JAN M ROTHMAN MD
NPI 1639176027
Internal Medicine - Medical Oncology in Erie, PA
NPI Status: Active since June 30, 2005
Contact Information
2500 W. 12TH ST
THE REGIONAL CANCER CTR
ERIE, PA
ZIP 16505
Phone: (814) 838-9000
Fax: (814) 838-0443
- Individual
- Male
- Years of Experience 42
- Internal Medicine
- Medical Oncology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About JAN ROTHMAN
This page provides the complete NPI Profile along with additional information for Jan Rothman, an internist established in Erie, Pennsylvania with a medical specialization in Internal Medicine, focusing in medical oncology and more than 42 years of experience. The healthcare provider is registered in the NPI registry with number 1639176027 assigned on June 2005. The practitioner's primary taxonomy code is 207RX0202X with license number MD054402 (PA). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1639176027
- Provider Name
- JAN M ROTHMAN MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2500 W. 12TH ST THE REGIONAL CANCER CTR ERIE, PA 16505
- Location Phone
- (814) 838-9000
- Location Fax
- (814) 838-0443
- Mailing Address
- 2500 W 12TH ST THE REGIONAL CANCER CENTER ERIE, PA 16505
- Mailing Phone
- (814) 838-9000
- Mailing Fax
- (814) 838-0443
- Medical School Name
- OTHER
- Graduation Year
- 1984
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-30-2005
- Last Update Date
- 03-31-2010
- Code Navigator
An internist like Jan Rothman is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, 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
Internal Medicine Medical Oncology
- Taxonomy Code
- 207RX0202X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD054402
- License State
- PA
- Taxonomy Description
- An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway HMO 7450 for HSA - HMO
- Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Catastrophic Pathway HMO 9200 - HMO
- Anthem Gold Pathway HMO 1500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway X HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway HMO 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway HMO 5000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway HMO 5400 for HSA - HMO
- Anthem Silver Pathway X HMO 4000 ($0 Virtual PCP + $0 Select Drugs) - HMO
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.
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 |
|---|---|---|---|
| 670635 | OTHER (01) | PA | HIGHMARK |
| 900000950 | MEDICARE PIN (08) | PA | |
| 140052 | OTHER (01) | PA MCR GR# | |
| E62536 | MEDICARE UPIN (02) | PA | |
| 0127400 | MEDICAID (05) | OH | |
| 0159 | OTHER (01) | PA BLUE CROSS | |
| 0015075870001 | MEDICAID (05) | PA | |
| 670635FYN | MEDICARE PIN (08) | PA |
Medicare Participation & PECOS Enrollment Status
Jan Rothman 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.
Jan Rothman 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: 2163486150
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: I20100225000047
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.
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 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 29 times for 27 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 551 times for 301 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 402 times for 154 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 262 times for 115 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 49 times for 32 patientsInitial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
This service was performed 62 times for 59 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 26 times for 25 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 32 times for 32 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 39 times for 39 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $41.71 for a new patient copayment and $24.2 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 16505 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $166.87
- Minimum New Patient Price $54.64
- Maximum New Patient Price $166.87
- Average New Patient Copayment $41.71
- Minimum New Patient Copayment $13.66
- Maximum New Patient Copayment $41.71
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $96.82
- Minimum Established Patient Price $17.33
- Maximum Established Patient Price $135.84
- Average Established Patient Copayment $24.2
- Minimum Established Patient Copayment $4.33
- Maximum Established Patient Copayment $33.96
* 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 |
|---|---|---|
| Closing the Referral Loop: Receipt of Specialist Report | 88% | 294 |
| 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 | ||
| Documentation of Current Medications in the Medical Record | 92% | 5086 |
| 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 | 93% | 1585 |
| 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 | 7% | 492 |
| 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. | ||
| Medication Reconciliation | 94% | 534 |
| 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. | ||
| Oncology: Medical and Radiation - Pain Intensity Quantified | 99% | 796 |
| Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified | ||
| Patient-Specific Education | 22% | 1211 |
| 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: Body Mass Index (BMI) Screening and Follow-Up Plan | 47% | 1546 |
| 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 encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 6% | 143 |
| 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 | 99% | 1211 |
| 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. | ||
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. Jan Rothman is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| UPMC CHAUTAUQUA AT WCA | 207 FOOTE AVENUE JAMESTOWN, NY 14701 | (716) 487-0141 | Acute Care Hospitals | |
| UPMC HAMOT | 201 STATE STREET ERIE, PA 16550 | (814) 877-6000 | 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 | 3 | 9 | 1 | 7 | 6 | 0 | 2 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 6 | 9 | 2 | 7 | 12 | 0 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 6 + 9 + 2 + 7 + 1 + 2 + 0 + 4 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1639176027 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639176027, enumerated as an "individual" on June 30, 2005.
The provider is located at 2500 W. 12TH ST THE REGIONAL CANCER CTR ERIE, PA 16505 and the phone number is (814) 838-9000.
Internal Medicine with taxonomy code 207RX0202X and a focus in Medical Oncology.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Highmark Blue. Please consult your insurance carrier or call the provider to verify.
Jan Rothman is affiliated with: UPMC CHAUTAUQUA AT WCA and UPMC HAMOT.
