ROBERT E PEDERSEN O.D.
NPI 1821173972
Optometrist in Stockton, CA


Quality Rating: 80.95 out of 100 score

NPI Status: Active since October 26, 2006

Contact Information

255 E WEBER AVE
STOCKTON, CA
ZIP 95202
Phone: (209) 466-5566
Fax: (209) 466-5566

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  • Individual
  • Male
  • Optometrist
  • Medicare Quality Reporting

About ROBERT PEDERSEN

This page provides the complete NPI Profile along with additional information for Robert Pedersen, a provider established in Stockton, California with a medical specialization in Optometrist. The healthcare provider is registered in the NPI registry with number 1821173972 assigned on October 2006. The practitioner's primary taxonomy code is 152W00000X with license number OPT8002TPA (CA). The provider is registered as an individual and his NPI record was last updated 13 years ago.

NPI
1821173972
Provider Name
ROBERT E PEDERSEN O.D.
Gender
Male
Entity Type
Individual
Location Address
255 E WEBER AVE STOCKTON, CA 95202
Location Phone
(209) 466-5566
Location Fax
(209) 466-5566
Mailing Address
255 E WEBER AVE STOCKTON, CA 95202
Mailing Phone
(209) 466-5566
Mailing Fax
(209) 466-5566
Is Sole Proprietor?
No
Enumeration Date
10-26-2006
Last Update Date
01-31-2013
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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

Optometrist

Taxonomy Code
152W00000X
Type
Eye and Vision Services Providers
License No.
OPT8002TPA
License State
CA
Taxonomy Description
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Insurance Plans Accepted

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

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

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
SD0080021MEDICARE PIN (08)CA 
BU701VMEDICARE PIN (08)CA 
BU701YMEDICARE PIN (08)CA 
BU701TMEDICARE PIN (08)CA 
BU701XMEDICARE PIN (08)CA 
U12255MEDICARE UPIN (02)CA 
BU701ZMEDICARE PIN (08) 
BU701WMEDICARE PIN (08)CA 

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 80.95, 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: 80.95 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: 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 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: 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 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: 19.85

    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: 19.85

    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
Diabetes: Eye Exam 86% 21
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

Reviews for ROBERT E PEDERSEN O.D.

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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 1821173972, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

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
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
2
Doubled → 4
Pos 4
1
Unchanged
Pos 5
1
Doubled → 2
Pos 6
7
Unchanged
Pos 7
3
Doubled → 6
Pos 8
9
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
2
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 2 → 4 1 → 2 3 → 6 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 4 + 1 + 2 + 7 + 6 + 9 + 1 + 4 + 24 = 68

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

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1821173972.

Other Providers at the Same Location


The following 12 providers are registered at the same or a nearby location.

Ophthalmology
255 E WEBER AVE
STOCKTON, CA 95202
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Ophthalmology
255 E WEBER AVE
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Ophthalmology
255 E WEBER AVE
STOCKTON, CA 95202
Optometrist
255 E WEBER AVE
STOCKTON, CA 95202
Ophthalmology
255 E WEBER AVE
STOCKTON, CA 95202
Ophthalmology
255 E WEBER AVE
STOCKTON, CA 95202
Optometrist
255 E WEBER AVE
STOCKTON, CA 95202
Ophthalmology
255 E WEBER AVE
STOCKTON, CA 95202
Optometrist
255 E WEBER AVE
STOCKTON, CA 95202
Ophthalmology
255 E WEBER AVE
STOCKTON, CA 95202

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821173972, enumerated as an "individual" on October 26, 2006.

The provider is located at 255 E WEBER AVE STOCKTON, CA 95202 and the phone number is (209) 466-5566.

Optometrist with taxonomy code 152W00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.