DR. MERICK S KIRSHNER MD
NPI 1831183870
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Phoenix, AZ

NPI Status: Active since September 06, 2005

Contact Information

2777 E CAMELBACK RD STE 200
PHOENIX, AZ
ZIP 85016
Phone: (602) 952-0002
Fax: (602) 224-9119

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 36
Thoracic Surgery (Cardiothoracic Vascula...
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About MERICK KIRSHNER

This page provides the complete NPI Profile along with additional information for Merick Kirshner, a provider established in Phoenix, Arizona with a medical specialization in Thoracic Surgery (cardiothoracic Vascular Surgery) and more than 36 years of experience. He graduated from Temple University School Of Medicine in 1990. The healthcare provider is registered in the NPI registry with number 1831183870 assigned on September 2005. The practitioner's primary taxonomy code is 208G00000X with license number 25272 (AZ). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI: 1831183870
Provider Name: DR. MERICK S KIRSHNER MD
Gender: Male
Entity Type: Individual
Location Address: 2777 E CAMELBACK RD STE 200 PHOENIX, AZ 85016
Location Phone: (602) 952-0002
Location Fax: (602) 224-9119
Mailing Address: PO BOX 98819 LAS VEGAS, NV 89193
Mailing Phone: (602) 867-8644
Mailing Fax: (602) 224-9119
Medical School Name: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year: 1990
Is Sole Proprietor?: No
Enumeration Date: 09-06-2005
Last Update Date: 06-25-2021
Code Navigator

Location Map

Secondary Locations

3805 E. BELL RD SUITE 3100
Phoenix, AZ 85032
(602) 867-8644

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: Thoracic Surgery (Cardiothoracic Vascular Surgery)
Taxonomy Code: 208G00000X
Type: Allopathic & Osteopathic Physicians
License No.: 25272
License State: AZ
Taxonomy Description: A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

Insurance Plans Accepted

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

Ambetter from Arizona Complete Health

Choice Bronze HSA - HMO
Choice Bronze HSA + Vision + Adult Dental - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Complete Silver - HMO
Complete Silver + Vision + Adult Dental - HMO
Elite Gold - HMO
Elite Gold + Vision + Adult Dental - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO

Antidote Health Plan of Arizona, Inc.

Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Bronze Standard - HMO
Catastrophic Standard - HMO
Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO

Blue Cross Blue Shield of Arizona

AZ Blue ACA StandardHealth Silver with Health Choice - HMO
AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
AZ Blue AdvanceHealth Bronze Neighborhood (4 Free PCP Visits) - HMO
AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) - HMO
AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
AZ Blue AdvanceHealth Silver Neighborhood (4 Free PCP Visits) - HMO
AZ Blue EverydayHealth Gold Focus (1 Free PCP Visit) - HMO
AZ Blue EverydayHealth Gold Neighborhood (1 Free PCP Visit) - HMO
AZ Blue EverydayHealth Prosano Gold ($0 Prosano Health Visits) - HMO

Imperial Insurance Companies, Inc.

Imperial Preferred Gold - HMO
Imperial Preferred Silver - HMO
Imperial Standard Bronze - HMO
Imperial Standard Gold - HMO
Imperial Standard Silver - HMO

Oscar Health Plan, Inc.

Bronze Classic Standard - HMO
Bronze Elite + PCP Saver Plus - HMO
Bronze Simple - HMO
Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
Bronze Simple Chronic Care CKM - HMO
Buena Salud Bronce Simple Para Diabetes - HMO
Gold Classic - HMO
Gold Classic Standard - HMO
Gold Simple - HMO
Gold Simple Diabetes - HMO

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
UHC Bronze Standard - HMO
UHC Bronze Standard+ (Dental + Vision) - HMO
UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
UHC Gold Standard - HMO
UHC Silver Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO

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

Medicare Participation & PECOS Enrollment Status

Merick Kirshner 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.

Merick Kirshner 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: 8729011713
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: I20050912000101
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.

