RACHEL R MARCUS M.D. NPI 1811953870
Specialist in Washington, DC

About RACHEL R MARCUS M.D.

Rachel Marcus is a provider established in Washington, District Of Columbia and her medical specialization is Specialist with more than 29 years of experience. She graduated from Stanford University School Of Medicine in 1994. The NPI number of Rachel Marcus is 1811953870 and was assigned on April 2006. The practitioner's primary taxonomy code is 174400000X with license number MD30443 (DC). The provider is registered as an individual and her NPI record was last updated 15 years ago.

NPI
1811953870
Provider Name RACHEL R MARCUS M.D.
Location Address2021 K ST NW SUITE 315 WASHINGTON, DC 20006
Location Phone(202) 775-0955
Mailing Address2021 K ST NW SUITE 315 WASHINGTON, DC 20006
GenderFemale
NPI Entity TypeIndividual
Medical School NameSTANFORD UNIVERSITY SCHOOL OF MEDICINE
Graduation Year1994
Is Sole Proprietor?No
Enumeration Date04-26-2006
Last Update Date02-11-2008

Rachel Marcus 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.

Rachel Marcus 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 Medstar Union Memorial Hospital and Medstar Good Samaritan Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 98.3, 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

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.

Taxonomy Code174400000X
ClassificationSpecialist
TypeOther Service Providers
License No.MD30443
License StateDC
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

RACHEL R MARCUS M.D.
2021 K ST NW
SUITE 315
WASHINGTON, DC
ZIP 20006
Phone: (202) 775-0955
Fax: (202) 467-4810

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Mailing Address

RACHEL R MARCUS M.D.
2021 K ST NW
SUITE 315
WASHINGTON, DC
ZIP 20006
Phone: (202) 775-0955
Fax: (202) 467-4810


Location Map

PECOS Enrollment and Medicare Participation Status

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 ID2769510965
PECOS Enrollment IDI20190502002164
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

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% 100
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% 99
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% 65.1
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 - 98.3
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.

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.

  • 1297Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)

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. Rachel Marcus is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
MEDSTAR UNION MEMORIAL HOSPITAL201 EAST UNIVERSITY PARKWAY
BALTIMORE, MD 21218
(410) 554-2227Acute Care Hospitals210024
MEDSTAR GOOD SAMARITAN HOSPITAL5601 LOCH RAVEN BOULEVARD
BALTIMORE, MD 21239
(443) 444-3902Acute Care Hospitals210056

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
H40917MEDICARE UPIN (02)DC
010306MEDICARE PIN (08)DC

