JULIE GOLDMAN M.D.
NPI 1750794178
Ophthalmology - Cornea and External Diseases Specialist in Bangor, ME

Quality Rating: 84.15 out of 100 score

NPI Status: Active since June 03, 2014

Contact Information

1 RIDGEWOOD DR
BANGOR, ME
ZIP 04401
Phone: (207) 945-6200
Fax: (207) 990-3015

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Table of Contents

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Overall Quality Performance
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 12
Ophthalmology
Cornea and External Diseases Specialist
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About JULIE GOLDMAN

This page provides the complete NPI Profile along with additional information for Julie Goldman, a provider established in Bangor, Maine with a medical specialization in Ophthalmology, focusing in cornea and external diseases specialist and more than 12 years of experience. She graduated from Columbia University College Of Physicians And Surgeons in 2014. The healthcare provider is registered in the NPI registry with number 1750794178 assigned on June 2014. The practitioner's primary taxonomy code is 207WX0120X with license number MD24889 (ME). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI: 1750794178
Provider Name: JULIE GOLDMAN M.D.
Gender: Female
Entity Type: Individual
Location Address: 1 RIDGEWOOD DR BANGOR, ME 04401
Location Phone: (207) 945-6200
Location Fax: (207) 990-3015
Mailing Address: 1 RIDGEWOOD DR BANGOR, ME 04401
Mailing Phone: (207) 945-6200
Mailing Fax: (207) 990-3015
Medical School Name: COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Graduation Year: 2014
Is Sole Proprietor?: No
Enumeration Date: 06-03-2014
Last Update Date: 04-10-2024
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Location Map

Secondary Locations

2640 Patriot Blvd Ste 100
Glenview, IL 60026
(847) 510-6000
1855 W Taylor St
Chicago, IL 60612
(312) 996-8937
1855 W Taylor St
Chicago, IL 60612
(312) 996-8937

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 Cornea and External Diseases Specialist
Taxonomy Code: 207WX0120X
Type: Allopathic & Osteopathic Physicians
License No.: MD24889
License State: ME
Taxonomy Description: An ophthalmologist who specializes in diseases of the cornea, sclera, eyelids, conjunctiva, and anterior segment of the eye.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine	260171 (MA)
2	207W00000X	Allopathic & Osteopathic Physicians	Ophthalmology	036.145877 (IL)

Insurance Plans Accepted

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

Anthem Blue Cross and Blue Shield

Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
Anthem Bronze Pathway X HMO 5000/10%/8000 w/HSA - HMO
Anthem Bronze Pathway X HMO 5000/20%/8000 w/HSA - HMO
Anthem Bronze Pathway X HMO 6500/30%/9200 Value - HMO
Anthem Bronze Pathway X HMO 7000/50%/8000 w/HSA - HMO
Anthem Bronze Pathway X HMO 8500/50%/9200 - HMO
Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
Anthem Gold Pathway X HMO 1000/20%/7500 - HMO
Anthem Gold Pathway X HMO 2000/0%/6500 RxD - HMO
Anthem Gold Pathway X HMO 2000/10%/4600 w/HSA - HMO

Blue Cross and Blue Shield of Illinois

Blue Choice Preferred Bronze PPO? 201 - PPO
Blue Choice Preferred Bronze PPO? 701 - PPO
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
Blue Choice Preferred Gold PPO? 204 - PPO
Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
Blue Choice Preferred Security PPO? 200 - PPO
Blue Choice Preferred Silver PPO? 203 - PPO
Blue Choice Preferred Silver PPO? 801 - PPO
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
Blue Precision Bronze HMO? 205 - HMO
Blue Precision Bronze HMO? 701 - HMO
Blue Precision Bronze HMO? Standard - Select Rx Copays - HMO
Blue Precision Gold HMO? 207 - HMO
Blue Precision Gold HMO? 703 - HMO
Blue Precision Gold HMO? Standard - Rx Copays - HMO
Blue Precision Silver HMO? 206 - HMO
Blue Precision Silver HMO? 704 - HMO
Blue Precision Silver HMO? Standard - Select Rx Copays - HMO
BlueCare Direct Bronze? Standard - Select Rx Copays with Advocate - HMO
BlueCare Direct Gold? Standard - Rx Copays with Advocate - HMO