Coronary angioplasty and stenting
Coronary artery bypass graft (CABG)
Coronary artery bypass using artery graft, 1 graft
Coronary artery bypass using vein or artery graft, 2 grafts
Coronary artery bypass using vein or artery graft, 3 grafts
Established patient office or other outpatient visit, 30-39 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Harvest of vein using an endoscope
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
Leg revascularization (restoring blood flow)
New patient office or other outpatient visit, 15-29 minutes
New patient office or other outpatient visit, 45-59 minutes
Pacemaker insertion or repair
Replacement of aortic valve on heart-lung machine
Replacement of aortic valve through the skin and femoral artery
Ultrasonic guidance during surgery

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $42.15 for a new patient copayment and $17.31 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 85016 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99205

Average New Patient Price $168.6
Minimum New Patient Price $55.44
Maximum New Patient Price $168.6

Average New Patient Copayment $42.15
Minimum New Patient Copayment $13.86
Maximum New Patient Copayment $42.15

Established Patients Visit Costs *

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

Average Established Patient Price $69.24
Minimum Established Patient Price $17.72
Maximum Established Patient Price $137.41

Average Established Patient Copayment $17.31
Minimum Established Patient Copayment $4.43
Maximum Established Patient Copayment $34.35

* 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.

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
Anticoagulant Management Improvements	Yes	N/A
Individual MIPS eligible clinicians and groups who prescribe oral Vitamin K antagonist therapy (warfarin) must attest that, for 60 percent of practice patients in the transition year and 75 percent of practice patients in Quality Payment Program Year 2 and future years, their ambulatory care patients receiving warfarin are being managed by one or more of the following improvement activities: • Patients are being managed by an anticoagulant management service, that involves systematic and coordinated care, incorporating comprehensive patient education, systematic prothrombin time (PT-INR) testing, tracking, follow-up, and patient communication of results and dosing decisions; • Patients are being managed according to validated electronic decision support and clinical management tools that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; • For rural or remote patients, patients are managed using remote monitoring or telehealth options that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; and/or • For patients who demonstrate motivation, competency, and adherence, patients are managed using either a patient self-testing (PST) or patient-self-management (PSM) program.
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement	Yes	N/A
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan.
Collection and use of patient experience and satisfaction data on access	Yes	N/A
Collection of patient experience and satisfaction data on access to care and development of an improvement plan, such as outlining steps for improving communications with patients to help understanding of urgent access needs.
Documentation of Current Medications in the Medical Record	71%	1420
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.
Engagement with QIN-QIO to implement self-management training programs	Yes	N/A
Engagement with a Quality Innovation Network-Quality Improvement Organization, which may include participation in self-management training programs such as diabetes.
Enhancements/regular updates to practice websites/tools that also include considerations for patients with cognitive disabilities	Yes	N/A
Enhancements and ongoing regular updates and use of websites/tools that include consideration for compliance with section 508 of the Rehabilitation Act of 1973 or for improved design for patients with cognitive disabilities. Refer to the CMS website on Section 508 of the Rehabilitation Act https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/Section508/index.html?redirect=/InfoTechGenInfo/07_Section508.asp that requires that institutions receiving federal funds solicit, procure, maintain and use all electronic and information technology (EIT) so that equal or alternate/comparable access is given to members of the public with and without disabilities. For example, this includes designing a patient portal or website that is compliant with section 508 of the Rehabilitation Act of 1973
e-Prescribing	93%	29
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 condition-specific chronic disease self-management support programs	Yes	N/A
Provide condition-specific chronic disease self-management support programs or coaching or link patients to those programs in the community.
Improved Practices that Engage Patients Pre-Visit	Yes	N/A
Implementation of workflow changes that engage patients prior to the visit, such as a pre-visit development of a shared visit agenda with the patient, or targeted pre-visit laboratory testing that will be resulted and available to the MIPS eligible clinician to review and discuss during the patient’s appointment..
Medication Reconciliation	100%	20
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.
Patient-Specific Education	58%	196
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.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	26%	798
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Provide Patient Access	62%	196
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.
Regular training in care coordination	Yes	N/A
Implementation of regular care coordination training.
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.	Yes	N/A
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.
Secure Messaging	4%	196
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.
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	85%	397
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD); OR - Adults aged >=21 years who have ever had a fasting or direct low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL; OR - Adults aged 40-75 years with a diagnosis of diabetes with a fasting or direct LDL-C level of 70-189 mg/dL
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.	546
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

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 1831183870, we treat the final digit (0) 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 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 6

Pos 4

Unchanged

Pos 5

Doubled → 2

Pos 6

Unchanged

Pos 7

Doubled → 6

Pos 8

Unchanged

Pos 9

Doubled → 14 → 1 + 4

Check

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 3 → 6 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 + 6 + 1 + 2 + 8 + 6 + 8 + 1 + 4 + 24 = 70

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

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

70 - 70 = 0

This NPI is valid

The calculated check digit is 0, which matches the last digit of 1831183870.