DR. ANTHONY BRIAN OCHOA MD
NPI 1720060395
Internal Medicine - Cardiovascular Disease in Traverse City, MI

NPI Status: Active since November 18, 2005

Contact Information

1200 SIXTH ST STE 200
TRAVERSE CITY, MI
ZIP 49684
Phone: (231) 935-5800
Fax: (231) 935-5799

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 31
Internal Medicine
Cardiovascular Disease
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About ANTHONY OCHOA

This page provides the complete NPI Profile along with additional information for Anthony Ochoa, an internist established in Traverse City, Michigan with a medical specialization in Internal Medicine, focusing in cardiovascular disease and more than 31 years of experience. He graduated from Uniformed Services Uhs Fe Hebert School Of Med in 1995. The healthcare provider is registered in the NPI registry with number 1720060395 assigned on November 2005. The practitioner's primary taxonomy code is 207RC0000X with license number 4301075199 (MI). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI: 1720060395
Provider Name: DR. ANTHONY BRIAN OCHOA MD
Gender: Male
Entity Type: Individual
Location Address: 1200 SIXTH ST STE 200 TRAVERSE CITY, MI 49684
Location Phone: (231) 935-5800
Location Fax: (231) 935-5799
Mailing Address: 2891 MOMENTUM PL CHICAGO, IL 60689
Mailing Phone: (231) 935-6080
Mailing Fax: (231) 935-5799
Medical School Name: UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED
Graduation Year: 1995
Is Sole Proprietor?: No
Enumeration Date: 11-18-2005
Last Update Date: 12-23-2020
Code Navigator

An internist like Anthony Ochoa 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.

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 Cardiovascular Disease
Taxonomy Code: 207RC0000X
Type: Allopathic & Osteopathic Physicians
License No.: 4301075199
License State: MI
Taxonomy Description: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Insurance Plans Accepted

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

Blue Cross Blue Shield of Michigan Mutual Insurance Company

Blue Cross� Premier PPO Bronze Extra - PPO
Blue Cross� Premier PPO Bronze Saver HSA - PPO
Blue Cross� Premier PPO Bronze Secure - PPO
Blue Cross� Premier PPO Gold - PPO
Blue Cross� Premier PPO Gold Extra - PPO
Blue Cross� Premier PPO Silver - PPO
Blue Cross� Premier PPO Silver Extra - PPO
Blue Cross� Premier PPO Silver Saver HSA - PPO
Blue Cross� Premier PPO Value - PPO

McLaren Health Plan Community

MHP Bronze - HMO
MHP Bronze Saver (Expanded) - HMO
MHP Expanded Bronze Standard - HMO
MHP Gold - HMO
MHP Gold Standard - HMO
MHP Silver Exchange - HMO
MHP Silver Exchange Rewards - HMO
MHP Silver Standard - HMO
MHP Young Adult/Catastrophic - HMO

Priority Health

MyPriority Balanced Silver - HMO
MyPriority Premier Silver - HMO
MyPriority Standard Bronze - HMO
MyPriority Standard Bronze - Travel - HMO
MyPriority Standard Gold - HMO
MyPriority Standard Silver - HMO
MyPriority Standard Silver - Travel - HMO
MyPriority Value Bronze - HMO
MyPriority Value Bronze HSA - HMO

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

Medicare Participation & PECOS Enrollment Status

Anthony Ochoa 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.

Anthony Ochoa 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: 7911073945
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: I20080829000559
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

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-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
4 DME suppliers used 33 Medicare Claims 33 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
3 DME suppliers used 13 Medicare Claims 13 Services Paid

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.

Electrocardiogram (ecg) 2-day continuous with review by health care professional
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 30-39 minutes
Evaluation of implantable heart and blood vessel monitoring system
Evaluation of implantable heart and blood vessel monitoring system
Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days
Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician
External shock to heart to regulate heart beat
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Heart rhythm review and interpretation of continous external ekg over 8-15 days
Hospital discharge day management, more than 30 minutes
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 45-59 minutes
Nuclear medicine studies of heart muscle at rest and with stress and spect
Pacemaker insertion or repair
Programming of dual lead implantable defibrillator system
Programming of dual lead pacemaker system
Programming of dual lead pacemaker system
Programming of multiple lead implantable defibrillator system
Programming of multiple lead implantable defibrillator system
Programming of single lead implantable defibrillator system
Programming of single lead pacemaker system
Programming of single lead pacemaker system
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Ultrasound of heart during rest, exercise and/or drug-induced stress with report
Ultrasound of heart with color-depicted blood flow, rate and valve function
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart with continuous electrocardiogram (ecg) during rest, exercise and/or drug induced stress with review and report
Ultrasound of heart with probe in esophagus, with report
Ultrasound of heart, follow-up
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.53 for a new patient copayment and $17.01 for an established patient copayment.

