (256) 362-1600
Fax: (256) 362-8698

Get Directions


Mailing Address

ARDEN LEROY AYLOR MD
803 NORTH ST E
TALLADEGA, AL
ZIP 35160
Phone: (256) 362-1600
Fax: (256) 362-8698


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 ID5799848149
PECOS Enrollment IDI20120119000576
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 35160 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
$55.54 $170.61 $85.95
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.88 $42.65 $21.48
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$16.93 $139.08 $99.33
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.23 $34.77 $24.83

* 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% 100
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% 53
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 - 91.7
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.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Closing the Referral Loop: Receipt of Specialist Report 0% 1028
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
Consultation of the Prescription Drug Monitoring ProgramYesN/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 100% 9187
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
Electronic Case ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to electronically submit case reporting of reportable conditions.
e-Prescribing 99% 32760
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT.
Immunization Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS).
Pneumococcal Vaccination Status for Older Adults 0% 675
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Practice Improvements for Bilateral Exchange of Patient InformationYesN/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: Body Mass Index (BMI) Screening and Follow-Up Plan 97% 2713
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 encounterNormal Parameters: Age 18 years and older BMI => 18.5 and < 25 kg/m2
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 81% 605
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 Patients Electronic Access to Their Health Information 16% 2728
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified electronic health record technology (CEHRT).
Public Health Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit data to public health registries.
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 electronic health record technology (CEHRT) in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 164.306(d)(3), implement security updates as necessary, and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Support Electronic Referral Loops By Sending Health Information 33% 1732
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider - (1) creates a summary of care record using certified electronic health record technology (CEHRT); and (2) electronically exchanges the summary of care record.
Use of certified EHR to capture patient reported outcomesYesN/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 High-Risk Medications in the Elderly 26% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
675
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted.1) Percentage of patients who were ordered at least one high-risk medication2) Percentage of patients who were ordered at least two of the same high-risk medication

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.

  • 392Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
  • 286Injection, dexamethasone sodium phosphate, 1mg (HCPCS:J1100)
  • 164Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 153Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter (HCPCS:G0434)
  • 60Administration of influenza virus vaccine (HCPCS:G0008)
  • 51Urinalysis, manual test (HCPCS:81002)
  • 46Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • 26Physician 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)
  • 22X-ray of chest, 2 views, front and side (HCPCS:71020)
  • 16X-ray of ribs of one side of body, minimum of 2 views (HCPCS:73510)
  • 14X-ray of shoulder, minimum of 2 views (HCPCS:73030)

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. Arden Aylor is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
NORTHEAST ALABAMA REGIONAL MEDICAL CENTER400 EAST 10TH STREET
ANNISTON, AL 36207
(256) 235-5121Acute Care Hospitals10078

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine28874ALNo

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.

2207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine28874ALNo

Taxonomy Description: a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

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
$$$$$$$$$OTHER (01)TXTRICARE
1996126-01MEDICAID (05)TX
511-35487OTHER (01)ALBLUE CROSS BLUE SHIELD
8L5146MEDICARE PIN (08)TX
PP30842OTHER (01)TXBLUE CROSS BLUE SHIELD

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.
1629267141
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2649461418
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 4 + 9 + 4 + 6 + 1 + 4 + 1 + 8 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1629267141 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 9 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1063493351DR. DAWSON LEIGH MURPHY M.D.
Individual
Surgery803 NORTH ST E
TALLADEGA, AL 35160
(256) 362-1600
1205817509DR. DAVID H ROBERTS M.D.
Individual
Surgery803 NORTH ST E
TALLADEGA, AL 35160
(256) 362-1600
1821150087REGIONAL HEALTH MANAGEMENT CORPORATION
Organization
Specialist803 NORTH ST E
TALLADEGA, AL 35160
(256) 362-1600
1598154635 APRIL BROWN CRNP
Individual
Nurse Practitioner (Family)803 NORTH ST E
TALLADEGA, AL 35160
(256) 362-1600
1336249994 ANNE B. DAVIS M.D.
Individual
Internal Medicine803 NORTH ST E
TALLADEGA, AL 35160
(256) 315-2252
1952401887 JOAN V. PATTERSON CRNP
Individual
Nurse Practitioner (Family)803 NORTH ST E
TALLADEGA, AL 35160
(256) 315-2252
1700956265 MARY PAGE H MCKINNEY CRNP
Individual
Nurse Practitioner803 NORTH ST E
TALLADEGA, AL 35160
(256) 315-2252
1164833539 BRIDGET GIBSON MD
Individual
Family Medicine803 NORTH ST E
TALLADEGA, AL 35160
(256) 315-2252
1861456923BAPTIST HEALTH CENTERS LLC
Organization
Internal Medicine803 NORTH ST E
TALLADEGA, AL 35160
(256) 315-2252

Frequently Asked Questions

What is Arden Aylor MD NPI number?

The NPI number assigned to Arden Aylor MD is 1629267141, registered as an "individual" on October 22, 2007

Where is Arden Aylor MD located?

The provider is located at 803 North St E Talladega, Al 35160 and the phone number is (256) 362-1600

Which is Arden Aylor MD specialty?

The provider's speciality is Family Medicine with a focus in Geriatric Medicine

How many years of experience does Arden Aylor MD have?

The provider has more than 19 years of experience.

What insurance does Arden Aylor MD accept?

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

Is Arden Aylor MD registered in PECOS?

Yes, as of November 14, 2022 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.

How much is a visit to Arden Aylor MD?

Medicare beneficiaries should expect a typical cost of $85.95 with an average copayment of $21.48 for new patient appointments. Established patients should expect a typical charge of $99.33 and an average copayment of 24.83. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Arden Aylor MD?

The most common procedures or services performed by this practitioner are: Injection beneath the skin or into muscle for therapy, diagnosis, or prevention, Injection, dexamethasone sodium phosphate, 1mg, Insertion of needle into vein for collection of blood sample, Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter, Administration of influenza virus vaccine, Urinalysis, manual test, Routine EKG using at least 12 leads including interpretation and report, Physician 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, X-ray of chest, 2 views, front and side, X-ray of ribs of one side of body, minimum of 2 views and X-ray of shoulder, minimum of 2 views.

Is Arden Aylor MD affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: NORTHEAST ALABAMA REGIONAL MEDICAL CENTER. 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 Arden Aylor MD was last updated on October 22, 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]