JOHN P ROSS MD
NPI 1679535470
Urology in Edmond, OK


Quality Rating: 71.66 out of 100 score

NPI Status: Active since April 05, 2006

Contact Information

14104 N. EASTERN AVE. STE. E
EDMOND, OK
ZIP 73013
Phone: (405) 340-1279
Fax: (405) 216-5089

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  • Individual
  • Male
  • Urology
  • Accepts Insurance

About JOHN ROSS

This page provides the complete NPI Profile along with additional information for John Ross, a provider established in Edmond, Oklahoma with a medical specialization in Urology. The healthcare provider is registered in the NPI registry with number 1679535470 assigned on April 2006. The practitioner's primary taxonomy code is 208800000X with license number 13842 (OK). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1679535470
Provider Name
JOHN P ROSS MD
Gender
Male
Entity Type
Individual
Location Address
14104 N. EASTERN AVE. STE. E EDMOND, OK 73013
Location Phone
(405) 340-1279
Location Fax
(405) 216-5089
Mailing Address
1211 N SHARTEL AVE STE 200 OKLAHOMA CITY, OK 73103
Mailing Phone
(405) 235-8008
Mailing Fax
(405) 216-5089
Is Sole Proprietor?
No
Enumeration Date
04-05-2006
Last Update Date
04-03-2019
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Location Map

Secondary Locations

  • 5950 University Ave Ste 341
    West Des Moines, IA 50266
    (515) 875-9800
  • 1211 N Shartel Ave Suite 300
    Oklahoma City, OK 73103
    (405) 235-8008

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

Urology

Taxonomy Code
208800000X
Type
Allopathic & Osteopathic Physicians
License No.
13842
License State
OK
Taxonomy Description
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

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)
1208800000XAllopathic & Osteopathic Physicians

Urology

MD-45914 (IA)

Insurance Plans Accepted

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

  • Harmony by Medica Bronze $0 Copay PCP Visits - PPO
  • Harmony by Medica Bronze $0 Copay PCP Visits + Adult Eye Exam - PPO
  • Harmony by Medica Bronze Premier - PPO
  • Harmony by Medica Bronze Premier + Adult Eye Exam - PPO
  • Harmony by Medica Expanded Bronze Standard - PPO
  • Harmony by Medica Expanded Bronze Standard + Adult Eye Exam - PPO
  • Harmony by Medica Gold $0 Copay PCP Visits - PPO
  • Harmony by Medica Gold $0 Copay PCP Visits + Adult Eye Exam - PPO
  • Harmony by Medica Gold Share - PPO
  • Harmony by Medica Gold Share + Adult Eye Exam - PPO
  • Harmony by Medica Gold Standard - PPO
  • Harmony by Medica Gold Standard + Adult Eye Exam - PPO
  • Harmony by Medica Silver $0 Copay PCP Visits - PPO
  • Harmony by Medica Silver $0 Copay PCP Visits + Adult Eye Exam - PPO
  • Harmony by Medica Silver Share - PPO
  • Harmony by Medica Silver Share + Adult Eye Exam - PPO
  • Harmony by Medica Silver Standard - PPO
  • Harmony by Medica Silver Standard + Adult Eye Exam - PPO
  • MENDING Direct Primary Care Bronze 4950 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Gold $0 Ded ($0 DPC $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Silver 2300 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Standard Bronze (No Direct Primary Care, for DPC select DPC Bronze) - HMO
  • MENDING Standard Gold (No Direct Primary Care, for DPC select DPC Gold) - HMO
  • MENDING Standard Silver (No Direct Primary Care, for DPC select DPC Silver) - 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.

*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
$$$$$$$$$OTHER (01)OKBCBS
100130030AMEDICAID (05)OK 

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.

Automated urinalysis test

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

This service was performed 292 times for 223 patients

Diagnostic exam of bladder and urethra using an endoscope

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

This service was performed 57 times for 43 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 375 times for 298 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 166 times for 148 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 27 times for 27 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 21 times for 21 patients

Ultrasound measurement of bladder capacity after voiding

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

This service was performed 85 times for 69 patients

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 71.66, 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: 71.66 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: 53.48

    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: 52.07

    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: 52.07

    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.

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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 1679535470, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

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
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
9
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
3
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
4
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
0
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 7 → 14 → 5 5 → 10 → 1 5 → 10 → 1 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 1 + 4 + 9 + 1 + 0 + 3 + 1 + 0 + 4 + 1 + 4 + 24 = 60

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

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1679535470.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1679535470, enumerated as an "individual" on April 05, 2006.

The provider is located at 14104 N. EASTERN AVE. STE. E EDMOND, OK 73013 and the phone number is (405) 340-1279.

Urology with taxonomy code 208800000X.

The provider might be accepting Accepts: Medica, Mending Health, Blue Cross Blue Shield,. Please consult your insurance carrier or call the provider to verify.