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 49684 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $126.15
Minimum New Patient Price $54.34
Maximum New Patient Price $166.68

Average New Patient Copayment $31.53
Minimum New Patient Copayment $13.58
Maximum New Patient Copayment $41.67

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $68.07
Minimum Established Patient Price $17.09
Maximum Established Patient Price $135.4

Average Established Patient Copayment $17.01
Minimum Established Patient Copayment $4.27
Maximum Established Patient Copayment $33.85

* 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
ACCPin3 Heart Failure: Patient Self Care Education	1%	87
Patients, age 18 and older, with a principle diagnosis of heart failure (LVEF <40) who received educational counseling on weight monitoring, sodium restriction, physical activity and medication instruction.
Anticoagulant Management Improvements	Yes	N/A
Individual MIPS eligible clinicians and groups who prescribe oral Vitamin K antagonist therapy (warfarin) must attest that, for 60 percent of practice patients in the transition year and 75 percent of practice patients in Quality Payment Program Year 2 and future years, their ambulatory care patients receiving warfarin are being managed by one or more of the following improvement activities: • Patients are being managed by an anticoagulant management service, that involves systematic and coordinated care, incorporating comprehensive patient education, systematic prothrombin time (PT-INR) testing, tracking, follow-up, and patient communication of results and dosing decisions; • Patients are being managed according to validated electronic decision support and clinical management tools that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; • For rural or remote patients, patients are managed using remote monitoring or telehealth options that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; and/or • For patients who demonstrate motivation, competency, and adherence, patients are managed using either a patient self-testing (PST) or patient-self-management (PSM) program.
Cardiac Rehabilitation Patient Referral from an Outpatient Setting	53%	176
Percentage of patients evaluated in an outpatient setting who within the previous 12 months have experienced an acute myocardial infarction (MI), coronary artery bypass graft (CABG) surgery, a percutaneous coronary intervention (PCI), cardiac valve surgery, or cardiac transplantation, or who have chronic stable angina (CSA) and have not already participated in an early outpatient cardiac rehabilitation/secondary prevention (CR) program for the qualifying event/diagnosis who were referred to a CR program
Care Plan	100%	885
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Coronary Artery Disease (CAD): Antiplatelet Therapy	92%	600
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
Diabetes: Medical Attention for Nephropathy	79%	87
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Documentation of Current Medications in the Medical Record	99%	1406
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
Engagement of patients through implementation of improvements in patient portal	Yes	N/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
e-Prescribing	93%	1183
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange	10%	29
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet	93%	446
Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active diagnosis of ischemic vascular disease (IVD) during the measurement period, and who had documentation of use of aspirin or another antiplatelet during the measurement period
Medication Reconciliation	93%	252
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	56%	1062
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access	92%	1062
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	12%	1062
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of High-Risk Medications in the Elderly	4% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	1742
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

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Anthony Ochoa is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type
MUNSON HEALTHCARE GRAYLING HOSPITAL	1100 E MICHIGAN AVE GRAYLING, MI 49738	(989) 348-5461	Acute Care Hospitals
MUNSON HEALTHCARE CADILLAC HOSPITAL	400 HOBART ST CADILLAC, MI 49601	(231) 876-7200	Acute Care Hospitals
MUNSON MEDICAL CENTER	1105 SIXTH STREET TRAVERSE CITY, MI 49684	(231) 935-5000	Acute Care Hospitals
MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL	825 N CENTER AVE GAYLORD, MI 49735	(989) 731-2100	Acute Care Hospitals
CHARLEVOIX AREA HOSPITAL	14700 LAKESHORE DRIVE CHARLEVOIX, MI 49720	(231) 547-4024	Critical Access Hospitals

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 1720060395, we treat the final digit (5) 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 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

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 → 4

Pos 4

Unchanged

Pos 5

Doubled → 0

Pos 6

Unchanged

Pos 7

Doubled → 0

Pos 8

Unchanged

Pos 9

Doubled → 18 → 1 + 8

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 2 → 4 0 → 0 0 → 0 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

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

2 + 7 + 4 + 0 + 0 + 6 + 0 + 3 + 1 + 8 + 24 = 55

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

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5

This NPI is valid

The calculated check digit is 5, which matches the last digit of 1720060395.