DR. MILAGROS PALAD CAILING M.D.
NPI 1770672560
Internal Medicine - Nephrology in Jacksonville, NC

NPI Status: Active since October 12, 2006

Contact Information

227 MEMORIAL DR
JACKSONVILLE, NC
ZIP 28546
Phone: (910) 346-2263
Fax: (910) 353-0549

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

Individual
Female
Years of Experience 34
Internal Medicine
Nephrology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About MILAGROS CAILING

This page provides the complete NPI Profile along with additional information for Milagros Cailing, an internist established in Jacksonville, North Carolina with a medical specialization in Internal Medicine, focusing in nephrology and more than 34 years of experience. The healthcare provider is registered in the NPI registry with number 1770672560 assigned on October 2006. The practitioner's primary taxonomy code is 207RN0300X with license number 2005-00955 (NC). The provider is registered as an individual and her NPI record was last updated 6 years ago.

NPI: 1770672560
Provider Name: DR. MILAGROS PALAD CAILING M.D.
Gender: Female
Entity Type: Individual
Location Address: 227 MEMORIAL DR JACKSONVILLE, NC 28546
Location Phone: (910) 346-2263
Location Fax: (910) 353-0549
Mailing Address: 227 MEMORIAL DR JACKSONVILLE, NC 28546
Mailing Phone: (910) 346-2263
Mailing Fax: (910) 353-0549
Medical School Name: OTHER
Graduation Year: 1993
Is Sole Proprietor?: Yes
Enumeration Date: 10-12-2006
Last Update Date: 09-07-2020
Code Navigator

An internist like Milagros Cailing 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.: 2005-00955
License State: NC
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:

Blue Cross and Blue Shield of NC

Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
Blue Advantage Bronze Standard | Nationwide Doctors - PPO
Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
Blue Advantage Gold Standard A | Nationwide Doctors - PPO
Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
Blue Advantage Silver Standard | Nationwide Doctors - PPO
Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals - HMO
UHC Bronze Standard (No Referrals) - HMO
UHC Bronze Standard+ Dental + Vision (No Referrals) - HMO
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
UHC Gold Standard (No Referrals) - HMO
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

Blue Cross Blue Shield

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

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.

Cigna

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
140CE	OTHER (01)	NC	BCBS
7139966	OTHER (01)	NC	CIGNA HEALTH CARE
5902090	MEDICAID (05)	NC
34D1048728	OTHER (01)	NC	CLIA #

Medicare Participation & PECOS Enrollment Status

Milagros Cailing 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.

Milagros Cailing 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: 5799701165
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: I20051015000103
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-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)
1 DME suppliers used 13 Medicare Claims 18 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.

Blood count, hemoglobin
Blood potassium level
Blood test, basic group of blood chemicals (calcium, total)
Blood test, comprehensive group of blood chemicals
Blood test, lipids (cholesterol and triglycerides)
Complete blood cell count (red cells, white blood cell, platelets), automated test
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
Creatinine level to test for kidney function or muscle injury
Dialysis services, 2-3 physician visits per month (20 years or older)
Dialysis services, 4 or more physician visits per month (20 years or older)
Dialysis services, per day, less than full month service (20 years or older)
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Ferritin (blood protein) level
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Hemodialysis procedure with physician evaluation
Home dialysis services per month (20 years or older)
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
Injection of drug or substance under skin or into muscle
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units
Insertion of needle into vein for collection of blood sample
Iron binding capacity
Iron level
Kidney function blood test panel
Magnesium level
Manual urinalysis test with examination using microscope, automated
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
Parathormone (parathyroid hormone) level
Phosphate level
Total protein level, urine
Uric acid level, blood
Urine microalbumin (protein) level
Vitamin d-3 level

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.25 for a new patient copayment and $23.98 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 28546 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $125.01
Minimum New Patient Price $54.12
Maximum New Patient Price $165.09

Average New Patient Copayment $31.25
Minimum New Patient Copayment $13.53
Maximum New Patient Copayment $41.27

Established Patients Visit Costs *

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

Average Established Patient Price $95.94
Minimum Established Patient Price $17.21
Maximum Established Patient Price $134.61

