MRS. SUSAN LEE WATKINS FNP NPI 1790774537

Nurse Practitioner - Family in Portland, OR

Individual Female Years of Experience 20 Nurse Practitioner Family PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About MRS. SUSAN LEE WATKINS FNP

Susan Watkins is a provider established in Portland, Oregon and her medical specialization is Nurse Practitioner with a focus in family with more than 20 years of experience. The NPI number of Susan Watkins is 1790774537 and was assigned on October 2005. The practitioner's primary taxonomy code is 363LF0000X with license number 200350114NP FNP PP (OR). The provider is registered as an individual and her NPI record was last updated 6 years ago.

A nurse practitioner (NP) like Mrs. Susan Lee Watkins Fnp is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

NPI

1790774537

Provider NameMRS. SUSAN LEE WATKINS FNP
Provider Location Address11782 SW BARNES RD SUITE 300 PORTLAND, OR 97225
Provider Mailing Address11782 SW BARNES RD SUITE 300 PORTLAND, OR 97225
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2003
Is Sole Proprietor?No
Enumeration Date10-14-2005
Last Update Date07-11-2016



Susan Watkins 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.

Susan Watkins 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 she has hospital affiliations with Providence St Vincent Medical Center.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: collection and use of patient experience and satisfaction data on access, documentation of current medications in the medical record, e-prescribing, falls: screening for future fall risk, health information exchange, implementation of formal quality improvement methods, practice changes, or other practice improvement processes, implementation of methodologies for improvements in longitudinal care management for high risk patients, leadership engagement in regular guidance and demonstrated commitment for implementing practice improvement changes, medication reconciliation, patient-specific education, pneumococcal vaccination status for older adults, preventive care and screening: influenza immunization, provide patient access, secure messaging, security risk analysis and use of high-risk medications in the elderly. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

The typical physician office visit costs for Medicare beneficiaries in this area are: $23.17 for a new patient copayment and $26.82 for an established patient copayment.



Primary Taxonomy

Taxonomy Code363LF0000X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationFamily
License No.200350114NP FNP PP
License StateOR

Business Address

MRS. SUSAN LEE WATKINS FNP
11782 SW BARNES RD
SUITE 300
PORTLAND, OR
ZIP 97225
Phone: (503) 214-5200
Fax: (503) 906-6613

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Mailing Address

MRS. SUSAN LEE WATKINS FNP
11782 SW BARNES RD
SUITE 300
PORTLAND, OR
ZIP 97225
Phone: (503) 214-5200
Fax: (503) 906-6613


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 ID1951204700
PECOS Enrollment IDI20040129000228
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 97225 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$60.52 $182.22 $92.69
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.13 $45.55 $23.17
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$19.23 $149.48 $107.31
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.8 $37.37 $26.82

* 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.

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
Collection and use of patient experience and satisfaction data on accessYesN/A
Collection of patient experience and satisfaction data on access to care and development of an improvement plan, such as outlining steps for improving communications with patients to help understanding of urgent access needs.
Documentation of Current Medications in the Medical Record 100% 2124
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
e-Prescribing 68% 25
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Falls: Screening for Future Fall Risk 99% 460
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Health Information Exchange 86% 42
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 formal quality improvement methods, practice changes, or other practice improvement processesYesN/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
Implementation of methodologies for improvements in longitudinal care management for high risk patientsYesN/A
Provide longitudinal care management to patients at high risk for adverse health outcome or harm that could include one or more of the following: Use a consistent method to assign and adjust global risk status for all empaneled patients to allow risk stratification into actionable risk cohorts. Monitor the risk-stratification method and refine as necessary to improve accuracy of risk status identification; Use a personalized plan of care for patients at high risk for adverse health outcome or harm, integrating patient goals, values and priorities; and/or Use on-site practice-based or shared care managers to proactively monitor and coordinate care for the highest risk cohort of patients.
Leadership engagement in regular guidance and demonstrated commitment for implementing practice improvement changesYesN/A
Ensure full engagement of clinical and administrative leadership in practice improvement that could include one or more of the following: Make responsibility for guidance of practice change a component of clinical and administrative leadership roles; Allocate time for clinical and administrative leadership for practice improvement efforts, including participation in regular team meetings; and/or Incorporate population health, quality and patient experience metrics in regular reviews of practice performance.
Medication Reconciliation 97% 1576
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 54% 1728
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 64% 461
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Influenza Immunization 42% 483
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
Provide Patient Access 88% 1728
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 68% 1728
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 AnalysisYesN/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.
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.
461
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

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.

