MS. GLADYS PACENZA NP
NPI 1639108210
Nurse Practitioner in New Windsor, NY


Quality Rating: 61.68 out of 100 score

NPI Status: Active since July 03, 2006

Contact Information

575 HUDSON VALLEY AVE
SUITE 200
NEW WINDSOR, NY
ZIP 12553
Phone: (845) 561-2773
Fax: (914) 593-7881

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  • Individual
  • Female
  • Years of Experience 21
  • Nurse Practitioner
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About GLADYS PACENZA

This page provides the complete NPI Profile along with additional information for Gladys Pacenza, a provider established in New Windsor, New York with a medical specialization in Nurse Practitioner and more than 21 years of experience. The healthcare provider is registered in the NPI registry with number 1639108210 assigned on July 2006. The practitioner's primary taxonomy code is 363L00000X with license number 430266 (NY). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1639108210
Provider Name
MS. GLADYS PACENZA NP
Gender
Female
Entity Type
Individual
Location Address
575 HUDSON VALLEY AVE SUITE 200 NEW WINDSOR, NY 12553
Location Phone
(845) 561-2773
Location Fax
(914) 593-7881
Mailing Address
PO BOX 5801 NEW YORK, NY 10087
Mailing Phone
(914) 593-7880
Mailing Fax
(914) 593-7881
Medical School Name
OTHER
Graduation Year
2005
Is Sole Proprietor?
No
Enumeration Date
07-03-2006
Last Update Date
03-07-2023
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A nurse practitioner (NP) like Gladys Pacenza is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, 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

Nurse Practitioner

Taxonomy Code
363L00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
430266
License State
NY
Taxonomy Description
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

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
430266OTHER (01)NYLICENSE NUMBER

Medicare Participation & PECOS Enrollment Status

Gladys Pacenza 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.

Gladys Pacenza 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: 1557368487

    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: I20061106000585

    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

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.

Anticoagulant management of patient taking warfarin

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

This service was performed 398 times for 94 patients

Blood test, clotting time

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

This service was performed 169 times for 54 patients

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

This 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 25 times for 25 patients

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

This 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 120 times for 107 patients

Programming of dual lead pacemaker system

Programming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.

This service was performed 50 times for 44 patients

Programming of single lead implantable defibrillator system

Programming of a single lead implantable defibrillator system involves setting up and adjusting a device implanted in your body. This device helps regulate your heartbeat. It can detect irregular heart rhythms and provide corrective electric shocks to restore a normal heartbeat.

This service was performed 17 times for 15 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $23.99 for a new patient copayment and $27.14 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 12553 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $95.99
  • Minimum New Patient Price $61.88
  • Maximum New Patient Price $187.05
  • Average New Patient Copayment $23.99
  • Minimum New Patient Copayment $15.47
  • Maximum New Patient Copayment $46.76

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $108.56
  • Minimum Established Patient Price $19.92
  • Maximum Established Patient Price $151.94
  • Average Established Patient Copayment $27.14
  • Minimum Established Patient Copayment $4.98
  • Maximum Established Patient Copayment $37.98

* 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 61.68, 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: 61.68 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: 24.11

    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: 100

    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.

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. Gladys Pacenza is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ST LUKE'S CORNWALL HOSPITAL70 DUBOIS STREET
NEWBURGH, NY 12550
(845) 561-4400Acute 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.
1639108210
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2669201622
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 6 + 9 + 2 + 0 + 1 + 6 + 2 + 2 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1639108210 is valid because the calculated check digit 0 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.

NEW WINDSOR GYNECOLOGY, PC

Obstetrics & Gynecology

575 HUDSON VALLEY AVE
SUITE 201
NEW WINDSOR, NY
ZIP 12553

(845) 567-3420

MR. JOHN FLETCHER GILLINDER MPT

Physical Therapist

575 HUDSON VALLEY AVE
NEW WINDSOR, NY
ZIP 12553

(845) 784-3777

HUDSON VALLEY INTERVENTIONAL MEDICINE, PLLC

Clinic/Center

(Radiology)

