DR. DAVID ROBERT ANTHONY M.D., M.P.H.
NPI 1649437682
Emergency Medicine in Dekalb, IL

NPI Status: Active since May 19, 2008

Contact Information

1 KISH HOSPITAL DR
DEKALB, IL
ZIP 60115
Phone: (815) 766-7334
Fax: (815) 766-9768

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Emergency Medicine
Accepts Insurance
PECOS Enrolled
Medicare Quality Reporting

About DAVID ANTHONY

This page provides the complete NPI Profile along with additional information for David Anthony, a provider established in Dekalb, Illinois with a medical specialization in Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1649437682 assigned on May 2008. The practitioner's primary taxonomy code is 207P00000X with license number 036140404 (IL). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI: 1649437682
Provider Name: DR. DAVID ROBERT ANTHONY M.D., M.P.H.
Gender: Male
Entity Type: Individual
Location Address: 1 KISH HOSPITAL DR DEKALB, IL 60115
Location Phone: (815) 766-7334
Location Fax: (815) 766-9768
Mailing Address: 525 E 68TH ST EMERGENCY DEPARTMENT NEW YORK, NY 10065
Is Sole Proprietor?: No
Enumeration Date: 05-19-2008
Last Update Date: 07-08-2022
Code Navigator

Location Map

Secondary Locations

525 E 68th St Emergency Department
New York, NY 10065
(212) 746-5026

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: Emergency Medicine
Taxonomy Code: 207P00000X
Type: Allopathic & Osteopathic Physicians
License No.: 036140404
License State: IL
Taxonomy Description: An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	207P00000X	Allopathic & Osteopathic Physicians	Emergency Medicine	254828 (NY)

Insurance Plans Accepted

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

Group Health Cooperative-SCW

Better Together HMO Bronze 6500 Ded/8750 MOOP HSA - HMO
Better Together HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
Better Together HMO Bronze No Medical Ded/10600 MOOP HSA - HMO
Better Together HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
Better Together HMO Gold 2000 Ded/8200 MOOP - HMO
Better Together HMO Gold 4000 Ded/4000 MOOP HSA - HMO
Better Together HMO Platinum 750 Ded/2000 MOOP with Vision - HMO
Better Together HMO Platinum No Ded/3300 MOOP - HMO
Better Together HMO Platinum No Ded/5200 MOOP - HMO
Better Together HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
Better Together HMO Silver 5975 Ded/5975 MOOP HSA - HMO
Better Together HMO Silver 6000 Ded/8900 MOOP - HMO
Partners HMO Bronze 10600 Ded/10600 MOOP HSA - HMO
Partners HMO Bronze 6000 Ded/10600 MOOP HSA - HMO
Partners HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
Partners HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
Partners HMO Gold 2000 Ded/8200 MOOP - HMO
Partners HMO Gold 4000 Ded/4000 MOOP HSA - HMO
Partners HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
Partners HMO Silver 5975 Ded/5975 MOOP HSA - HMO

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

Medicare Participation & PECOS Enrollment Status

David Anthony 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
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.

Critical care, first 30-74 minutes
Emergency department visit for life threatening or functioning severity
Emergency department visit for problem of high severity
Emergency department visit for problem of moderate severity

Physician Visit Costs

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 60115 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $85.71
Minimum New Patient Price $54.8
Maximum New Patient Price $168.44

Average New Patient Copayment $21.42
Minimum New Patient Copayment $13.7
Maximum New Patient Copayment $42.11

Established Patients Visit Costs *

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

Average Established Patient Price $97.25
Minimum Established Patient Price $17.16
Maximum Established Patient Price $136.56

Average Established Patient Copayment $24.31
Minimum Established Patient Copayment $4.29
Maximum Established Patient Copayment $34.14

* 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
Implementation of an ASP	Yes	N/A
Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance
Implementation of formal quality improvement methods, practice changes, or other practice improvement processes	Yes	N/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
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.
Participation in an AHRQ-listed patient safety organization.	Yes	N/A
Participation in an AHRQ-listed patient safety organization.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1649437682, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 78. The final step is to find the difference between that total and the next multiple of ten (80 - 78 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 8

Pos 4

Unchanged

Pos 5

Doubled → 8

Pos 6

Unchanged

Pos 7

Doubled → 14 → 1 + 4

Pos 8

Unchanged

Pos 9

Doubled → 16 → 1 + 6

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 4 → 8 7 → 14 → 5 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 8 + 9 + 8 + 3 + 1 + 4 + 6 + 1 + 6 + 24 = 78

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 78 is 80. The difference is the calculated check digit.

80 - 78 = 2

This NPI is valid

The calculated check digit is 2, which matches the last digit of 1649437682.