ANDREW C HILBURGER M.D.
NPI 1649230517
Psychiatry & Neurology - Neurology in Batavia, NY
Active since March 24, 2006PECOS EnrolledAccepts Medicare Assignment
68.02/100
CMS Quality Rating
About Andrew C Hilburger M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREW C HILBURGER M.D. (NPI 1649230517) is an individual neurology provider in Batavia, New York, licensed in New York (196659-1) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with United Memorial Medical Center, and maintains a secondary practice location in Warsaw.
NPPES Registry Identity
NPI1649230517
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameANDREW C HILBURGERCredential: M.D.
Location Address176 WASHINGTON AVEBatavia, NY 14020-2113
Mailing Address176 Washington AveBatavia, NY 14020-2113 · (585) 344-3190 · Fax (585) 344-3235
Phone(585) 344-3190
Fax(585) 344-3235
Sole ProprietorNo
Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 1988
Enumeration DateMarch 24, 2006
Last NPPES UpdateFebruary 19, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 19, 2024
✔ NPI 1649230517 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in NY · 196659-1
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
176 WASHINGTON AVE, Batavia, NY 14020
Secondary Practice Location 1
Location 1408 N Main StWarsaw, NY 14569-1015 · Phone (585) 786-1555
Other Identifiers 9
Other00010076801NY · Univera
Other000523391001NY · Blue Cross Wny
Medicaid01518969NY
Other03087NM · Blue Shield Rochester
Other1506703NM · Independent Health
Other101529GANY · Preferred Care
Other130010707NY · Railroad Medicare
Other9599212NY · Group Health Inc
OtherP010196659NY · Blue Choice
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
✔
Enrolled in Medicare and accepts Medicare assignment
Andrew C Hilburger M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
PECOS PAC ID2961527882
PECOS Enrollment IDI20100916000049
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
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.
212 services137 patients
Needle measurement of electrical activity in arm or leg muscles, complete study 95886
This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.
65 services44 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
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.
65 services61 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This 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.
60 services60 patients
Nerve conduction, 5-6 studies 95909
Nerve conduction studies involve testing the speed and strength of signals traveling through your nerves. This helps identify any nerve damage or dysfunction. For 5-6 studies, this means multiple nerves will be tested. Small electrodes are placed on your skin to send and receive signals, causing minimal discomfort.
26 services25 patients
Nerve conduction, 9-10 studies 95911
Nerve conduction studies involve sending small electrical shocks through the skin to measure how quickly nerves transmit signals. This helps detect nerve damage. 9-10 studies mean this process will be repeated on different nerves to gather comprehensive data.
20 services19 patients
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
United Memorial Medical Center
Acute Care Hospitals · Batavia, NYOwnershipVoluntary non-profit - Private
CMS Certification Number330073
Location127 North StreetBatavia, NY 14020 · Genesee County
Emergency services Birthing friendly
Strong Memorial Hospital
Acute Care Hospitals · Rochester, NYOwnershipVoluntary non-profit - Private
CMS Certification Number330285
Location601 Elmwood AveRochester, NY 14642 · Monroe County
Emergency services Birthing friendly
Medina Memorial Hospital
Critical Access Hospitals · Medina, NYOwnershipVoluntary non-profit - Private
CMS Certification Number331319
Location200 Ohio StreetMedina, NY 14103 · Orleans County
Emergency services
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 14020 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
New Patient
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
68.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practiceQuality
67.19
Promoting Interoperability
64
Improvement Activities
40
Cost
39.56
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
0%554 patients1/55-star benchmark: 92%
Care Plan
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…
100%227 patients5/55-star benchmark: 100%
Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
98%414 patients4/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
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
76%161 patients4/55-star benchmark: 95%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 84% · 58 patients
Patients 4MonthsOfStart: 87% · 84 patients
78%64 patients
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
28%162 patients2/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
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.
92%4,303 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%1,189 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
97%635 patients4/55-star benchmark: 99%
Patient-Generated Health Data
Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for at least one unique patient seen by the MIPS eligible clinician during the performance period.
2%1,247 patients
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
16%1,247 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
72%658 patients4/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
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…
21%2,086 patients1/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
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
69%865 patients4/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
99%357 patients4/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
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
Patients screenedForUse: 94% · 995 patients
Patients tobacco: 91% · 995 patients
85%209 patients4/55-star benchmark: 98%
Provide Patient Access
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…
90%1,247 patients4/55-star benchmark: 100%
Request/Accept Summary of Care
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an…
9%296 patients1/55-star benchmark: 100%
Secure Messaging
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 certified EHR technology to the patient (or the patient-authorized representative), or in…
15%1,247 patients1/55-star benchmark: 75%
Send a Summary of Care
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 EHR technology; and (2)…
28%111 patients2/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
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 medication.
Lower rates are better for this measure.
Patients 2+: 2% · 658 patients
6%658 patients3/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
8%1,247 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Psychiatry & Neurology (Neurology)
176 WASHINGTON AVE
BATAVIA, NY 14020
BATAVIA, NY 14020
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Andrew Hilburger's NPI number?
The NPI number for Andrew Hilburger is 1649230517. It was assigned to this individual provider in the NPPES registry on March 24, 2006.
Where is Andrew Hilburger located?
Andrew Hilburger practices at 176 Washington Ave, Batavia, NY 14020. The listed phone number is (585) 344-3190.
What is Andrew Hilburger's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.
Is Andrew Hilburger enrolled in Medicare?
Yes. Andrew Hilburger is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Andrew Hilburger affiliated with any hospitals?
According to CMS data, Andrew Hilburger is affiliated with United Memorial Medical Center, Strong Memorial Hospital and Medina Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Andrew Hilburger was last updated on February 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Andrew C Hilburger, M.D. · NPI 1649230517
Neurology physician in Batavia, New York. Individual provider, active in the CMS NPPES registry since March 24, 2006.
## Identity
- **NPI:** 1649230517 (Entity type: Individual)
- **Enumerated:** March 24, 2006
- **Primary specialty:** Psychiatry & Neurology - Neurology · taxonomy 2084N0400X
- **State license:** 196659-1 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 176 WASHINGTON AVE, Batavia, NY 14020-2113
- **Phone:** (585) 344-3190 · **Fax:** (585) 344-3235
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** State University Of Ny Upstate Medical University, class of 1988
## Record status
- **NPPES last updated:** February 19, 2024
- **Other identifiers:** Other 00010076801 (NY); Other 000523391001 (NY); Medicaid 01518969 (NY); and 6 more
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Source: [NPI Profile](https://npiprofile.com/npi/1649230517) · Data from the CMS NPPES public registry.