KRISTINE ZIEMBA MD, PHD
NPI 1811155864
Psychiatry & Neurology - Neurology in Charlottesville, VA

NPI Status: Active since May 27, 2008

Contact Information

1221 LEE STREET
CHARLOTTESVILLE, VA
ZIP 22908
Phone: (434) 924-2706
Fax: (434) 924-9068

NPI Profile Information
Primary Taxonomy
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 19
Psychiatry & Neurology
Neurology
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About KRISTINE ZIEMBA

This page provides the complete NPI Profile along with additional information for Kristine Ziemba, a provider established in Charlottesville, Virginia with a medical specialization in Psychiatry & Neurology, focusing in neurology and more than 19 years of experience. She graduated from University Of Kentucky College Of Medicine in 2008. The healthcare provider is registered in the NPI registry with number 1811155864 assigned on May 2008. The practitioner's primary taxonomy code is 2084N0400X with license number 0101280577 (VA). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI: 1811155864
Provider Name: KRISTINE ZIEMBA MD, PHD
Gender: Female
Entity Type: Individual
Location Address: 1221 LEE STREET CHARLOTTESVILLE, VA 22908
Location Phone: (434) 924-2706
Location Fax: (434) 924-9068
Mailing Address: PO BOX 9007 CHARLOTTESVILLE, VA 22906
Medical School Name: UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Graduation Year: 2008
Is Sole Proprietor?: No
Enumeration Date: 05-27-2008
Last Update Date: 01-25-2024
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Location Map

Secondary Locations

1215 Lee St
Charlottesville, VA 22908
(434) 924-2706

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: Psychiatry & Neurology Neurology
Taxonomy Code: 2084N0400X
Type: Allopathic & Osteopathic Physicians
License No.: 0101280577
License State: VA
Taxonomy Description: A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Medicare Participation & PECOS Enrollment Status

Kristine Ziemba 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.

Kristine Ziemba 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: 1759437346
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: I20240124002755
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.

Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Measurement of brain wave activity (eeg), awake and drowsy
Measurement of brain wave activity with video (veeg), 12-26 hours with review and report by health care professional
Measurement of brain wave activity with video (veeg), 2-12 hours with review and report by health care professional
New patient office or other outpatient visit, 60-74 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.26 for a new patient copayment and $24.78 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 22908 ZIP code area.

New Patients Visit Costs *

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

Average New Patient Price $129.04
Minimum New Patient Price $56.19
Maximum New Patient Price $170.3

Average New Patient Copayment $32.26
Minimum New Patient Copayment $14.04
Maximum New Patient Copayment $42.57

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $99.13
Minimum Established Patient Price $18.07
Maximum Established Patient Price $138.91

Average Established Patient Copayment $24.78
Minimum Established Patient Copayment $4.51
Maximum Established Patient Copayment $34.72

* 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.

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
Dementia: Functional Status Assessment	84%	92
Percentage of patients with dementia for whom an assessment of functional status was performed at least once in the last 12 months*
Documentation of Current Medications in the Medical Record	100%	1240
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	90%	1867
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: Plan of Care	96%	26
Percentage of patients aged 65 years and older with a history of falls that had a plan of care for falls documented within 12 months
Falls: Screening for Future Fall Risk	41%	301
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Provide Education Opportunities for New Clinicians	Yes	N/A
MIPS eligible clinicians acting as a preceptor for clinicians-in-training (such as medical residents/fellows, medical students, physician assistants, nurse practitioners, or clinical nurse specialists) and accepting such clinicians for clinical rotations in community practices in small, underserved, or rural areas.
Provide Patient Access	13%	800
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.
Screening for Psychiatric or Behavioral Health Disorders	100%	583
Percent of all visits for patients with a diagnosis of epilepsy where the patient was screened for psychiatric or behavioral disorders.
Secure Messaging	5%	800
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.
Sleep Apnea: Assessment of Sleep Symptoms	88%	33
Percentage of visits for patients aged 18 years and older with a diagnosis of obstructive sleep apnea that includes documentation of an assessment of sleep symptoms, including presence or absence of snoring and daytime sleepiness
Tobacco use	Yes	N/A
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Kristine Ziemba is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type
UNIVERSITY OF VIRGINIA MEDICAL CENTER	1215 LEE STREET CHARLOTTESVILLE, VA 22908	(434) 924-0000	Acute Care Hospitals
NOVANT PRINCE WILLIAM MEDICAL CENTER	8700 SUDLEY RD MANASSAS, VA 20110	(703) 369-8000	Acute Care Hospitals
UVA HEALTH HAYMARKET MEDICAL CENTER	15225 HEALTHCOTE BOULEVARD HAYMARKET, VA 20169	(571) 284-1000	Acute Care Hospitals

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 1811155864, we treat the final digit (4) 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 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

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 → 2

Pos 4

Unchanged

Pos 5

Doubled → 2

Pos 6

Unchanged

Pos 7

Doubled → 10 → 1 + 0

Pos 8

Unchanged

Pos 9

Doubled → 12 → 1 + 2

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 1 → 2 1 → 2 5 → 10 → 1 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 2 + 1 + 2 + 5 + 1 + 0 + 8 + 1 + 2 + 24 = 56

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

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4

This NPI is valid

The calculated check digit is 4, which matches the last digit of 1811155864.