Average Established Patient Copayment $23.98
Minimum Established Patient Copayment $4.3
Maximum Established Patient Copayment $33.65

* 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
Breast Cancer Screening	8%	193
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Colorectal Cancer Screening	28%	365
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Diabetes: Medical Attention for Nephropathy	100%	199
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Documentation of Current Medications in the Medical Record	92%	1564
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.
e-Prescribing	94%	1849
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	17%	59
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.
Implementation of condition-specific chronic disease self-management support programs	Yes	N/A
Provide condition-specific chronic disease self-management support programs or coaching or link patients to those programs in the community.
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.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop	Yes	N/A
Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology.
Improved Practices that Disseminate Appropriate Self-Management Materials	Yes	N/A
Provide self-management materials at an appropriate literacy level and in an appropriate language.
Medication Reconciliation	100%	1382
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%	686
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.
Pneumococcal Vaccination Status for Older Adults	45%	411
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	70%	678
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
Preventive Care and Screening: Influenza Immunization	59%	532
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	8%	40
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Provide Patient Access	98%	686
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	10%	686
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.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of High-Risk Medications in the Elderly	1% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	411
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

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. Milagros Cailing is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type
UNC HEALTH WAYNE	2700 WAYNE MEMORIAL DR GOLDSBORO, NC 27534	(919) 736-1110	Acute Care Hospitals
UNC LENOIR HEALTH CARE	100 AIRPORT RD KINSTON, NC 28501	(252) 522-7000	Acute Care Hospitals
ONSLOW MEMORIAL HOSPITAL	317 WESTERN BOULEVARD JACKSONVILLE, NC 28540	(910) 577-2345	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 1770672560, 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.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 14 → 1 + 4

Pos 4

Unchanged

Pos 5

Doubled → 12 → 1 + 2

Pos 6

Unchanged

Pos 7

Doubled → 4

Pos 8

Unchanged

Pos 9

Doubled → 12 → 1 + 2

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 7 → 14 → 5 6 → 12 → 3 2 → 4 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

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

2 + 7 + 1 + 4 + 0 + 1 + 2 + 7 + 4 + 5 + 1 + 2 + 24 = 60

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.

60 - 60 = 0

This NPI is valid

The calculated check digit is 0, which matches the last digit of 1770672560.

Other Providers at the Same Location

The following 2 providers are registered at the same or a nearby location.

MID ATLANTIC NEUROLOGY & SLEEP MEDICINE, P.A.

Psychiatry & Neurology (Neurology)

227 MEMORIAL DR
JACKSONVILLE, NC 28546

Onslow County (910) 353-3624

GABRIELLE GRACE RIVERA FNP-C

Nurse Practitioner

227 MEMORIAL DR
JACKSONVILLE, NC 28546

Onslow County (910) 346-2263

About MILAGROS CAILING

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: 5799701165

PECOS Enrollment ID: I20051015000103

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

Blood count, hemoglobin

Blood potassium level

Blood test, basic group of blood chemicals (calcium, total)

Blood test, comprehensive group of blood chemicals

Blood test, lipids (cholesterol and triglycerides)

Complete blood cell count (red cells, white blood cell, platelets), automated test

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

Creatinine level to test for kidney function or muscle injury

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

Dialysis services, 4 or more physician visits per month (20 years or older)

Dialysis services, per day, less than full month service (20 years or older)

Established patient office or other outpatient visit, 20-29 minutes

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

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

Ferritin (blood protein) level

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

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

Hemodialysis procedure with physician evaluation

Home dialysis services per month (20 years or older)

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care per day, typically 70 minutes

Injection of drug or substance under skin or into muscle

Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units

Insertion of needle into vein for collection of blood sample

Iron binding capacity

Iron level

Kidney function blood test panel

Magnesium level

Manual urinalysis test with examination using microscope, automated

New patient office or other outpatient visit, 45-59 minutes

New patient office or other outpatient visit, 60-74 minutes

Parathormone (parathyroid hormone) level

Phosphate level

Total protein level, urine

Uric acid level, blood

Urine microalbumin (protein) level

Vitamin d-3 level

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Quality Reporting

Find Provider Hospital Affiliations - Privileges

Reviews for DR. MILAGROS PALAD CAILING M.D.

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