SHANE B ROWAN MD NPI 1831166636

Internal Medicine (Clinical Cardiac Electrophysiology) in Cleveland, OH

NPI 1831166636 Individual Male Years of Experience 21 Internal Medicine Clinical Cardiac Electrophysiology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 82.7

NPI Profile for SHANE B ROWAN MD

Shane Rowan is an internal medicine provider established in Cleveland, Ohio and his medical specialization is internal medicine (clinical cardiac electrophysiology) with more than 21 years of experience. He graduated from Vanderbilt University School Of Medicine in 2002. The NPI number of Shane Rowan is 1831166636 and was assigned on March 2006. The practitioner's primary taxonomy code is 207RC0001X with license number 095600 (OH). The provider is registered as an individual and his NPI record was last updated 10 years ago.

An internist like Shane B Rowan Md is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Shane Rowan 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.

Shane Rowan 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 North Colorado Medical Center, Mckee Medical Center, Community Hospital, Sterling Regional Medcenter and Washakie Medical Center.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 82.7, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $32.89 for a new patient copayment and $25.3 for an established patient copayment.

NPI

1831166636

Provider Name SHANE B ROWAN MD
Provider Location Address2500 METROHEALTH DR CLEVELAND, OH 44109
Provider Mailing Address2500 METROHEALTH DR CLEVELAND, OH 44109
GenderMale
NPI Entity TypeIndividual
Medical School NameVANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduation Year2002
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date03-01-2006
Last Update Date03-14-2012


Primary Taxonomy

Taxonomy Code207RC0001X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationClinical Cardiac Electrophysiology
License No.095600
License StateOH
Taxonomy DescriptionA field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.

Business Address

SHANE B ROWAN MD
2500 METROHEALTH DR
CLEVELAND, OH
ZIP 44109
Phone: (216) 778-2328
Fax: (216) 778-3927

Get Directions


Mailing Address

SHANE B ROWAN MD
2500 METROHEALTH DR
CLEVELAND, OH
ZIP 44109
Phone: (216) 778-2328
Fax: (216) 778-3927



PECOS Enrollment and Medicare Participation

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 ID5496796856
PECOS Enrollment IDI20050516000671
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

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 44109 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$56.74 $173.94 $131.59
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.18 $43.48 $32.89
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.31 $141.66 $101.2
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.32 $35.41 $25.3

* The physician office visit costs information is obtained by Medicare's 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 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% 84.5
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% 70
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% 66.6
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 - 82.7
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.

  • 305Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report (HCPCS:93010)
  • 91Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)
  • 85Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report (HCPCS:93280)
  • 46Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • 25Evaluation, testing and programming adjustment of defibrillator with analysis, review and report (HCPCS:93284)
  • 25Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes (HCPCS:33208)
  • 22Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report (HCPCS:93018)
  • 21Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 14Evaluation, testing and programming adjustment of defibrillator with analysis, review and report (HCPCS:93283)

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. Shane Rowan is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
NORTH COLORADO MEDICAL CENTER1801 - 16TH ST
GREELEY, CO 80631
(970) 810-4121Acute Care Hospitals60001
MCKEE MEDICAL CENTER2000 BOISE AVE
LOVELAND, CO 80538
(970) 669-4640Acute Care Hospitals60030
COMMUNITY HOSPITAL2000 CAMPBELL DRIVE
TORRINGTON, WY 82240
(307) 532-4181Critical Access Hospitals531307
STERLING REGIONAL MEDCENTER615 FAIRHURST ST
STERLING, CO 80751
(970) 522-0122Acute Care Hospitals60076
WASHAKIE MEDICAL CENTER400 SOUTH 15TH STREET
WORLAND, WY 82401
(307) 347-3221Critical Access Hospitals531306

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
801957MEDICARE ID-TYPE UNSPECIFIED (04)CO
I28755MEDICARE UPIN (02)CO
78024048MEDICAID (05)CO

NPI Validation Check Digit Calculation


The following table explains step by step the 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.
1831166636
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2861261266
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 6 + 1 + 2 + 6 + 1 + 2 + 6 + 6 + 24 = 64
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 64 = 66

The NPI number 1831166636 is valid because the calculated check digit 6 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
1992704886 CARIE TWICHELL AA
Individual
Anesthesiologist Assistant2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4809
1104827740 JULIA A. RILEY PHARM.D.
Individual
Pharmacist2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-1946
1013909209MR. KRISTEN NILS HANSEN RPH
Individual
Pharmacist2500 METROHEALTH DR WOMENS AND CHILDRENS PLAZA
CLEVELAND, OH 44109
(216) 778-8537
1710970082MS. KELLYE KAUFMAN AA-C
Individual
Anesthesiologist Assistant2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4801
1881687564MR. BRADEN JOSEPH KUNZELMAN RPH
Individual
Pharmacist2500 METROHEALTH DR AMBULATORY PHARMACY
CLEVELAND, OH 44109
(216) 778-7548
1508859281MS. STEPHANIE E CROSS RPH
Individual
Pharmacist2500 METROHEALTH DR OUTPATIENT PHARMACY
CLEVELAND, OH 44109
(216) 778-3017
1255324943MRS. TANIA NICOLE BIERLY RPH
Individual
Pharmacist2500 METROHEALTH DR OUTPATIENT PHARMACY
CLEVELAND, OH 44109
(216) 778-2201
1154315364MR. JOSEPH PEACHMAN A.A.
Individual
Anesthesiologist Assistant2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4801
1801880596MR. MICHAEL L PYRTKO RPH
Individual
Pharmacist2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-7548
1588658157MS. EBONY NICOLE ALEXANDER RPH
Individual
Pharmacist2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-3017
1275522765 HANS C GEHO M.D.
Individual
Internal Medicine2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-7800
1376523670DR. ANDRE PROCHOROFF MD
Individual
Psychiatry & Neurology (Child & Adolescent Psychiatry)2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4933
1144284928DR. BEN H BROUHARD MD
Individual
Pediatrics (Pediatric Nephrology)2500 METROHEALTH DR ROOM A-109
CLEVELAND, OH 44109
(216) 778-4900
1740246347 SHARI DANIELLE BOLEN M.D.
Individual
Internal Medicine2500 METROHEALTH DR METROHEALTH MEDICAL CENTER-INTERNAL MEDICINE CLINIC
CLEVELAND, OH 44109
(216) 778-2273
1457304255 WILLIAM E CAPPAERT M.D.
Individual
Ophthalmology2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-2236
1316987902 SHARON LYNN MACK CNP
Individual
Nurse Practitioner2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-7800
1770523516MS. ANNETTE M LYNCH MSN, CNS
Individual
Clinical Nurse Specialist (Perinatal)2500 METROHEALTH DR DEPARTMENT OF PEDIATRICS/PERINATAL
CLEVELAND, OH 44109
(216) 778-7800
1427099183DR. KARL G WAGNER MD
Individual
Anesthesiology2500 METROHEALTH DR DEPARTMENT OF ANESTHESIOLOGY
CLEVELAND, OH 44109
(216) 778-4809
1760428155 GRAHAM H CREASEY MD
Individual
Physical Medicine & Rehabilitation (Spinal Cord Injury Medicine)2500 METROHEALTH DR MHMC-PM&R
CLEVELAND, OH 44109
(216) 778-8802
1508892290 JAMES F QUILTY MD
Individual
Pediatrics2500 METROHEALTH DR MHMC-PEDIATRICS
CLEVELAND, OH 44109
(216) 778-5198

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Shane B Rowan Md is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
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.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.