DIJANA JEFIC MD
NPI 1730134057
Internal Medicine - Nephrology in Henderson, NV

Quality Rating: 75 out of 100 score

NPI Status: Active since May 24, 2006

Contact Information

229 N PECOS RD
STE 120
HENDERSON, NV
ZIP 89074
Phone: (702) 256-3637
Fax: (702) 256-3307

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Table of Contents

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

Individual
Female
Years of Experience 30
Internal Medicine
Nephrology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About DIJANA JEFIC

This page provides the complete NPI Profile along with additional information for Dijana Jefic, an internist established in Henderson, Nevada with a medical specialization in Internal Medicine, focusing in nephrology and more than 30 years of experience. The healthcare provider is registered in the NPI registry with number 1730134057 assigned on May 2006. The practitioner's primary taxonomy code is 207RN0300X with license number 13545 (NV). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI: 1730134057
Provider Name: DIJANA JEFIC MD
Gender: Female
Entity Type: Individual
Location Address: 229 N PECOS RD STE 120 HENDERSON, NV 89074
Location Phone: (702) 256-3637
Location Fax: (702) 256-3307
Mailing Address: 861 CORONADO CENTER DR STE 211 HENDERSON, NV 89052
Mailing Phone: (702) 818-9246
Mailing Fax: (702) 256-3307
Medical School Name: OTHER
Graduation Year: 1996
Is Sole Proprietor?: No
Enumeration Date: 05-24-2006
Last Update Date: 02-19-2021
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An internist like Dijana Jefic 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 Nephrology
Taxonomy Code: 207RN0300X
Type: Allopathic & Osteopathic Physicians
License No.: 13545
License State: NV
Taxonomy Description: An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Insurance Plans Accepted

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

Ambetter from Arizona Complete Health

Choice Bronze HSA - HMO
Choice Bronze HSA + Vision + Adult Dental - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Complete Silver - HMO
Complete Silver + Vision + Adult Dental - HMO
Elite Gold - HMO
Elite Gold + Vision + Adult Dental - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO
Standard Expanded Bronze - HMO
Standard Expanded Bronze + Vision + Adult Dental - HMO
Standard Gold - HMO
Standard Gold + Vision + Adult Dental - HMO
Standard Silver - HMO
Standard Silver + Vision + Adult Dental - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

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
1730134057	MEDICAID (05)	NV

Medicare Participation & PECOS Enrollment Status

Dijana Jefic 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.

Dijana Jefic 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: 2567475528
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: I20101214000091
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.

Unknown

Treatment-Treatment - Miscellaneous (RX029N)
Tacrolimus, immediate release, oral, 1 mg (HCPCS:J7507)
3 DME suppliers used 27 Medicare Claims 1170 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period (HCPCS:Q0511)
4 DME suppliers used 13 Medicare Claims 13 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period (HCPCS:Q0512)
4 DME suppliers used 30 Medicare Claims 30 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.

Critical care, first 30-74 minutes
Dialysis services, 1 physician visit per month (20 years or older)
Dialysis services, 2-3 physician visits per month (20 years or older)
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 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, 60-74 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.81 for a new patient copayment and $25.15 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 89074 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $131.25
Minimum New Patient Price $57.07
Maximum New Patient Price $173.24

Average New Patient Copayment $32.81
Minimum New Patient Copayment $14.26
Maximum New Patient Copayment $43.31

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $100.6
Minimum Established Patient Price $18.27
Maximum Established Patient Price $140.96

Average Established Patient Copayment $25.15
Minimum Established Patient Copayment $4.56
Maximum Established Patient Copayment $35.24

* 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 75, 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: 75 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: N/A

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: N/A

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: N/A

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: N/A

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: N/A

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
Diabetes screening	Yes	N/A
Diabetes screening for people with schizophrenia or bipolar disease who are using antipsychotic medication.
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.
Implementation of an ASP	Yes	N/A
Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance
Implementation of formal quality improvement methods, practice changes, or other practice improvement processes	Yes	N/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
Implementation of improvements that contribute to more timely communication of test results	Yes	N/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	21%	522
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
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	8%	522
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.
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.
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 certified EHR to capture patient reported outcomes	Yes	N/A
In support of improving patient access, performing additional activities that enable capture of patient reported outcomes (e.g., home blood pressure, blood glucose logs, food diaries, at-risk health factors such as tobacco or alcohol use, etc.) or patient activation measures through use of certified EHR technology, containing this data in a separate queue for clinician recognition and review.
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.	372
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
Use of QCDR to promote standard practices, tools and processes in practice for improvement in care coordination	Yes	N/A
Participation in a Qualified Clinical Data Registry, demonstrating performance of activities that promote use of standard practices, tools and processes for quality improvement (e.g., documented preventative screening and vaccinations that can be shared across MIPS eligible clinician or groups).

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. Dijana Jefic is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
SAINT ROSE DOMINICAN HOSPITALS - SIENA CAMPUS	3001 ST ROSE PARKWAY HENDERSON, NV 89052	(702) 616-5000	Acute Care 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 1730134057, we treat the final digit (7) 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

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 → 6

Pos 4

Unchanged

Pos 5

Doubled → 2

Pos 6

Unchanged

Pos 7

Doubled → 8

Pos 8

Unchanged

Pos 9

Doubled → 10 → 1 + 0

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 3 → 6 1 → 2 4 → 8 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 7 + 6 + 0 + 2 + 3 + 8 + 0 + 1 + 0 + 24 = 53

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

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7

This NPI is valid

The calculated check digit is 7, which matches the last digit of 1730134057.

Other Providers at the Same Location

The following 1 provider is registered at the same or a nearby location.

HILARY MEI LIU

Physician Assistant

229 N PECOS RD
HENDERSON, NV 89074

Clark County (702) 605-5750

About DIJANA JEFIC

Location Map

Specialty - Primary Taxonomy

Internal Medicine Nephrology

Insurance Plans Accepted

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 2567475528

PECOS Enrollment ID: I20101214000091

Accepts Medicare Assignment? 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

Unknown

Areas of Expertise

Critical care, first 30-74 minutes

Dialysis services, 1 physician visit per month (20 years or older)

Dialysis services, 2-3 physician visits per month (20 years or older)

Established patient office or other outpatient visit, 30-39 minutes

Established patient office or other outpatient visit, 40-54 minutes

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care per day, typically 35 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, 60-74 minutes

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Overall MIPS Quality Performance

Final Score: 75 out of 100

Quality Score: N/A

Promoting Interoperability Score: N/A

Improvement Activities Score: N/A

Cost Score: N/A

Cost Score: N/A

Quality Reporting

Find Provider Hospital Affiliations - Privileges

Reviews for DIJANA JEFIC MD

NPI NPI Number Validation

How NPI Validation Works

Digit-by-digit view

Step 1: Double every other digit from the right

Step 2: Add all digits plus the NPI constant

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

Other Providers at the Same Location

Frequently Asked Questions