DR. GERALD JAMES ROPER MD
NPI 1720070642
Ophthalmology in Batesville, IN
NPI Status: Active since August 17, 2005
Contact Information
1049 STATE ROAD 229 N
BATESVILLE, IN
ZIP 47006
Phone: (812) 934-9400
Fax: (812) 933-0913
- Individual
- Male
- Ophthalmology
- PECOS Enrolled
- Medicare Quality Reporting
About GERALD ROPER
This page provides the complete NPI Profile along with additional information for Gerald Roper, a provider established in Batesville, Indiana with a medical specialization in Ophthalmology. The healthcare provider is registered in the NPI registry with number 1720070642 assigned on August 2005. The practitioner's primary taxonomy code is 207W00000X with license number 01043840 (IN). The provider is registered as an individual and his NPI record was last updated 7 years ago.
- NPI
- 1720070642
- Provider Name
- DR. GERALD JAMES ROPER MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1049 STATE ROAD 229 N BATESVILLE, IN 47006
- Location Phone
- (812) 934-9400
- Location Fax
- (812) 933-0913
- Mailing Address
- 1049 STATE ROAD 229 BATESVILLE, IN 47006
- Mailing Phone
- (812) 209-9050
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-17-2005
- Last Update Date
- 12-27-2019
- Code Navigator
Ophthalmologists like Gerald Roper specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
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
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 01043840
- License State
- IN
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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.
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 |
|---|---|---|---|
| 180043678 | OTHER (01) | IN | RAILROAD MEDICARE |
| 3521526086A0 | OTHER (01) | PARAGON HEALTH | |
| 200189850 | MEDICAID (05) | IN | |
| 000000352907 | OTHER (01) | IN | ANTHEM |
| 0801868 | OTHER (01) | UNITED HEALTHCARE | |
| 74708 | OTHER (01) | HUMANA |
Medicare Participation & PECOS Enrollment Status
Gerald Roper 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
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
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 47006 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $122.49
- Minimum New Patient Price $53.07
- Maximum New Patient Price $161.76
- Average New Patient Copayment $30.62
- Minimum New Patient Copayment $13.26
- Maximum New Patient Copayment $40.44
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.48
- Minimum Established Patient Price $16.93
- Maximum Established Patient Price $132.22
- Average Established Patient Copayment $16.62
- Minimum Established Patient Copayment $4.23
- Maximum Established Patient Copayment $33.05
* 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 |
|---|---|---|
| Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 100% | 20 |
| Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage AND the level of macular degeneration severity during one or more office visits within 12 months | ||
| Diabetes: Eye Exam | 100% | 26 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care | 100% | 41 |
| Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months | ||
| Documentation of Current Medications in the Medical Record | 100% | 124 |
| 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 New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| Tobacco use | Yes | N/A |
| Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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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 1720070642, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
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 58 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720070642, enumerated as an "individual" on August 17, 2005.
The provider is located at 1049 STATE ROAD 229 N BATESVILLE, IN 47006 and the phone number is (812) 934-9400.
Ophthalmology with taxonomy code 207W00000X.
The provider might be accepting Accepts: Railroad Medicare, Medicare, Medicaid, Anthem Blue. Please consult your insurance carrier or call the provider to verify.
