DAVID F GOUVEIA M.D. NPI 1801860614
Orthopaedic Surgery in Falmouth, MA

Individual Male Orthopaedic Surgery PECOS Enrolled MIPS Quality Score 88.7

About DAVID F GOUVEIA M.D.

David Gouveia is a provider established in Falmouth, Massachusetts and his medical specialization is Orthopaedic Surgery. The NPI number of David Gouveia is 1801860614 and was assigned on February 2006. The practitioner's primary taxonomy code is 207X00000X with license number 25638 (MA). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI
1801860614
Provider Name DAVID F GOUVEIA M.D.
Provider Location Address100 TER HEUN DR FALMOUTH, MA 02540
Provider Mailing AddressPO BOX 2460 TEATICKET, MA 02536
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?N/A
Enumeration Date02-16-2006
Last Update Date07-08-2007

David Gouveia 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..

David Gouveia is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 88.7, 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.



Primary Taxonomy

Taxonomy Code207X00000X
ClassificationOrthopaedic Surgery
TypeAllopathic & Osteopathic Physicians
License No.25638
License StateMA
Taxonomy DescriptionAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Business Address

DAVID F GOUVEIA M.D.
100 TER HEUN DR
FALMOUTH, MA
ZIP 02540
Phone: (508) 548-3699

Get Directions


Mailing Address

DAVID F GOUVEIA M.D.
PO BOX 2460
TEATICKET, MA
ZIP 02536
Phone: (508) 548-3699
Fax: (508) 548-6036


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
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

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% 85.5
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% 74.8
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 - 88.7
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.

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
A35079MEDICARE UPIN (02)MA
0134252MEDICAID (05)MA
B30111MEDICARE ID-TYPE UNSPECIFIED (04)MA

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.
1801860614
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2801166062
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 0 + 1 + 1 + 6 + 6 + 0 + 6 + 2 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 44

The NPI number 1801860614 is valid because the calculated check digit 4 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
1518967322 CYNTHIA A HINES MD
Individual
Anesthesiology100 TER HEUN DR
FALMOUTH, MA 02540
(508) 548-5300
1528033065DR. LESLIE D MAX M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)100 TER HEUN DR FALMOUTH HOSPITAL, DEPT. OF PATHOLOGY
FALMOUTH, MA 02540
(508) 457-3536
1124093950 VLADIMIR KOREN MD
Individual
Hospitalist100 TER HEUN DR FALMOUTH HOSPITAL HOSPITALIST DEPARTMENT
FALMOUTH, MA 02540
(508) 457-3748
1821065244 JONATHAN COSTA DO
Individual
Hospitalist100 TER HEUN DR FALMOUTH HOSPITAL HOSPITALIST DEPARTMENT
FALMOUTH, MA 02540
(508) 457-3748
1144298084 MICHELLE SWEKLA MD
Individual
Hospitalist100 TER HEUN DR FALMOUTH HOSPITAL HOSPITALIST DEPARTMENT
FALMOUTH, MA 02540
(508) 457-3748
1760450258 JAMES M SCHERMERHORN PA
Individual
Physician Assistant100 TER HEUN DR
FALMOUTH, MA 02540
(508) 457-3929
1710955125 ARSHAD M MIAN MD
Individual
Hospitalist100 TER HEUN DR FALMOUTH HOSPITAL HOSPITALIST DEPARTMENT
FALMOUTH, MA 02540
(508) 457-3748
1861461246 JOHN E HILL JR. PA
Individual
Physician Assistant100 TER HEUN DR FALMOUTH HOSPITAL EMERGENCY DEPARTMENT
FALMOUTH, MA 02540
(508) 457-3929
1295794840 JONATHAN R PILCHER MD
Individual
Emergency Medicine100 TER HEUN DR FALMOUTH HOSPITAL - EMERGENCY DEPARTMENT
FALMOUTH, MA 02540
(508) 457-3929
1760446959DR. RAMON BLANCO MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)100 TER HEUN DR
FALMOUTH, MA 02540
(508) 457-3536
1316901341DR. EUGENE FERRARO M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)100 TER HEUN DR FALMOUTH HOSPITAL, DEPT. OF PATHOLOGY
FALMOUTH, MA 02540
(508) 457-3536
1639137235 RYAN J BEMIS M.D.
Individual
Emergency Medicine100 TER HEUN DR
FALMOUTH, MA 02540
(508) 457-3660
1053379701CAPE COD HEALTHCARE INC
Organization
General Acute Care Hospital100 TER HEUN DR
FALMOUTH, MA 02540
(508) 548-5300
1033162201DR. BERTRAND STEVENS DUNCAN M.D.
Individual
Surgery100 TER HEUN DR FALMOUTH HOSPITAL
FALMOUTH, MA 02540
(508) 548-5300
1366497315 JULIE L. BEMIS N.P.
Individual
Nurse Practitioner (Family)100 TER HEUN DR
FALMOUTH, MA 02540
(508) 457-3748
1861431694 PENNY VIATOR MD
Individual
Anesthesiology100 TER HEUN DR
FALMOUTH, MA 02540
(508) 548-8989
1205877305 ANDREW SHAYNE MD
Individual
Anesthesiology100 TER HEUN DR
FALMOUTH, MA 02540
(508) 548-8989
1114968211 MARK STEPHEN KAMP MD
Individual
Anesthesiology100 TER HEUN DR
FALMOUTH, MA 02540
(508) 548-8989
1518997261 DIANE M. DADDARIO M.D.
Individual
Emergency Medicine100 TER HEUN DR EMERGENCY DEPARTMENT
FALMOUTH, MA 02540
(508) 457-3929
1295756617 JUDEE M. MCCARTHY N.P.
Individual
Nurse Practitioner100 TER HEUN DR HOSPITALIST DEPARTMENT
FALMOUTH, MA 02540
(508) 457-3748

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
David F Gouveia M.d. 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.