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.
1811953870
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
28211856814
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 2 + 1 + 1 + 8 + 5 + 6 + 8 + 1 + 4 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1811953870 is valid because the calculated check digit 0 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
1093712184DR. STUART BRIAN SIBEL D.P.M.
Individual
Podiatrist (Foot Surgery)2021 K ST NW STE 520
WASHINGTON, DC 20006
(202) 223-4616
1609874494DR. DAVID A. SCHESSEL MD
Individual
Otolaryngology (Otology & Neurotology)2021 K ST NW SUITE 206
WASHINGTON, DC 20006
(202) 785-5000
1659370948DR. WERNER FRANKLIN BARTH M.D.
Individual
Internal Medicine (Rheumatology)2021 K ST NW SUITE 350
WASHINGTON, DC 20006
(202) 293-1470
1427059161 DAVID RANGE MD
Individual
Otolaryngology2021 K ST NW 210
WASHINGTON, DC 20006
(202) 223-3560
1972595791MRS. SUSAN RHODES HELLYER M.S., CCC-A, FAAA
Individual
Audiologist-Hearing Aid Fitter2021 K ST NW
WASHINGTON, DC 20006
(202) 223-0886
1699752840METROPOLITAN GASTROENTEROLOGY GROUP
Organization
Specialist2021 K ST NW SUITE T-110
WASHINGTON, DC 20006
(202) 296-3449
1407828601DR. SANDRA IRENE READ MD
Individual
Dermatology2021 K ST NW #508
WASHINGTON, DC 20006
(202) 223-6830
1770549818 ELIZABETH M ROSS M.D.
Individual
Specialist2021 K ST NW SUITE 315
WASHINGTON, DC 20006
(202) 775-0955
1679539654 KENNETH M.H. LEE M.D.
Individual
Specialist2021 K ST NW SUITE 315
WASHINGTON, DC 20006
(202) 775-0955
1073560561 NORMAN L BARR M.D.
Individual
Otolaryngology2021 K ST NW SUITE 210
WASHINGTON, DC 20006
(202) 223-3560
1649215120DR. GEORGE SAMMAN M.D.
Individual
Obstetrics & Gynecology (Gynecology)2021 K ST NW SUITE204
WASHINGTON, DC 20006
(202) 833-8538
1275566804DR. CLARENCE CONROY LINDQUIST D.D.S.
Individual
Dentist (Oral and Maxillofacial Surgery)2021 K ST NW SUITE 317
WASHINGTON, DC 20006
(202) 466-7555
1467477695MR. ANTOINE TOUMA MSPT,FAAOMPT
Individual
Physical Therapist2021 K ST NW SUITE 500
WASHINGTON, DC 20006
(202) 463-7611
1558386565DR. PAULA RUSSO D.D.S., M.S.
Individual
Dentist (Endodontics)2021 K ST NW SUITE 522
WASHINGTON, DC 20006
(202) 861-0045
1740202266 JAMES GORDON VAP M.D.
Individual
Otolaryngology2021 K ST NW SUITE 210
WASHINGTON, DC 20006
(202) 223-3560
1316052541DR. ANTHONY STEVEN UNGER M.D.
Individual
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)2021 K ST NW SUITE 400
WASHINGTON, DC 20006
(202) 466-5151
1124133384DR. RICHARD WERNER BARTH M.D.
Individual
Orthopaedic Surgery (Hand Surgery)2021 K ST NW SUITE 400
WASHINGTON, DC 20006
(202) 466-5151
1790890895DR. JONAS RONAN RUDZKI M.D.
Individual
Orthopaedic Surgery (Sports Medicine)2021 K ST NW SUITE 400
WASHINGTON, DC 20006
(202) 466-5151
1205938842DR. FREDRICK WILLIAM LUZIETTI D.D.S.
Individual
Dentist (General Practice)2021 K ST NW SUITE 518
WASHINGTON, DC 20006
(202) 296-4356
1629171269 MATTHEW ALLEN PARKER MD
Individual
Internal Medicine2021 K ST NW SUITE 512
WASHINGTON, DC 20006
(202) 293-3636

Frequently Asked Questions

What is Rachel Marcus M.D. NPI number?

The NPI number assigned to Rachel Marcus M.D. is 1811953870, registered as an "individual" on April 26, 2006

Where is Rachel Marcus M.D. located?

The provider is located at 2021 K St Nw Suite 315 Washington, Dc 20006 and the phone number is (202) 775-0955

Which is Rachel Marcus M.D. specialty?

The provider's speciality is Specialist

How many years of experience does Rachel Marcus M.D. have?

The provider has more than 29 years of experience. She graduated from Stanford University School Of Medicine in 1994.

What insurance does Rachel Marcus M.D. accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Rachel Marcus M.D. registered in PECOS?

Yes, as of January 10, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary 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 are Rachel Marcus M.D. Quality Ratings?

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

What are some of the services provided by Rachel Marcus M.D.?

The most common procedures or services performed by this practitioner are: Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function.

Is Rachel Marcus M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: MEDSTAR UNION MEMORIAL HOSPITAL and MEDSTAR GOOD SAMARITAN HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

The NPI record of Rachel Marcus M.D. was last updated on April 26, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]