NELS C GUNNARSEN M.D.
NPI 1821193160
Radiology - Diagnostic Radiology in Sacramento, CA


Quality Rating: 86.68 out of 100 score

NPI Status: Active since September 13, 2006

Contact Information

4860 Y ST
SUITE 3100
SACRAMENTO, CA
ZIP 95817
Phone: (916) 703-2273
Fax: (916) 703-2274

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  • Individual
  • Male
  • Years of Experience 36
  • Radiology
  • Diagnostic Radiology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About NELS GUNNARSEN

This page provides the complete NPI Profile along with additional information for Nels Gunnarsen, a provider established in Sacramento, California with a medical specialization in Radiology, focusing in diagnostic radiology and more than 36 years of experience. He graduated from Vanderbilt University School Of Medicine in 1990. The healthcare provider is registered in the NPI registry with number 1821193160 assigned on September 2006. The practitioner's primary taxonomy code is 2085R0202X with license number G87827 (CA). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1821193160
Provider Name
NELS C GUNNARSEN M.D.
Gender
Male
Entity Type
Individual
Location Address
4860 Y ST SUITE 3100 SACRAMENTO, CA 95817
Location Phone
(916) 703-2273
Location Fax
(916) 703-2274
Mailing Address
4860 Y STREET SUITE 3100 DEPARTMENT OF RADIOLOGY, UNIVERSITY OF CALIFORNIA,DAVIS SACRAMENTO, CA 95817
Mailing Phone
(916) 703-2273
Mailing Fax
(916) 703-2274
Medical School Name
VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
1990
Is Sole Proprietor?
No
Enumeration Date
09-13-2006
Last Update Date
03-07-2023
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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

Radiology Diagnostic Radiology

Taxonomy Code
2085R0202X
Type
Allopathic & Osteopathic Physicians
License No.
G87827
License State
CA
Taxonomy Description
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Insurance Plans Accepted

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

  • Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
  • Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
  • Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Sendero Health Austin512 Silver / $40 PCP / $75 Specialist / $15 Generic Drugs / $0 Deductible - HMO
  • Sendero Health Capital Silver / $40 PCP / $80 Specialist / $20 Generic Drugs - HMO
  • Sendero Health Hill Country Gold / $30 PCP / $60 Specialist / $15 Generic Drugs - HMO
  • Sendero Health Original Silver / $20 PCP + 2 $0 PCP Visits / $10 Generic Drugs - HMO
  • Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs - HMO
  • Sendero Health Quality Care Bronze High Deductible / $50 PCP / $25 Generic Drugs / $100 Specialist - HMO
  • Sendero Health Real Gold / $350 Deductible - HMO
  • Wellpoint Essential Bronze 4000 HSA ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze 6000 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs) - HMO
  • Wellpoint Essential Bronze 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze POS 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Bronze POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Bronze POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Catastrophic 9200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO

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
G87827OTHER (01)CAMEDICAL LICENSE

Medicare Participation & PECOS Enrollment Status

Nels Gunnarsen 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.

Nels Gunnarsen 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: 2466459466

    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: I20200424001714, I20210607001248

    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.

Biopsy of breast and placement of locating device using ultrasound, first growth

A breast biopsy with locating device placement involves taking a small sample from an unusual growth, using ultrasound for precise targeting. This sample is studied for any abnormal cells. A locating device is also placed to mark the area for future reference.

This service was performed 17 times for 17 patients

Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)

Diagnostic digital breast tomosynthesis is a 3D imaging test that allows doctors to examine your breast tissue layer by layer. It's performed on one or both sides. It helps in detecting abnormalities more accurately. It's often done in addition to other tests.

This service was performed 135 times for 132 patients

Diagnostic mammography of 1 breast

Diagnostic mammography of 1 breast is a detailed imaging test that allows doctors to closely examine a specific area in the breast. It's often used when a routine screening reveals an abnormality. This test can help identify any unusual changes or issues.

This service was performed 104 times for 101 patients

Diagnostic mammography of both breasts

Diagnostic mammography involves using special imaging technology to capture detailed images of both breasts. This procedure helps in identifying any unusual changes or abnormalities. It's a crucial step in ensuring breast health and early detection of potential issues.

This service was performed 57 times for 57 patients

Limited ultrasound scan of 1 breast

A limited ultrasound scan of one breast is a non-invasive imaging test. It uses sound waves to create pictures of the inside of your breast. It helps identify any unusual growths or changes. It's safe, quick, and typically painless.

This service was performed 79 times for 76 patients

Screening 3d breast mammography

Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.

This service was performed 122 times for 122 patients

Screening mammography

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

This service was performed 122 times for 122 patients

X-ray of surgical specimen

An X-ray of a surgical specimen involves taking detailed images of the tissue or organ removed during surgery. This helps in examining the specimen more closely to understand the disease better. It's a safe, non-invasive procedure, providing valuable insights to your healthcare team.

This service was performed 18 times for 17 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $23.15 for a new patient copayment and $18.75 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 95817 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $92.61
  • Minimum New Patient Price $60.44
  • Maximum New Patient Price $180.85
  • Average New Patient Copayment $23.15
  • Minimum New Patient Copayment $15.11
  • Maximum New Patient Copayment $45.21

Established Patients Visit Costs *

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

  • Average Established Patient Price $75.03
  • Minimum Established Patient Price $19.88
  • Maximum Established Patient Price $148.15
  • Average Established Patient Copayment $18.75
  • Minimum Established Patient Copayment $4.97
  • Maximum Established Patient Copayment $37.03

* 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 86.68, 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: 86.68 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: 75.78

    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: 100

    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: 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.