575 HUDSON VALLEY AVE
SUITE 101
NEW WINDSOR, NY
ZIP 12553

(845) 220-2222

VASCULAR SURGEONS OF WESTCHESTER, LLC

Surgery

(Vascular Surgery)

575 HUDSON VALLEY AVE
SUITE 200
NEW WINDSOR, NY
ZIP 12553

(914) 593-1200

MRS. BARBARA MARIE RICH MPT

Physical Therapist

575 HUDSON VALLEY AVE
NEW WINDSOR, NY
ZIP 12553

(845) 784-3777

MS. LORETTA A MARTIN RPA

Legal Medicine

575 HUDSON VALLEY AVE
SUITE 201
NEW WINDSOR, NY
ZIP 12553

(845) 220-2270

LOIS ANN MACDONALD CDN

Dietitian, Registered

575 HUDSON VALLEY AVE
SUITE 201
NEW WINDSOR, NY
ZIP 12553

(845) 220-2270

NORTHEAST ORTHOPEDICS AND SPORTS MEDICINE PLLC

Durable Medical Equipment & Medical Supplies

575 HUDSON VALLEY AVE
NEW WINDSOR, NY
ZIP 12553

(845) 359-1877

HUDSON VALLEY HEALTH GROUP,LLP

Internal Medicine

(Hematology & Oncology)

575 HUDSON VALLEY AVE
SUITE 100
NEW WINDSOR, NY
ZIP 12553

(845) 565-9800

SABRINA N STENT NP

Nurse Practitioner

(Adult Health)

575 HUDSON VALLEY AVE
SUITE 200
NEW WINDSOR, NY
ZIP 12553

(845) 561-2773

JAVIER RUIZ MD

Internal Medicine

(Hematology & Oncology)

575 HUDSON VALLEY AVE
SUITE100
NEW WINDSOR, NY
ZIP 12553

(845) 565-9800

DR. LEILA BOUKHRIS M.D.

Internal Medicine

575 HUDSON VALLEY AVE
SUITE 100
NEW WINDSOR, NY
ZIP 12553

(845) 565-9800

HUDSON VALLEY DIAGNOSTIC IMAGING, PLLC

Radiology

(Diagnostic Radiology)

575 HUDSON VALLEY AVE
SUITE 101
NEW WINDSOR, NY
ZIP 12553

(845) 220-2222

NEW WINDSOR FAMILY MEDICINE, PLLC

Legal Medicine

575 HUDSON VALLEY AVE
SUITE 201
NEW WINDSOR, NY
ZIP 12553

(845) 220-2270

NEW WINDSOR FAMILY MEDICINE, PLLC

Clinic/Center

(Primary Care)

575 HUDSON VALLEY AVE
SUITE 201
NEW WINDSOR, NY
ZIP 12553

(845) 220-2270

JOHN REED MD

Family Medicine

575 HUDSON VALLEY AVE
SUITE 201
NEW WINDSOR, NY
ZIP 12553

(845) 220-2270

KISHA MARIE HOWARD-SCHRAMM NP

Nurse Practitioner

(Family)

575 HUDSON VALLEY AVE
STE 201
NEW WINDSOR, NY
ZIP 12553

(845) 220-2270

JENNIFER LYNNE TITCHNELL PAC

Physician Assistant

(Medical)

575 HUDSON VALLEY AVE
SUITE 201
NEW WINDSOR, NY
ZIP 12553

(845) 220-2270

DR. AHMAD HADID MD

Internal Medicine

(Cardiovascular Disease)

575 HUDSON VALLEY AVE
STE 200
NEW WINDSOR, NY
ZIP 12553

(845) 561-2773

MRS. PATRICIA ANN RAINALDI ANP

Nurse Practitioner

(Adult Health)

575 HUDSON VALLEY AVE
NEW WINDSOR, NY
ZIP 12553

(845) 561-2773

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639108210, enumerated as an "individual" on July 03, 2006.

The provider is located at 575 HUDSON VALLEY AVE SUITE 200 NEW WINDSOR, NY 12553 and the phone number is (845) 561-2773.

Nurse Practitioner with taxonomy code 363L00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Gladys Pacenza is affiliated with: ST LUKE'S CORNWALL HOSPITAL.