PAUL JOSEPH BIGGS M.D. NPI 1780755249

Pathology (Anatomic Pathology & Clinical Pathology) in Birmingham, AL

NPI 1780755249 Individual Male Years of Experience 45 Pathology Anatomic Pathology & Clinical Pathology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 78.7 Medicare Quality Reporting

About PAUL BIGGS

Paul Biggs is a provider established in Birmingham, Alabama and his medical specialization is pathology (anatomic pathology & clinical pathology) with more than 45 years of experience. He graduated from Indiana University School Of Medicine in 1977. The NPI number of Paul Biggs is 1780755249 and was assigned on November 2006. The practitioner's primary taxonomy code is 207ZP0102X with license number 00010849 (AL). The provider is registered as an individual and his NPI record was last updated 15 years ago.

Paul Biggs 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

Paul Biggs 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 Princeton Baptist Medical Center and Walker Baptist Medical Center.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 78.7, 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 following quality measures were reported for this provider: tcpi participation.

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.26 for a new patient copayment and $17.46 for an established patient copayment.

NPI

1780755249

Provider Name PAUL JOSEPH BIGGS M.D.
Provider Location Address701 PRINCETON AVE SW BIRMINGHAM, AL 35211
Provider Mailing Address402 OFFICE PARK DR SUITE 200 BIRMINGHAM, AL 35223
GenderMale
NPI Entity TypeIndividual
Medical School NameINDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year1977
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date11-13-2006
Last Update Date07-08-2007


Primary Taxonomy

Taxonomy Code207ZP0102X
ClassificationPathology
TypeAllopathic & Osteopathic Physicians
SpecializationAnatomic Pathology & Clinical Pathology
License No.00010849
License StateAL
Taxonomy DescriptionA pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

Business Address

PAUL JOSEPH BIGGS M.D.
701 PRINCETON AVE SW
BIRMINGHAM, AL
ZIP 35211
Phone: (205) 783-3441
Fax: (205) 783-7464

Get Directions


Mailing Address

PAUL JOSEPH BIGGS M.D.
402 OFFICE PARK DR
SUITE 200
BIRMINGHAM, AL
ZIP 35223
Phone: (205) 802-5220
Fax: (205) 802-5401



Medicare Participation

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.

Registered in PECOS? Yes
PECOS PAC ID9436142361
PECOS Enrollment IDI20101004000002
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

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 35211 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$55.54 $170.61 $129.05
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.88 $42.65 $32.26
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$16.93 $139.08 $69.84
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.23 $34.77 $17.46

* The physician office visit costs information is obtained by Medicare's 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 Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's 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.

MIPS Measure Score Weight Score
Quality 40% 72
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 (PI) 25% 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 15% 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 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 20% 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.
MIPS Final Score - 78.7
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 Reporting

The following quality measures meet 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 Number of Patients
TCPI ParticipationYesN/A
Participation in the CMS Transforming Clinical Practice Initiative

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.

  • 934Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)
  • 449Special stained specimen slides to examine tissue (HCPCS:88341)
  • 164Pathology examination of tissue using a microscope, moderately low complexity (HCPCS:88304)
  • 162Pathology examination of tissue using a microscope, moderately high complexity (HCPCS:88307)
  • 117Tissue or cell analysis by immunologic technique (HCPCS:88342)

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. Paul Biggs is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
PRINCETON BAPTIST MEDICAL CENTER701 PRINCETON AVENUE SOUTHWEST
BIRMINGHAM, AL 35211
(205) 783-3800Acute Care Hospitals10103
WALKER BAPTIST MEDICAL CENTER3400 HIGHWAY 78 EAST
JASPER, AL 35502
(205) 387-4000Acute Care Hospitals10089

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
1110034OTHER (01)AL
0004005938OTHER (01)AL
C75570MEDICARE UPIN (02)AL

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1659376846 ALTON W BAKER MD
Individual
Specialist701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3000
1265412241MRS. JENNIFER ANNE WARREN CRNA
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1154301158DR. TIMOTHY WAYNE AIKEN MD
Individual
Anesthesiology701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1669452587MRS. MARCIA DELOIS BOSWELL CRNA
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1932189917MR. JEFFREY CLAYTON HUDSON CRNA
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1366422354MR. ROBERT W MEDICI CRNA
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1053391045MRS. MARGARET LUCHINI NICHOLAS CRNA
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1558341552MR. CHRISTOPHER JOSEPH DRAMER CRNA
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1548240542MS. GAIL A LOWERY CRNA
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1366422362 GINGER GREEN OSBORNE CRNA
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1538149539MRS. SANDRA ELIZABETH LANE CRNA
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1730169129DR. JAMES R TOMLINSON MD
Individual
Anesthesiology701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1255311643DR. RICHARD J LEWIS MD
Individual
Anesthesiology701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1871566422 CECILLE M HAMMER CRNA
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(334) 386-2051
1538124425 BRUCE ERIC BURNS M.D.
Individual
Emergency Medicine701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3500
1538194535DR. JORDAN LLOYD TURNER DO
Individual
Emergency Medicine701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3500
1548351604 VONDA LEE MORROW ARD C.R.N.A.
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1972685246 KURTIS A. TETER C.R.N.A.
Individual
Nurse Anesthetist, Certified Registered701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3144
1346311891DR. DUDLEY E. SCOTT DAY M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(205) 783-3240
1336216951 CHRISTOPHER N HILLMAN M.D.
Individual
Anesthesiology701 PRINCETON AVE SW
BIRMINGHAM, AL 35211
(334) 783-3144

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.