JORGE PLASENCIA M.D. NPI 1760466346

Family Medicine in Saginaw, MI

NPI 1760466346 Individual Male Years of Experience 27 Family Medicine PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About JORGE PLASENCIA

Jorge Plasencia is a primary care provider established in Saginaw, Michigan and his medical specialization is family medicine with more than 27 years of experience. The NPI number of Jorge Plasencia is 1760466346 and was assigned on December 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 4301068139 (MI). The provider is registered as an individual and his NPI record was last updated 10 years ago.

A primary care provider (PCP) like Jorge Plasencia M.d. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Jorge Plasencia is enrolled in PECOS and is eligible to order or refer healthcare 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

Jorge Plasencia is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Covenant Medical Center.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: electronic submission of patient centered medical home accreditation, e-prescribing, health information exchange, immunization registry reporting, medication reconciliation, onc direct review attestation, patient-specific education, provide patient access, secure messaging, security risk analysis and specialized registry reporting. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

NPI

1760466346

Provider Name JORGE PLASENCIA M.D.
Provider Location Address4705 TOWNE CTR SUITE 202 SAGINAW, MI 48604
Provider Mailing Address4449 FASHION SQUARE BLVD SAGINAW, MI 48603
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1995
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date12-06-2005
Last Update Date12-20-2011


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.4301068139
License StateMI
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

JORGE PLASENCIA M.D.
4705 TOWNE CTR
SUITE 202
SAGINAW, MI
ZIP 48604
Phone: (989) 791-3401
Fax: (989) 791-3466

Get Directions


Mailing Address

JORGE PLASENCIA M.D.
4449 FASHION SQUARE BLVD
SAGINAW, MI
ZIP 48603
Phone: (989) 790-0007
Fax: (989) 790-7547



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID7113914227
PECOS Enrollment IDI20040429001068
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 order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 58Administration of influenza virus vaccine (HCPCS:G0008)
  • 37Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • 16Hemoglobin A1C level (HCPCS:83036)
  • 12Pneumococcal vaccine for injection into muscle (HCPCS:90670)
  • 12Administration of pneumococcal vaccine (HCPCS:G0009)

Quality Reporting

The following quality measures meets Medicare's statistical reporting standards for the year 2018. 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 Rate Number of Patients
e-Prescribing 96% 8066
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 14% 118
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.
Medication Reconciliation 95% 1442
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 100% 1661
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 95% 1661
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 84% 1661
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.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Jorge Plasencia is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
COVENANT MEDICAL CENTER1447 N HARRISON
SAGINAW, MI 48602
(989) 583-4000Acute Care Hospitals230070

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
G93568MEDICARE UPIN (02)MI
4767454MEDICAID (05)MI
0P20440MEDICARE ID-TYPE UNSPECIFIED (04)MI

Other Providers at the same location


The following 11 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1306830963 NIKOLAI KINACHTCHOUK M.D.
Individual
Internal Medicine4705 TOWNE CTR SUITE 102
SAGINAW, MI 48604
(989) 790-2984
1568630952JEFFREY R LEVIN MD PC
Organization
Psychiatry & Neurology (Neurology)4705 TOWNE CTR STE 302
SAGINAW, MI 48604
(989) 249-8001
1285806471JACOB C. NINAN MD PC
Organization
Internal Medicine (Hematology & Oncology)4705 TOWNE CTR SUITE 204
SAGINAW, MI 48604
(989) 799-6110
1134496292 JENNIFER RADEWAHN PA
Individual
Physician Assistant4705 TOWNE CTR STE 102
SAGINAW, MI 48604
(989) 790-2941
1124012786 LIOUDMILA KINACHTCHOUK M.D.
Individual
Internal Medicine4705 TOWNE CTR SUITE 102
SAGINAW, MI 48604
(989) 790-2984
1063739654ASCENSION ST. MARY'S HOSPITAL
Organization
Surgery (Trauma Surgery)4705 TOWNE CTR SUITE 104
SAGINAW, MI 48604
(989) 497-3157
1649597998ASCENSION ST. MARY'S HOSPITAL
Organization
Plastic Surgery4705 TOWNE CTR SUITE 104
SAGINAW, MI 48604
(989) 497-3157
1851327159DR. DEBASISH MRIDHA M.D.
Individual
Psychiatry & Neurology (Neurology)4705 TOWNE CTR SUITE 201
SAGINAW, MI 48604
(989) 799-2770
1003004086MICHIGAN ADVANCED NEUROLOGY CENTER, PLLC
Organization
Psychiatry & Neurology (Neurology)4705 TOWNE CTR STE. 201
SAGINAW, MI 48604
(989) 799-2770
1982642898PLASENCIA FAMILY MEDICINE PLLC
Organization
Family Medicine4705 TOWNE CTR SUITE 202
SAGINAW, MI 48604
(989) 791-3401
1639263098DR. WILLIAM JOHN PITTAS D.O.
Individual
Surgery (Plastic and Reconstructive Surgery)4705 TOWNE CTR SUITE 104
SAGINAW, MI 48604
(989) 497-3157

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.