  • 341Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
  • 71X-ray of knee, 3 views (HCPCS:73562)
  • 49X-ray of foot, minimum of 3 views (HCPCS:73630)
  • 39X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • 16X-ray of ribs of one side of body, minimum of 2 views (HCPCS:73510)
  • 11Repair of knee joint (HCPCS:27447)

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. Susan Watkins is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
PROVIDENCE ST VINCENT MEDICAL CENTER9205 SW BARNES ROAD
PORTLAND, OR 97225
(503) 216-2213Acute Care Hospitals380004

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 Identifier Issuer
082010084RNOTHER (01)OROREGON LICENSE NUMBER

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.
1790774537
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27180147856
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 + 7 + 8 + 5 + 6 + 24 = 73
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 73 = 77

The NPI number 1790774537 is valid because the calculated check digit 7 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
1184693020MR. MICHAEL D MONETA MD
Individual
Anesthesiology11782 SW BARNES RD BLDG C #200
PORTLAND, OR 97225
(503) 906-4300
1295704443MR. DALE L NUNEZ MD
Individual
Anesthesiology11782 SW BARNES RD BLDG C #200
PORTLAND, OR 97225
(503) 906-4300
1356300925MICHAEL D MONETA MD PC
Organization
Anesthesiology11782 SW BARNES RD BLDG C #200
PORTLAND, OR 97225
(503) 906-4300
1770543308DALE L NUNEZ MD PC
Organization
Anesthesiology11782 SW BARNES RD BLDG C #200
PORTLAND, OR 97225
(503) 906-4300
1326002601 THELMA J MAYS MD
Individual
Anesthesiology11782 SW BARNES RD BLDG C 200
PORTLAND, OR 97225
(503) 906-4300
1285699074 KATRINA KELLAR ATC, OTC
Individual
Technician, Other11782 SW BARNES RD
PORTLAND, OR 97225
(503) 214-5200
1174580435THELMA JEAN MAYS MD PC
Organization
Anesthesiology11782 SW BARNES RD BLDG C 200
PORTLAND, OR 97225
(503) 906-4300
1093737934DR. ILMAR SOOT M.D.
Individual
Specialist11782 SW BARNES RD STE 300
PORTLAND, OR 97225
(503) 214-5200
1336153352 ROBERT L BURKHART P.A.
Individual
Physician Assistant (Surgical)11782 SW BARNES RD STE 300
PORTLAND, OR 97225
(503) 214-5200
1609887413CSS JV, LLC
Organization
Clinic/Center (Ambulatory Surgical)11782 SW BARNES RD #200
PORTLAND, OR 97225
(503) 906-4300
1376640631MS. REBECCA CHANGIZIAN CST SAC
Individual
11782 SW BARNES RD SUITE 200
PORTLAND, OR 97225
(503) 906-4300
1821370875LIMELIGHT GROUP
Organization
Anesthesiology11782 SW BARNES RD BUILDING C SUITE 200
PORTLAND, OR 97225
(503) 906-4300
1235485053 NICK ADAM GEORGE MPT
Individual
Physical Therapist (Orthopedic)11782 SW BARNES RD STE 100
PORTLAND, OR 97225
(503) 906-4323
1366799405 JESSICA LYNN MARTSCHINSKE MA, ATC/L, OTC
Individual
Specialist/Technologist (Athletic Trainer)11782 SW BARNES RD SUITE 300
PORTLAND, OR 97225
(503) 214-5200
1184962128 MICHELE SHIVACK PT,ATC
Individual
Physical Therapist (Orthopedic)11782 SW BARNES RD SUITE 300
PORTLAND, OR 97225
(503) 906-4323
1801043591 RONALD C SMITH PA-C, MMSC
Individual
Physician Assistant (Surgical)11782 SW BARNES RD SUITE 300
PORTLAND, OR 97225
(503) 214-5200
1063738755MS. SANDI JO MCRAE OT
Individual
Occupational Therapist11782 SW BARNES RD STE 300
PORTLAND, OR 97225
(503) 214-5200
1922116623 ROSALYN MARIE MONTGOMERY M.D.
Individual
Orthopaedic Surgery11782 SW BARNES RD SUITE 300
PORTLAND, OR 97225
(503) 214-5200
1073059754 DANIEL LEWIS FISHER CST
Individual
Specialist/Technologist, Other (Surgical Technologist)11782 SW BARNES RD SUITE 300
PORTLAND, OR 97225
(503) 214-5200
1902344187 CORVIN W TOMPKINS SA-C
Individual
Specialist/Technologist, Other (Surgical Assistant)11782 SW BARNES RD SUITE 200
PORTLAND, OR 97225
(503) 906-4300

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
Mrs. Susan Lee Watkins Fnp 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.