Blue Cross and Blue Shield of Montana

Blue Focus Bronze POS? 205 - POS
Blue Focus Bronze POS? 705 - POS
Blue Focus Bronze POS? Standard - POS
Blue Focus Gold POS? 207 - POS
Blue Focus Gold POS? Standard - POS
Blue Focus Silver POS? 206 - POS
Blue Focus Silver POS? Standard - POS
Blue Preferred Bronze PPO? 201 - PPO
Blue Preferred Bronze PPO? 202 - PPO
Blue Preferred Bronze PPO? Standard - PPO
Blue Preferred Gold PPO? 204 - PPO
Blue Preferred Gold PPO? Standard - PPO
Blue Preferred Security PPO? 200 - PPO
Blue Preferred Silver PPO? 203 - PPO
Blue Preferred Silver PPO? 308 - PPO
Blue Preferred Silver PPO? Standard - PPO

Blue Cross and Blue Shield of Oklahoma

Blue Advantage Bronze PPO? 202 - PPO
Blue Advantage Bronze PPO? 203 - PPO
Blue Advantage Bronze PPO? Standard - PPO
Blue Advantage Gold PPO? 309 - PPO
Blue Advantage Gold PPO? 604 - PPO
Blue Advantage Gold PPO? Standard - PPO
Blue Advantage Silver PPO? 204 - PPO
Blue Advantage Silver PPO? 501 - PPO
Blue Advantage Silver PPO? Standard - PPO
Blue Preferred Bronze PPO? Standard - PPO
Blue Preferred Gold PPO? Standard - PPO
Blue Preferred Security PPO? 200 - PPO
Blue Preferred Silver PPO? Standard - PPO
MyBlue Gold HMO? 704 - HMO
MyBlue Gold HMO? 804 - HMO
MyBlue Gold HMO? Standard - HMO
MyBlue Silver HMO? 705 - HMO
MyBlue Silver HMO? 803 - HMO
MyBlue Silver HMO? Standard - HMO

Blue Cross and Blue Shield of Texas

Blue Advantage Bronze HMO? 204 - HMO
Blue Advantage Bronze HMO? 301 - HMO
Blue Advantage Bronze HMO? Standard - HMO
Blue Advantage Gold HMO? 206 - HMO
Blue Advantage Gold HMO? 603 - HMO
Blue Advantage Gold HMO? Standard - HMO
Blue Advantage Plus Bronze? 303 - POS
Blue Advantage Plus Bronze? 305 - POS
Blue Advantage Plus Bronze? Standard - POS
Blue Advantage Plus Gold? 203 - POS
Blue Advantage Plus Gold? 803 - POS
Blue Advantage Plus Gold? Standard - POS
Blue Advantage Plus Silver? 202 - POS
Blue Advantage Plus Silver? 605 - POS
Blue Advantage Plus Silver? Standard - POS
Blue Advantage Security HMO? 200 - HMO
Blue Advantage Silver HMO? 205 - HMO
Blue Advantage Silver HMO? 801 - HMO
Blue Advantage Silver HMO? Standard - HMO
MyBlue Health Bronze? 402 - HMO

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

Medicare Participation & PECOS Enrollment Status

Julie Goldman 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.

Julie Goldman 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: 6204058100
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: I20210609002469
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

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.

Cataract surgery
Closure of tear duct opening using plug
Ct scan of cornea
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Imaging of retina
Measurement of corneal curvature and depth of eye
New patient office or other outpatient visit, 45-59 minutes
Removal of cataract with insertion of prosthetic lens

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $30.8 for a new patient copayment and $16.68 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 04401 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $123.23
Minimum New Patient Price $53.26
Maximum New Patient Price $162.77

Average New Patient Copayment $30.8
Minimum New Patient Copayment $13.31
Maximum New Patient Copayment $40.69

Established Patients Visit Costs *

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

Average Established Patient Price $66.74
Minimum Established Patient Price $16.9
Maximum Established Patient Price $132.79

Average Established Patient Copayment $16.68
Minimum Established Patient Copayment $4.22
Maximum Established Patient Copayment $33.19

* 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 84.15, 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: 84.15 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: 72.37

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: 99

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: 61.67

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: 61.67

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.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	7	5	0	7	9	4	1	7	8
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	10	0	14	9	8	1	14
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 1 + 4 + 9 + 8 + 1 + 1 + 4 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 8									8

The NPI number 1750794178 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.