DR. MARY D DEGROOT DPM
NPI 1720071970
Podiatrist in New Lenox, IL
Quality Rating: 58.96 out of 100 score
NPI Status: Active since August 23, 2005
Contact Information
1938 E LINCOLN HWY
SUITE 206
NEW LENOX, IL
ZIP 60451
Phone: (815) 462-9225
Fax: (815) 462-5385
- Individual
- Female
- Years of Experience 25
- Podiatrist
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About MARY DEGROOT
This page provides the complete NPI Profile along with additional information for Mary Degroot, a provider established in New Lenox, Illinois with a medical specialization in Podiatrist and more than 25 years of experience. The healthcare provider is registered in the NPI registry with number 1720071970 assigned on August 2005. The practitioner's primary taxonomy code is 213E00000X with license number 016005141 (IL). The provider is registered as an individual and her NPI record was last updated 15 years ago.
- NPI
- 1720071970
- Provider Name
- DR. MARY D DEGROOT DPM
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1938 E LINCOLN HWY SUITE 206 NEW LENOX, IL 60451
- Location Phone
- (815) 462-9225
- Location Fax
- (815) 462-5385
- Mailing Address
- 1938 E LINCOLN HWY SUITE 206 NEW LENOX, IL 60451
- Mailing Phone
- (815) 462-9225
- Mailing Fax
- (815) 462-5385
- Medical School Name
- OTHER
- Graduation Year
- 2001
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-23-2005
- Last Update Date
- 01-26-2011
- Code Navigator
A podiatrist like Mary Degroot provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.
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
Podiatrist
- Taxonomy Code
- 213E00000X
- Type
- Podiatric Medicine & Surgery Service Providers
- License No.
- 016005141
- License State
- IL
- Taxonomy Description
- A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCare EPO Bronze - EPO
- BlueCare EPO Gold - EPO
- BlueCare EPO Gold Plus - EPO
- BlueCare EPO Silver Plus - EPO
- BlueCare EPO Simple Bronze HDHP - EPO
- BlueCare EPO Simple Silver HDHP - EPO
- BlueCare EPO Standardized Expanded Bronze - EPO
- BlueCare EPO Standardized Gold - EPO
- BlueCare EPO Standardized Silver - 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.
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 |
|---|---|---|---|
| 01634686 | OTHER (01) | IL | BCBS |
| 210098 | MEDICARE PIN (08) | IL | |
| P00194730 | OTHER (01) | IL | RAILROAD MEDICARE |
| K49906 | MEDICARE PIN (08) | IL | |
| V01817 | MEDICARE UPIN (02) | ||
| 016005141 | MEDICAID (05) | IL | |
| 5554880001 | MEDICARE NSC (07) | IL |
Medicare Participation & PECOS Enrollment Status
Mary Degroot 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.
Mary Degroot 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) and a Home Health Agency (HHA).
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: 7416918644
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: I20041021000429
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: No
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.
Follow-up nursing facility visit per day, typically 10 minutes
New patient custodial care facility, group care, or assisted living visit, typically 20 minutes
Removal of fingernails or toenails, 1-5 nails
Removal of fingernails or toenails, 1-5 nails
Removal of fingernails or toenails, 6 or more nails
Removal of noncancer thickened skin growth, 1 growth
Removal of noncancer thickened skin growth, 2-4 growths
Trimming of dystrophic nails, any number
Trimming of dystrophic nails, any number
A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.
This service was performed 21 times for 19 patientsThis service involves a 20-minute visit for new patients at a custodial care facility, group care, or assisted living setting. The healthcare provider will assess your health, discuss any concerns, and develop a care plan tailored to your needs.
This service was performed 21 times for 21 patientsThis procedure involves the careful removal of 1-5 nails from fingers or toes. It's typically done to treat conditions like ingrown nails, fungal infections, or damaged nails. Local anesthesia is used for comfort, and the area heals over time with appropriate care.
This service was performed 12 times for 12 patientsThis procedure involves the careful removal of 1-5 nails from fingers or toes. It's typically done to treat conditions like ingrown nails, fungal infections, or damaged nails. Local anesthesia is used for comfort, and the area heals over time with appropriate care.
This service was performed 817 times for 380 patientsThis procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
This service was performed 154 times for 76 patientsThis procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.
This service was performed 255 times for 121 patientsThis procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.
This service was performed 217 times for 94 patientsTrimming of dystrophic nails involves the careful cutting and shaping of thickened or deformed nails. This is often required when nails are affected by conditions such as fungus or psoriasis. The procedure helps to reduce discomfort and improve nail health.
This service was performed 12 times for 12 patientsTrimming of dystrophic nails involves the careful cutting and shaping of thickened or deformed nails. This is often required when nails are affected by conditions such as fungus or psoriasis. The procedure helps to reduce discomfort and improve nail health.
This service was performed 801 times for 376 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $23.25 for a new patient copayment and $18.59 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 60451 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $93.02
- Minimum New Patient Price $59.81
- Maximum New Patient Price $181.38
- Average New Patient Copayment $23.25
- Minimum New Patient Copayment $14.95
- Maximum New Patient Copayment $45.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $74.38
- Minimum Established Patient Price $19.15
- Maximum Established Patient Price $147.12
- Average Established Patient Copayment $18.59
- Minimum Established Patient Copayment $4.78
- Maximum Established Patient Copayment $36.78
* 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.
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 58.96, 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.
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Final Score: 58.96 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.
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Quality Score: 67.94
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.
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Promoting Interoperability Score: 0
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: 45.25
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: 45.25
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.
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 |
|---|---|---|
| Patient-Specific Education | 98% | 1233 |
| 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 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 100% | 1233 |
| 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 | 99% | 1233 |
| 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. | ||
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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 1720071970, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
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 60 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 15 providers are registered at the same or a nearby location.
NEW LENOX, IL 60451
NEW LENOX, IL 60451
NEW LENOX, IL 60451
NEW LENOX, IL 60451
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720071970, enumerated as an "individual" on August 23, 2005.
The provider is located at 1938 E LINCOLN HWY SUITE 206 NEW LENOX, IL 60451 and the phone number is (815) 462-9225.
Podiatrist with taxonomy code 213E00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Kansas, Inc., Blue. Please consult your insurance carrier or call the provider to verify.
