RAJEEV VIBHAKAR MD
NPI 1699753376
Pediatrics - Pediatric Hematology-Oncology in Aurora, CO


Quality Rating: 84.53 out of 100 score

NPI Status: Active since January 04, 2006

Contact Information

13123 E 16TH AVE
AURORA, CO
ZIP 80045
Phone: (720) 777-1234

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  • Individual
  • Male
  • Years of Experience 27
  • Pediatrics
  • Pediatric Hematology-Oncology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About RAJEEV VIBHAKAR

This page provides the complete NPI Profile along with additional information for Rajeev Vibhakar, a pediatrician established in Aurora, Colorado with a medical specialization in Pediatrics, focusing in pediatric hematology-oncology and more than 27 years of experience. He graduated from New York Medical College in 1999. The healthcare provider is registered in the NPI registry with number 1699753376 assigned on January 2006. The practitioner's primary taxonomy code is 2080P0207X with license number 47629 (CO). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI
1699753376
Provider Name
RAJEEV VIBHAKAR MD
Gender
Male
Entity Type
Individual
Location Address
13123 E 16TH AVE AURORA, CO 80045
Location Phone
(720) 777-1234
Mailing Address
PO BOX 876 AURORA, CO 80040
Mailing Phone
(303) 493-7000
Medical School Name
NEW YORK MEDICAL COLLEGE
Graduation Year
1999
Is Sole Proprietor?
No
Enumeration Date
01-04-2006
Last Update Date
01-04-2011
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A pediatrician like Rajeev Vibhakar is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

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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

Pediatrics Pediatric Hematology-Oncology

Taxonomy Code
2080P0207X
Type
Allopathic & Osteopathic Physicians
License No.
47629
License State
CO
Taxonomy Description
A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.

Insurance Plans Accepted

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

  • Medica Insure Bronze $0 Copay PCP Visits - EPO
  • Medica Insure Bronze Premier - EPO
  • Medica Insure Bronze Share - EPO
  • Medica Insure Expanded Bronze Standard - EPO
  • Medica Insure Gold $0 Copay PCP Visits - EPO
  • Medica Insure Gold Share - EPO
  • Medica Insure Gold Standard - EPO
  • Medica Insure Silver $0 Copay PCP Visits - EPO
  • Medica Insure Silver Share - EPO
  • Medica Insure Silver Standard - EPO

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
CO304759MEDICARE PIN (08)CO 
66706335MEDICAID (05)CO 

Medicare Participation & PECOS Enrollment Status

Rajeev Vibhakar 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.

Rajeev Vibhakar 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: 8628093705

    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: I20090622000249

    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

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 84.53, 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: 84.53 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: 83.68

    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: 64.74

    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: 64.74

    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 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.
1699753376
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
261891456314
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 8 + 9 + 1 + 4 + 5 + 6 + 3 + 1 + 4 + 24 = 74
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 74 = 66

The NPI number 1699753376 is valid because the calculated check digit 6 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.

LISA WANGER PA

Physician Assistant

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

JOYCE MARIE GIBBONS PA C

Physician Assistant

13123 E 16TH AVE
B145
AURORA, CO
ZIP 80045

(720) 777-6652

DAVID ECKHARDT PA

Physician Assistant

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

STANLEY LOFTNESS MD

Anesthesiology

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

SEAN O'LEARY MD

Pediatrics

(Pediatric Infectious Diseases)

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

FREDERICK SUCHY M.D.

Pediatrics

(Pediatric Gastroenterology)

13123 E 16TH AVE
THE CHILDRENS HOSPITAL
AURORA, CO
ZIP 80045

(720) 777-1234

ROBIN SAWARYNSKI PA

Physician Assistant

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

DUNCAN WILCOX MD

Urology

(Pediatric Urology)

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

DR. KRISTA A YORK MD

Pediatrics

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

KENDRA BJORAKER PHD

Clinical Neuropsychologist

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

ERIKA SIDNEY MD

Pediatrics

(Pediatric Emergency Medicine)

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

ROBERT KRAMER MD

Pediatrics

(Pediatric Gastroenterology)

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

TRISTA BOWYER MD

Pediatrics

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

RICHARD HENDERSHOT MD

Anesthesiology

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

TRAVIS HEARE MD

Orthopaedic Surgery

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

BETSEY H BUCCA LCSW

Social Worker

(Clinical)

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1932

PATRICIA LAVESSER OTR

Occupational Therapist

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

DR. DESMOND K RUNYAN MD

Pediatrics

13123 E 16TH AVE
B390
AURORA, CO
ZIP 80045

(303) 864-5364

MS. MELANIE SABERIAN PNP

Nurse Practitioner

(Pediatrics)

13123 E 16TH AVE
THE CHILDREN'S HOSPITAL
AURORA, CO
ZIP 80045

(720) 777-1234

REGINA REYNOLDS MD

Pediatrics

(Neonatal-Perinatal Medicine)

13123 E 16TH AVE
AURORA, CO
ZIP 80045

(720) 777-1234

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1699753376, enumerated as an "individual" on January 04, 2006.

The provider is located at 13123 E 16TH AVE AURORA, CO 80045 and the phone number is (720) 777-1234.

Pediatrics with taxonomy code 2080P0207X and a focus in Pediatric Hematology-Oncology.

The provider might be accepting Accepts: Medica, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.