MR. ROBERT BLAINE HOPP M.D.
NPI 1801835509
Dermatology in Kennewick, WA

Quality Rating: 75 out of 100 score

NPI Status: Active since June 06, 2006

Contact Information

8901 W GAGE BLVD
KENNEWICK, WA
ZIP 99336
Phone: (509) 735-1100
Fax: (509) 735-1180

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Table of Contents

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
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 44
Dermatology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About ROBERT HOPP

This page provides the complete NPI Profile along with additional information for Robert Hopp, a provider established in Kennewick, Washington with a medical specialization in Dermatology and more than 44 years of experience. He graduated from Medical College Of Wisconsin in 1982. The healthcare provider is registered in the NPI registry with number 1801835509 assigned on June 2006. The practitioner's primary taxonomy code is 207N00000X with license number 24575 (WA). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI: 1801835509
Provider Name: MR. ROBERT BLAINE HOPP M.D.
Gender: Male
Entity Type: Individual
Location Address: 8901 W GAGE BLVD KENNEWICK, WA 99336
Location Phone: (509) 735-1100
Location Fax: (509) 735-1180
Mailing Address: 8901 W GAGE BLVD KENNEWICK, WA 99336
Mailing Phone: (509) 735-1100
Mailing Fax: (509) 735-1180
Medical School Name: MEDICAL COLLEGE OF WISCONSIN
Graduation Year: 1982
Is Sole Proprietor?: Yes
Enumeration Date: 06-06-2006
Last Update Date: 03-21-2017
Code Navigator

A dermatologist like Robert Hopp is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

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: Dermatology
Taxonomy Code: 207N00000X
Type: Allopathic & Osteopathic Physicians
License No.: 24575
License State: WA
Taxonomy Description: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	207ND0101X	Allopathic & Osteopathic Physicians	Dermatology MOHS-Micrographic Surgery	24575 (WA)
2	207ND0900X	Allopathic & Osteopathic Physicians	Dermatology Dermatopathology	24575 (WA)
3	207NI0002X	Allopathic & Osteopathic Physicians	Dermatology Clinical & Laboratory Dermatological Immunology	24575 (WA)

Insurance Plans Accepted

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

BridgeSpan Health Company

BridgeSpan Standard Bronze Plan - EPO
BridgeSpan Standard Gold Plan - EPO
BridgeSpan Standard Silver Plan - EPO

Moda Health Plan, Inc.

Moda Health Affinity Bronze 8000 - EPO
Moda Health Affinity Bronze 9000 - EPO
Moda Health Affinity Bronze HDHP 7500 - EPO
Moda Health Affinity Gold 1000 - EPO
Moda Health Affinity Gold 1500 - EPO
Moda Health Affinity Gold 250 - EPO
Moda Health Affinity Silver 3000 - EPO
Moda Health Affinity Silver 3400 - EPO
Moda Health Affinity Silver 4500 - EPO
Moda Health Affinity Silver 6000 - EPO

PacificSource Health Plans

Core Bronze HSA 10600 - EPO
Core Bronze HSA 7500 - EPO
Core Bronze HSA 8300 - EPO
Core Gold 1500 - EPO
Core Gold 3000 - EPO
Core Silver 3500 - EPO
Core Silver 4500 - EPO
Core Silver 5000 - EPO
Core Silver 7500 - EPO
Core Standard Expanded Bronze HSA - EPO

Premera Blue Cross Blue Shield of Alaska

Premera Blue Cross Alaska One Gold - PPO
Premera Blue Cross Preferred Bronze 5800 HSA - PPO
Premera Blue Cross Preferred Bronze 6350 - PPO
Premera Blue Cross Preferred Gold 1500 - PPO
Premera Blue Cross Preferred Silver 4500 - PPO
Premera Blue Cross Standard Bronze II - PPO
Premera Blue Cross Standard Gold - PPO
Premera Blue Cross Standard Silver - PPO
Premera Blue Cross Family Dental - PPO
Premera Blue Cross Pediatric Dental - PPO

Providence Health Plan

HSA Qualified 7500 Bronze - Choice Network - EPO
HSA-E Qualified 7500 Bronze - Signature Network - EPO
Providence Oregon Standard Bronze Plan - Choice Network - EPO
Providence Oregon Standard Bronze Plan - Signature Network - EPO
Providence Oregon Standard Gold Plan - Choice Network - EPO
Providence Oregon Standard Gold Plan - Signature Network - EPO
Providence Oregon Standard Silver Plan - Choice Network - EPO
Providence Oregon Standard Silver Plan - Signature Network - EPO

Regence BlueCross BlueShield of Oregon

Bronze 8000 Individual Connect - EPO
Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
Bronze HSA 7000 Individual Connect - EPO
Gold 2300 Individual Connect - EPO
Regence Standard Bronze Plan Individual Connect - EPO
Regence Standard Gold Plan Individual Connect - EPO
Regence Standard Silver Plan Individual Connect - EPO
Silver 6500 Individual Connect - EPO

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
A06626	MEDICARE UPIN (02)	WA

Medicare Participation & PECOS Enrollment Status

Robert Hopp 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.

