BRIAN HARPER WETCHLER D.O.
NPI 1710253158
Internal Medicine in Woodbury, NY
NPI Status: Active since March 29, 2012
Contact Information
135 CROSSWAYS PARK DR STE LL7
WOODBURY, NY
ZIP 11797
Phone: (516) 212-7630
Fax: (516) 200-2482
- Individual
- Male
- Internal Medicine
- PECOS Enrolled
- Opted-Out Medicare
- Medicare Quality Reporting
About BRIAN WETCHLER
This page provides the complete NPI Profile along with additional information for Brian Wetchler, an internist established in Woodbury, New York with a medical specialization in Internal Medicine. The healthcare provider is registered in the NPI registry with number 1710253158 assigned on March 2012. The practitioner's primary taxonomy code is 207R00000X with license number 271383 (NY). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1710253158
- Provider Name
- BRIAN HARPER WETCHLER D.O.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 135 CROSSWAYS PARK DR STE LL7 WOODBURY, NY 11797
- Location Phone
- (516) 212-7630
- Location Fax
- (516) 200-2482
- Mailing Address
- 135 CROSSWAYS PARK DR STE LL7 WOODBURY, NY 11797
- Mailing Phone
- (516) 212-7630
- Mailing Fax
- (516) 200-2482
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-29-2012
- Last Update Date
- 11-25-2024
- Code Navigator
An internist like Brian Wetchler is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Brian Wetchler opted out of Medicare effective on 04-12-2021 until 04-12-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
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
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 271383
- License State
- NY
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Medicare Participation & PECOS Enrollment Status
Brian Wetchler 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
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-12-2021
Opt-Out End Date: 04-12-2027
Eligible to Order and Refer? 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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Hospital Beds (DB000N)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
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 11797 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $154.28
- Minimum New Patient Price $67.4
- Maximum New Patient Price $203.53
- Average New Patient Copayment $38.57
- Minimum New Patient Copayment $16.85
- Maximum New Patient Copayment $50.88
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $117.62
- Minimum Established Patient Price $21.66
- Maximum Established Patient Price $164.45
- Average Established Patient Copayment $29.4
- Minimum Established Patient Copayment $5.41
- Maximum Established Patient Copayment $41.11
* 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 |
|---|---|---|
| Breast Cancer Screening | 27% | 325 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Colorectal Cancer Screening | 35% | 612 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Consultation of the Prescription Drug Monitoring Program | Yes | N/A |
| Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance. | ||
| Documentation of Current Medications in the Medical Record | 99% | 3348 |
| 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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Pneumococcal Vaccination Status for Older Adults | 67% | 888 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 37% | 1314 |
| 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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Use of High-Risk Medications in the Elderly | 0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 888 |
| 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. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
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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 1710253158, we treat the final digit (8) 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 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710253158, enumerated as an "individual" on March 29, 2012.
The provider is located at 135 CROSSWAYS PARK DR STE LL7 WOODBURY, NY 11797 and the phone number is (516) 212-7630.
Internal Medicine with taxonomy code 207R00000X.
