MR. ARKADY BENJAMINE KAGAN MD
NPI 1790839538
Ophthalmology in Los Angeles, CA

Quality Rating: 75 out of 100 score

NPI Status: Active since January 22, 2007

Contact Information

5455 WILSHIRE BLVD
SUITE 1714
LOS ANGELES, CA
ZIP 90036
Phone: (323) 937-2269
Fax: (323) 936-6640

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Table of Contents

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Overall Quality Performance
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 35
Ophthalmology
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About ARKADY KAGAN

This page provides the complete NPI Profile along with additional information for Arkady Kagan, a provider established in Los Angeles, California with a medical specialization in Ophthalmology and more than 35 years of experience. He graduated from Ohio State University College Of Medicine in 1991. The healthcare provider is registered in the NPI registry with number 1790839538 assigned on January 2007. The practitioner's primary taxonomy code is 207W00000X with license number G76135 (CA). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI: 1790839538
Provider Name: MR. ARKADY BENJAMINE KAGAN MD
Gender: Male
Entity Type: Individual
Location Address: 5455 WILSHIRE BLVD SUITE 1714 LOS ANGELES, CA 90036
Location Phone: (323) 937-2269
Location Fax: (323) 936-6640
Mailing Address: 5455 WILSHIRE BLVD SUITE 1714 LOS ANGELES, CA 90036
Mailing Phone: (323) 937-2269
Mailing Fax: (323) 936-6640
Medical School Name: OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year: 1991
Is Sole Proprietor?: Yes
Enumeration Date: 01-22-2007
Last Update Date: 07-28-2020
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Ophthalmologists like Arkady Kagan specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.

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: Ophthalmology
Taxonomy Code: 207W00000X
Type: Allopathic & Osteopathic Physicians
License No.: G76135
License State: CA
Taxonomy Description: An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

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.

*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
00G761350	MEDICAID (05)	CA

Medicare Participation & PECOS Enrollment Status

Arkady Kagan 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.

Arkady Kagan 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: 4486847381
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: I20101025000162
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

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.

Cataract surgery
Closure of tear duct opening using plug
Creation of eye fluid drainage tracts in iris using a laser, per session
Dilation to improve eye fluid flow
Established patient complete exam of visual system
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient problem focused exam of visual system
Exam of visual field with extended testing
Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye
Imaging of optic nerve
Imaging of retina
Injection of chemical for paralysis of nerve muscles on side of face
Injection, incobotulinumtoxin a, 1 unit
Laser repair to improve eye fluid flow
Measurement of corneal curvature and depth of eye
Microfluid analysis of tears
New patient complete exam of visual system
New patient office or other outpatient visit, 45-59 minutes
New patient problem focused exam of visual system
Photography of the retina
Placement of amniotic membrane on eye surface for wound healing
Removal of cataract with insertion of prosthetic lens
Removal of recurring cataract in lens capsule using a laser

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $35.59 for a new patient copayment and $19.49 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 90036 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $142.39
Minimum New Patient Price $62.96
Maximum New Patient Price $187.6

Average New Patient Copayment $35.59
Minimum New Patient Copayment $15.74
Maximum New Patient Copayment $46.9

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $77.96
Minimum Established Patient Price $20.84
Maximum Established Patient Price $153.61

Average Established Patient Copayment $19.49
Minimum Established Patient Copayment $5.21
Maximum Established Patient Copayment $38.4

* 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 75, 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.

Final Score: 75 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.
Quality Score: N/A

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 Score: 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 Score: N/A

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 compromises 15% providers final MPIS scores.

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 Score: 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.
Cost Score: 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.

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
Documentation of Current Medications in the Medical Record	19%	2035
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
Electronic submission of Patient Centered Medical Home accreditation	Yes	N/A
I attest that I am a Patient Centered Medical Home (PCMH) or Comparable Specialty Practice that has achieved certification from a national program, regional or state program, private payer, or other body that administers patient-centered medical home accreditation and should receive full credit for the Improvement Activities performance category.
e-Prescribing	99%	729
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Patient-Specific Education	97%	410
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.
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access	83%	528
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	66%	410
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.
Use of High-Risk Medications in the Elderly	0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	794
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

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.
1	7	9	0	8	3	9	5	3	8
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	18	0	16	3	18	5	6
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 8 + 0 + 1 + 6 + 3 + 1 + 8 + 5 + 6 + 24 = 72
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 72 = 8									8

The NPI number 1790839538 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 18 providers are registered at the same or nearby location.

MRS. ANNA KAGAN MD

Psychiatry & Neurology

(Psychiatry)

5455 WILSHIRE BLVD
SUITE 1714
LOS ANGELES, CA
ZIP 90036

About ARKADY KAGAN

Location Map

Specialty - Primary Taxonomy

Ophthalmology

Insurance Plans Accepted

Medicare

Medicaid

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 4486847381

PECOS Enrollment ID: I20101025000162

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

Areas of Expertise

Cataract surgery

Closure of tear duct opening using plug

Creation of eye fluid drainage tracts in iris using a laser, per session

Dilation to improve eye fluid flow

Established patient complete exam of visual system

Established patient office or other outpatient visit, 10-19 minutes

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

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

Established patient problem focused exam of visual system

Exam of visual field with extended testing

Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye

Imaging of optic nerve

Imaging of retina

Injection of chemical for paralysis of nerve muscles on side of face

Injection, incobotulinumtoxin a, 1 unit

Laser repair to improve eye fluid flow

Measurement of corneal curvature and depth of eye

Microfluid analysis of tears

New patient complete exam of visual system

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

New patient problem focused exam of visual system

Photography of the retina

Placement of amniotic membrane on eye surface for wound healing

Removal of cataract with insertion of prosthetic lens

Removal of recurring cataract in lens capsule using a laser

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Overall MIPS Quality Performance

Final Score: 75 out of 100

Quality Score: N/A

Promoting Interoperability Score: N/A

Improvement Activities Score: N/A

Cost Score: N/A

Cost Score: N/A

Quality Reporting

Reviews for MR. ARKADY BENJAMINE KAGAN MD

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions

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