SONYA CAROL WORTHINGTON CRNA
NPI 1770728131
Nurse Anesthetist, Certified Registered in Louisville, KY
About Sonya Carol Worthington Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SONYA CAROL WORTHINGTON CRNA (NPI 1770728131) is an individual nurse anesthetist, certified registered in Louisville, Kentucky, licensed in Kentucky (3005934) and active in the NPI registry since December 2008. She is affiliated with Jewish Hospital & St Mary's Healthcare and is a graduate of Other (2008).
NPPES Registry Identity
Specialties & Licenses
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Other Identifiers 5
Accepted Insurance
Medicare Participation & PECOS Enrollment Status
Sonya Worthington 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.
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.
PECOS PAC ID: 4587729702
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: I20090223000059, I20130904000346
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.
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.
Anesthesia for exam of colon using an endoscope
Anesthesia for lens surgery
Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope
Anesthesia for other procedure on large bowel using an endoscope
Anesthesia for procedure on eyelid
Anesthesia for procedure on small and large bowel using an endoscope
Anesthesia for a colon examination with an endoscope is a method used to ensure comfort during the procedure. It involves administering medication to help you relax or sleep, thus reducing discomfort as the endoscope, a thin, flexible tube, is navigated through your colon.
This service was performed 15 times for 15 patientsAnesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.
This service was performed 232 times for 217 patientsThis procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.
This service was performed 19 times for 19 patientsAnesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.
This service was performed 41 times for 40 patientsAnesthesia for an eyelid procedure helps ensure comfort and painlessness during the operation. It's typically a local anesthetic, applied to numb your eyelid and surrounding area. You'll likely be awake but won't feel any discomfort. It's a safe, routine part of many eye procedures.
This service was performed 29 times for 28 patientsAnesthesia for an endoscopic procedure on the small and large bowel ensures comfort and relaxation during the procedure. It involves administering medicine to help you sleep or feel drowsy. This allows the doctor to examine your bowels without causing you discomfort or pain.
This service was performed 12 times for 12 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $30.69 for a new patient copayment and $16.56 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 40207 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $122.77
- Minimum New Patient Price $52.76
- Maximum New Patient Price $162.27
- Average New Patient Copayment $30.69
- Minimum New Patient Copayment $13.19
- Maximum New Patient Copayment $40.56
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.24
- Minimum Established Patient Price $16.53
- Maximum Established Patient Price $131.99
- Average Established Patient Copayment $16.56
- Minimum Established Patient Copayment $4.13
- Maximum Established Patient Copayment $32.99
* 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 73.19, 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: 73.19 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: 58.74
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 comprises 40% of a provider's final MIPS score.
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: 100
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 comprises 25% of a provider's final MIPS score.
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 comprises 15% of a provider's final MIPS score.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score. -
Cost Score: 51.91
The Cost performance category assesses 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 comprises 20% of a provider's final MIPS score.
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. Sonya Worthington is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| JEWISH HOSPITAL & ST MARY'S HEALTHCARE | 200 ABRAHAM FLEXNER WAY LOUISVILLE, KY 40202 | (502) 587-4011 | Acute Care Hospitals | |
| NORTON HOSPITALS, INC | 200 EAST CHESTNUT STREET LOUISVILLE, KY 40202 | (502) 629-8000 | Acute Care Hospitals |
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
LOUISVILLE, KY 40207
LOUISVILLE, KY 40207
LOUISVILLE, KY 40207
LOUISVILLE, KY 40207
LOUISVILLE, KY 40207
LOUISVILLE, KY 40207
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770728131, enumerated as an "individual" on December 12, 2008.
The provider is located at 3920 DUTCHMANS LN LOUISVILLE, KY 40207 and the phone number is (502) 259-6710.
Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
The provider might be accepting Accepts: CareSource, Medicare, Medicaid and Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.
Sonya Worthington is affiliated with: JEWISH HOSPITAL & ST MARY'S HEALTHCARE and NORTON HOSPITALS, INC.