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. Nels Gunnarsen is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
LANSDALE HOSPITAL100 MEDICAL CAMPUS DRIVE
LANSDALE, PA 19446
(215) 368-2100Acute Care Hospitals
ABINGTON MEMORIAL HOSPITAL1200 OLD YORK ROAD
ABINGTON, PA 19001
(215) 481-2000Acute Care Hospitals

Reviews for NELS C GUNNARSEN M.D.

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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.
1821193160
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2841296112
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 4 + 1 + 2 + 9 + 6 + 1 + 1 + 2 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1821193160 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.

DR. TIMOTHY WILLIAM CUTLER PHARM.D.

Pharmacist

(Geriatric)

4860 Y ST
SACRAMENTO, CA
ZIP 95817

(916) 703-4006

REGENTS OF THE UNIVERSITY OF CA

Clinic/Center

(Pain)

4860 Y ST
SACRAMENTO, CA
ZIP 95817

(916) 734-6824

REGENTS OF THE UNIV OF CA

Psychiatry & Neurology

(Neurology)

4860 Y ST
SACRAMENTO, CA
ZIP 95817

(916) 734-5496

ALBERT T LIU MD

Obstetrics & Gynecology

4860 Y ST
STE 2500
SACRAMENTO, CA
ZIP 95817

(916) 734-6930

DR. H. DAVID MOEHRING MD

Orthopaedic Surgery

(Orthopaedic Trauma)

4860 Y ST
ACC #3800
SACRAMENTO, CA
ZIP 95817

(916) 734-2863

DR. GEORGE T. RAB MD

Orthopaedic Surgery

4860 Y ST
ACC #3800
SACRAMENTO, CA
ZIP 95817

(916) 734-2958

DR. ROLANDO F. ROBERTO MD

Orthopaedic Surgery

(Orthopaedic Surgery of the Spine)

4860 Y ST
ACC #3800
SACRAMENTO, CA
ZIP 95817

(916) 734-6234

DR. ROBERT M SZABO MD

Orthopaedic Surgery

(Hand Surgery)

4860 Y ST
ACC #3800
SACRAMENTO, CA
ZIP 95817

(916) 734-3678

SARAH MARSHALL MD

Family Medicine

4860 Y ST
STE 1600
SACRAMENTO, CA
ZIP 95817

(916) 734-2833

DR. STEVEN DAVID BRASS MD

Psychiatry & Neurology

(Neurology)

4860 Y ST
SUITE 0100
SACRAMENTO, CA
ZIP 95817

(916) 734-3588

DR. MARK A LEE MD

Orthopaedic Surgery

(Orthopaedic Trauma)

4860 Y ST
ACC #3800
SACRAMENTO, CA
ZIP 95817

(916) 734-2729

DR. CHRIS STERLING SHIN M.D.

Physical Medicine & Rehabilitation

4860 Y ST
SUITE 3850
SACRAMENTO, CA
ZIP 95817

(916) 734-5292

DR. HOLLY HONG ZHAO M.D.

Physical Medicine & Rehabilitation

4860 Y ST
SUITE 3850
SACRAMENTO, CA
ZIP 95817

(916) 734-5294

DR. CRAIG MICHEL MCDONALD M.D.

Physical Medicine & Rehabilitation

(Pediatric Rehabilitation Medicine)

4860 Y ST
SUITE 3850
SACRAMENTO, CA
ZIP 95817

(916) 734-5291

DR. LOREN T DAVIDSON M.D.

Physical Medicine & Rehabilitation

4860 Y ST
SUITE 3850
SACRAMENTO, CA
ZIP 95817

(916) 734-5292

PROF. ARTHUR CLAYTON HUNTLEY M.D.

Dermatology

4860 Y ST
DEPARTMENT OF DERMATOLOGY SUITE 3400
SACRAMENTO, CA
ZIP 95817

(916) 734-6795

DR. EZRA A AMSTERDAM M.D.

Internal Medicine

(Cardiovascular Disease)

4860 Y ST
SUITE 2820
SACRAMENTO, CA
ZIP 95817

(916) 724-3764

DR. RICHARD WANLASS PH.D.

Clinical Neuropsychologist

4860 Y ST
SUITE 1100
SACRAMENTO, CA
ZIP 95817

(916) 734-3420

WILLIAM J. BOMMER M.D.

Internal Medicine

(Cardiovascular Disease)

4860 Y ST
SUITE 0200
SACRAMENTO, CA
ZIP 95817

(916) 734-3761

UMA N. SRIVATSA M.D.

Internal Medicine

(Cardiovascular Disease)

4860 Y ST
SUITE 2820
SACRAMENTO, CA
ZIP 95817

(916) 734-3764

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821193160, enumerated as an "individual" on September 13, 2006.

The provider is located at 4860 Y ST SUITE 3100 SACRAMENTO, CA 95817 and the phone number is (916) 703-2273.

Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.

The provider might be accepting Accepts: Aetna CVS Health, Blue Cross and Blue Shield of. Please consult your insurance carrier or call the provider to verify.

Nels Gunnarsen is affiliated with: LANSDALE HOSPITAL and ABINGTON MEMORIAL HOSPITAL.