JAMES TONEY DPM NPI 1821354234
Podiatrist - Foot & Ankle Surgery in Lansing, MI
About JAMES TONEY DPM
James Toney is a provider established in Lansing, Michigan and his medical specialization is Podiatrist with a focus in foot & ankle surgery with more than 11 years of experience. He graduated from University Of Arizona College Of Medicine in 2012. The NPI number of James Toney is 1821354234 and was assigned on April 2012. The practitioner's primary taxonomy code is 213ES0103X with license number 5901002460 (MI). The provider is registered as an individual and his NPI record was last updated 7 years ago.
| NPI | 1821354234 |
| Provider Name | JAMES TONEY DPM |
| Location Address | 3390 E JOLLY RD LANSING, MI 48910 |
| Location Phone | (517) 882-8673 |
| Mailing Address | 3820 GORMAN DR LANSING, MI 48906 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE |
| Graduation Year | 2012 |
| Is Sole Proprietor? | Yes |
| Enumeration Date | 04-10-2012 |
| Last Update Date | 10-23-2015 |
James Toney 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) and a Home Health Agency (HHA).
James Toney 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 he has hospital affiliations with .
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 94.6, 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 following quality measures were reported for this provider: completion of training and receipt of approved waiver for provision opioid medication-assisted treatments, consultation of the prescription drug monitoring program, diabetes: eye exam, diabetes: foot exam, documentation of current medications in the medical record, engagement of new medicaid patients and follow-up, e-prescribing, implementation of documentation improvements for practice/process improvements, medication reconciliation, participation in quality improvement initiatives, patient-specific education, pneumococcal vaccination status for older adults, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, provide patient access, secure messaging, security risk analysis, tobacco use and use of high-risk medications in the elderly.
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 Code | 213ES0103X |
| Classification | Podiatrist |
| Type | Podiatric Medicine & Surgery Service Providers |
| Specialization | Foot & Ankle Surgery |
| License No. | 5901002460 |
| License State | MI |
Business Address
JAMES TONEY DPM
3390 E JOLLY RD
LANSING, MI
ZIP 48910
Phone: (517) 882-8673
Mailing Address
JAMES TONEY DPM
3820 GORMAN DR
LANSING, MI
ZIP 48906
Phone: (810) 210-8470
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 ID | 5799005872 |
| PECOS Enrollment ID | I20150514000284 |
| 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 Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | No |
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 | |
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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. |
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| Promoting Interoperability (PI) | 25% | 82 | |
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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. |
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| Improvement Activities | 15% | 40 | |
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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. |
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| Cost | 20% | N/A | |
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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. |
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| MIPS Final Score | - | 94.6 | |
| 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 Reporting
The following quality measures meet Medicare's statistical reporting standards for the year 2018. 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 |
|---|---|---|
| Completion of training and receipt of approved waiver for provision opioid medication-assisted treatments | Yes | N/A |
| Completion of training and obtaining an approved waiver for provision of medication -assisted treatment of opioid use disorders using buprenorphine. | ||
| Consultation of the Prescription Drug Monitoring Program | Yes | N/A |
| Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance. | ||
| Diabetes: Eye Exam | 11% | 121 |
| 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 | ||
| Diabetes: Foot Exam | 80% | 121 |
| The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year | ||
| Documentation of Current Medications in the Medical Record | 95% | 4604 |
| 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 | ||
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| e-Prescribing | 100% | 420 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Implementation of documentation improvements for practice/process improvements | Yes | N/A |
| Implementation of practices/processes that document care coordination activities (e.g., a documented care coordination encounter that tracks all clinical staff involved and communications from date patient is scheduled for outpatient procedure through day of procedure). | ||
| Medication Reconciliation | 67% | 918 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Participation in Quality Improvement Initiatives | Yes | N/A |
| Participation in other quality improvement programs such as Bridges to Excellence or American Board of Medical Specialties (ABMS) Multi-Specialty Portfolio Program. | ||
| Patient-Specific Education | 3% | 1602 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 20% | 728 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 38% | 1602 |
| 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. | ||
| Secure Messaging | 0% | 1602 |
| 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. | ||
| 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. | ||
| Use of High-Risk Medications in the Elderly | 0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 728 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 213EP1101X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Primary Podiatric Medicine | 5901002460 | MI | No |
Taxonomy Description: Not Available | |||||||
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. | |||||||||
| 1 | 8 | 2 | 1 | 3 | 5 | 4 | 2 | 3 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 4 | 1 | 6 | 5 | 8 | 2 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 4 + 1 + 6 + 5 + 8 + 2 + 6 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1821354234 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 8 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1699887083 | JOHN THROCKMORTON, DPM PC Organization | Podiatrist (Foot & Ankle Surgery) | 3390 E JOLLY RD LANSING, MI 48910 (517) 882-8673 |
| 1487893533 | MATTHEW KARL WOLFGANG THOMSON D.P.M. Individual | Podiatrist (Foot & Ankle Surgery) | 3390 E JOLLY RD LANSING, MI 48910 (517) 882-8673 |
| 1114300530 | FOREMOST PODIATRY, P.C. Organization | Podiatrist (Foot & Ankle Surgery) | 3390 E JOLLY RD LANSING, MI 48910 (517) 882-8673 |
| 1598783623 | DR. FRANK ROSENBAUM M.D. Individual | Ophthalmology | 3390 E JOLLY RD LANSING, MI 48910 (517) 393-2020 |
| 1669490702 | DR. LANCE CAMERON LEMON M.D. Individual | Ophthalmology | 3390 E JOLLY RD LANSING, MI 48910 (517) 393-2020 |
| 1013085901 | MID MICHIGAN OPHTHALMOLOGY PC Organization | Ophthalmology | 3390 E JOLLY RD LANSING, MI 48910 (517) 393-2020 |
| 1427475607 | JONATHON M RAYMAN DPM Individual | Podiatrist (Foot & Ankle Surgery) | 3390 E JOLLY RD LANSING, MI 48910 (517) 882-8673 |
| 1225569767 | DR. MICHAEL DZIEWIT JR. D.P.M Individual | Podiatrist (Foot & Ankle Surgery) | 3390 E JOLLY RD LANSING, MI 48910 (561) 882-8673 |
Frequently Asked Questions
What is James Toney DPM NPI number?
The NPI number assigned to James Toney DPM is 1821354234, registered as an "individual" on April 10, 2012
Where is James Toney DPM located?
The provider is located at 3390 E Jolly Rd Lansing, Mi 48910 and the phone number is (517) 882-8673
Which is James Toney DPM specialty?
The provider's speciality is Podiatrist with a focus in Foot & Ankle Surgery
How many years of experience does James Toney DPM have?
The provider has more than 11 years of experience. He graduated from University Of Arizona College Of Medicine in 2012.
Is James Toney DPM 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) and a Home Health Agency (HHA).
What are James Toney DPM 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.
How do I update my NPI information?
The NPI record of James Toney DPM was last updated on April 10, 2012. 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]
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