NICHOLAS LLOYD CROMWELL MD NPI 1790708626

Obstetrics & Gynecology - Gynecology in Springville, NY

Individual Male Years of Experience 32 Obstetrics & Gynecology Gynecology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 84.7

About NICHOLAS LLOYD CROMWELL MD

Nicholas Cromwell is a women's health care provider established in Springville, New York and his medical specialization is Obstetrics & Gynecology with a focus in gynecology with more than 32 years of experience. He graduated from State University Of New York At Buffalo School Of Medicine in 1991. The NPI number of Nicholas Cromwell is 1790708626 and was assigned on July 2006. The practitioner's primary taxonomy code is 207VG0400X with license number 1911901 (NY). The provider is registered as an individual and his NPI record was last updated 3 years ago.

Women's health care providers like Nicholas Lloyd Cromwell Md treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

NPI

1790708626

Provider Name NICHOLAS LLOYD CROMWELL MD
Provider Location Address27 FRANKLIN ST SPRINGVILLE, NY 14141
Provider Mailing Address27 FRANKLIN ST SPRINGVILLE, NY 14141
GenderMale
NPI Entity TypeIndividual
Medical School NameSTATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
Graduation Year1991
Is Sole Proprietor?No
Enumeration Date07-25-2006
Last Update Date06-07-2019



Nicholas Cromwell 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.

Nicholas Cromwell 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 Kaleida Health.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 84.7, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $32.94 for a new patient copayment and $17.92 for an established patient copayment.



Primary Taxonomy

Taxonomy Code207VG0400X
ClassificationObstetrics & Gynecology
TypeAllopathic & Osteopathic Physicians
SpecializationGynecology
License No.1911901
License StateNY

Business Address

NICHOLAS LLOYD CROMWELL MD
27 FRANKLIN ST
SPRINGVILLE, NY
ZIP 14141
Phone: (716) 592-7400

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Mailing Address

NICHOLAS LLOYD CROMWELL MD
27 FRANKLIN ST
SPRINGVILLE, NY
ZIP 14141
Phone: (716) 592-7400


Secondary Locations

27 Franklin St
Springville, NY 14141
(716) 592-7400
14 Center Road
West Seneca, NY 14224
(716) 824-7307

PECOS Enrollment and 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 ID8224127717
PECOS Enrollment IDI20071207000089
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 14141 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
$57.17 $174.05 $131.79
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.29 $43.51 $32.94
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
$17.76 $142.28 $71.71
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.44 $35.57 $17.92

* 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% 91.4
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% 55
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% 74.1
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 - 84.7
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.

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. Nicholas Cromwell is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
KALEIDA HEALTH100 HIGH STREET
BUFFALO, NY 14210
(716) 859-8620Acute Care Hospitals330005

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics1911901NYNo

Taxonomy Description: Not Available

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
01768914MEDICAID (05)NY

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.
1790708626
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271801401664
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 8 + 0 + 1 + 4 + 0 + 1 + 6 + 6 + 4 + 24 = 64
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 64 = 66

The NPI number 1790708626 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


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

NPI Name / Type Taxonomy Address
1427017490 MICHAEL ALANDO JOHNSON M.D.
Individual
Ophthalmology27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-5006
1588690416 DOREEN NUESSLE LCSWR
Individual
Social Worker (Clinical)27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1750311445 JENNIFER EINARSSON LCSWR
Individual
Social Worker (Clinical)27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1861574170 JOAN REYNOLDS RPA-C
Individual
Family Medicine27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-7400
1194886911 SUSAN SPITTAL ASHBY LCSW
Individual
Social Worker (Clinical)27 FRANKLIN ST SPRINGVILLE COUNSELING CENTER
SPRINGVILLE, NY 14141
(716) 592-9301
1487859732MR. DAVID JOHN WILLIAMS RPH
Individual
Pharmacist27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9065
1710268404 KIM ROGERS
Individual
Counselor27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1700036464 MONICA K BALON PA
Individual
Physician Assistant27 FRANKLIN ST SUITE 1
SPRINGVILLE, NY 14141
(716) 592-7400
1396178364 VINCENT SHERMAN
Individual
Counselor27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1285808873 AMANDA RAE LEONE LMHC, CASAC
Individual
Counselor (Mental Health)27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1306118732 TAMMY LYN DAVIS
Individual
Counselor (Mental Health)27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1265891923 GINA HOWES
Individual
Licensed Practical Nurse27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1922459403 JAMIE BOROW
Individual
Counselor27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1598939480MENTAL HEALTH SERVICES OF ERIE COUNTY SECV
Organization
Community/Behavioral Health27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1811162670MENTAL HEALTH SERVICES OR ERIE COUNTY SECV
Organization
Community/Behavioral Health27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1396287926 CAITLYN CONNORS
Individual
Counselor (Addiction (Substance Use Disorder))27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1033617360 NICOLE KAUS
Individual
Counselor27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1255704664 ALICIA KAUFMAN LMSW
Individual
Social Worker27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301
1407221963BUFFALO MEDICAL GROUP, PC
Organization
Durable Medical Equipment & Medical Supplies27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 630-1295
1386129583 MARY MORGAN
Individual
Counselor27 FRANKLIN ST
SPRINGVILLE, NY 14141
(716) 592-9301

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
Nicholas Lloyd Cromwell Md is registered as an entity type code: 1. The entity type code describes 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.