ANDRES MARTIN ALDRETE M.D. NPI 1679580831
Emergency Medicine in Monterey, CA

Individual Male Emergency Medicine PECOS Enrolled MIPS Quality Score 100

About ANDRES MARTIN ALDRETE M.D.

Andres Aldrete is a provider established in Monterey, California and his medical specialization is Emergency Medicine. The NPI number of Andres Aldrete is 1679580831 and was assigned on August 2006. The practitioner's primary taxonomy code is 207P00000X with license number G78430 (CA). The provider is registered as an individual and his NPI record was last updated 11 years ago.

NPI
1679580831
Provider Name ANDRES MARTIN ALDRETE M.D.
Provider Location Address23625 HOLMAN HWY MONTEREY, CA 93940
Provider Mailing AddressPO BOX HH BUSINESS DEVELOPMENT & CONTRACTING MONTEREY, CA 93942
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Enumeration Date08-01-2006
Last Update Date07-29-2011

Andres Aldrete 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..

Andres Aldrete is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, 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.



Primary Taxonomy

Taxonomy Code207P00000X
ClassificationEmergency Medicine
TypeAllopathic & Osteopathic Physicians
License No.G78430
License StateCA
Taxonomy DescriptionAn 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.

Business Address

ANDRES MARTIN ALDRETE M.D.
23625 HOLMAN HWY
MONTEREY, CA
ZIP 93940
Phone: (831) 624-5311
Fax: (831) 625-4948

Get Directions


Mailing Address

ANDRES MARTIN ALDRETE M.D.
PO BOX HH
BUSINESS DEVELOPMENT & CONTRACTING
MONTEREY, CA
ZIP 93942
Phone: (831) 625-4945
Fax: (831) 625-4764


PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's 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.

MIPS Measure Score Weight Score
Quality 40% 98.6
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 (PI) 25% N/A
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 15% 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 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 20% 96.3
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.
MIPS Final Score - 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.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 110X-ray of chest, 1 view, front (HCPCS:71010)
  • 15X-ray of chest, 2 views, front and side (HCPCS:71020)

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
930086627OTHER (01)CARAILROAD
F15656MEDICARE UPIN (02)CA
00G784300OTHER (01)CABLUE SHIELD
00G784300MEDICARE ID-TYPE UNSPECIFIED (04)CA

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.
1679580831
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
26149108086
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 4 + 9 + 1 + 0 + 8 + 0 + 8 + 6 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1679580831 is valid because the calculated check digit 1 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.

NPI Name / Type Taxonomy Address
1144227380 GERALDINE C TAPLIN M.D
Individual
Internal Medicine (Infectious Disease)23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 771-1444
1215985205DR. GERALD DIETER GRIFFIN MD, PHARMD
Individual
General Practice23625 HOLMAN HWY COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA
MONTEREY, CA 93940
(831) 625-4511
1053325308MONTEREY PENINSULA ANESTHESIA MEDICAL GROUP, INC.
Organization
Anesthesiology23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1255347753 DAVID DANSKY M.D.
Individual
Emergency Medicine23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 625-4900
1548277999 JOHN HAGE M.D.
Individual
Emergency Medicine23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1831106061 DAVID ERNST WHITLOCK M.D.
Individual
Emergency Medicine23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1356358527 MARILYN UWATE R.D., M.ED., C.D.E.,
Individual
Dietitian, Registered23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1124035084 GREGOR JAMES PUTZKA MFT
Individual
Marriage & Family Therapist23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1033126990 BARBARA ANN QUINN M.S., R.D., C.D.E.
Individual
Dietitian, Registered23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1477561876 MICHELLE ANN KRUEGER-KALINSKI M.D.
Individual
Emergency Medicine23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1861402539 MARY L LOUNSBURY PH.D
Individual
Psychologist (Adult Development & Aging)23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1750391421 SUZI I BRAUNER-TATUM LCSW
Individual
Social Worker (Clinical)23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1639189335 MARTIN LOUIS SKERRITT LCSW
Individual
Social Worker23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1104933647 JUDD KARL NICHOLAS M.D.
Individual
Emergency Medicine23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1093822546 LISA HOLDEN M.S., R.D., C.D.E.
Individual
Dietitian, Registered23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1720195266 PAUL FILE M.D.
Individual
Emergency Medicine23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1467560367 SUSAN TITUS C.N.S.
Individual
Clinical Nurse Specialist (Psychiatric/Mental Health)23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1861572422 JESSE KAHN M.D.
Individual
Radiology (Body Imaging)23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1275612285 FRANK A TAKACS MD
Individual
Anesthesiology23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311
1871615666 PATRICIA L VINCENT R.D.
Individual
Dietitian, Registered23625 HOLMAN HWY
MONTEREY, CA 93940
(831) 624-5311

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Andres Martin Aldrete M.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.