Robert Hopp 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: 7911978663
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: I20120912000245
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.

Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg
Application of light to destroy precancer skin growth
Established patient office or other outpatient visit, 10-19 minutes
Pathology examination of tissue using a microscope, intermediate complexity
Pathology examination of tissue using a microscope, moderately low complexity
Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks
Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks
Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks
Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks
Special stained specimen slides to examine tissue, each additional procedure
Special stained specimen slides to examine tissue, initial procedure
Therapy procedure using ultraviolet radiation with tar or petroleum jelly application

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.07 for a new patient copayment and $17.82 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 99336 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $88.29
Minimum New Patient Price $57.27
Maximum New Patient Price $172.8

Average New Patient Copayment $22.07
Minimum New Patient Copayment $14.31
Maximum New Patient Copayment $43.2

Established Patients Visit Costs *

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

Average Established Patient Price $71.29
Minimum Established Patient Price $18.56
Maximum Established Patient Price $141.11

Average Established Patient Copayment $17.82
Minimum Established Patient Copayment $4.64
Maximum Established Patient Copayment $35.27

* 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
Care coordination agreements that promote improvements in patient tracking across settings	Yes	N/A
Establish effective care coordination and active referral management that could include one or more of the following: Establish care coordination agreements with frequently used consultants that set expectations for documented flow of information and MIPS eligible clinician or MIPS eligible clinician group expectations between settings. Provide patients with information that sets their expectations consistently with the care coordination agreements; Track patients referred to specialist through the entire process; and/or Systematically integrate information from referrals into the plan of care.
Care transition documentation practice improvements	Yes	N/A
Implementation of practices/processes for care transition that include documentation of how a MIPS eligible clinician or group carried out a patient-centered action plan for first 30 days following a discharge (e.g., staff involved, phone calls conducted in support of transition, accompaniments, navigation actions, home visits, patient information access, etc.).
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.
Implementation of documentation improvements for practice/process improvements	Yes	N/A
Implementation of practices/processes that document care coordination activities (e.g., a documented care coordination encounter that tracks all clinical staff involved and communications from date patient is scheduled for outpatient procedure through day of procedure).
Implementation of improvements that contribute to more timely communication of test results	Yes	N/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Implementation of practices/processes for developing regular individual care plans	Yes	N/A
Implementation of practices/processes, including a discussion on care, to develop regularly updated individual care plans for at-risk patients that are shared with the beneficiary or caregiver(s). Individual care plans should include consideration of a patient’s goals and priorities, as well as desired outcomes of care.
Practice Improvements for Bilateral Exchange of Patient Information	Yes	N/A
Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: • Participate in a Health Information Exchange if available; and/or • Use structured referral notes.
Practice Improvements that Engage Community Resources to Support Patient Health Goals	Yes	N/A
Develop pathways to neighborhood/community-based resources to support patient health goals that could include one or more of the following: • Maintain formal (referral) links to community-based chronic disease self-management support programs, exercise programs and other wellness resources with the potential for bidirectional flow of information; and provide a guide to available community resources. • Including through the use of tools that facilitate electronic communication between settings; • Screen patients for health-harming legal needs; • Screen and assess patients for social needs using tools that are preferably health IT enabled and that include to any extent standards-based, coded question/field for the capture of data as is feasible and available as part of such tool; and/or • Provide a guide to available community resources.
Regular training in care coordination	Yes	N/A
Implementation of regular care coordination training.
Use of QCDR to promote standard practices, tools and processes in practice for improvement in care coordination	Yes	N/A
Participation in a Qualified Clinical Data Registry, demonstrating performance of activities that promote use of standard practices, tools and processes for quality improvement (e.g., documented preventative screening and vaccinations that can be shared across MIPS eligible clinician or groups).

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1801835509, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 0

Pos 4

Unchanged

Pos 5

Doubled → 16 → 1 + 6

Pos 6

Unchanged

Pos 7

Doubled → 10 → 1 + 0

Pos 8

Unchanged

Pos 9

Doubled → 0

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 8 → 16 → 7 5 → 10 → 1 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 0 + 1 + 1 + 6 + 3 + 1 + 0 + 5 + 0 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9

This NPI is valid

The calculated check digit is 9, which matches the last digit of 1801835509.