DR. SAMI MOHAMMAD SHOUKAIR M.D. NPI 1851319560

Internal Medicine - Cardiovascular Disease in La Palma, CA

Individual Male Years of Experience 45 Internal Medicine Cardiovascular Disease PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About DR. SAMI MOHAMMAD SHOUKAIR M.D.

Sami Shoukair is an internist established in La Palma, California and his medical specialization is Internal Medicine with a focus in cardiovascular disease with more than 45 years of experience. The NPI number of Sami Shoukair is 1851319560 and was assigned on July 2006. The practitioner's primary taxonomy code is 207RC0000X with license number C39836 (CA). The provider is registered as an individual and his NPI record was last updated 15 years ago.

An internist like Dr. Sami Mohammad Shoukair M.d. 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.

NPI

1851319560

Provider NameDR. SAMI MOHAMMAD SHOUKAIR M.D.
Provider Location Address5471 LA PALMA AVE SUITE 203 LA PALMA, CA 90623
Provider Mailing Address424 ELMHURST PL FULLERTON, CA 92835
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1978
Is Sole Proprietor?Yes
Enumeration Date07-18-2006
Last Update Date07-08-2007



Sami Shoukair 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.

Sami Shoukair 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 La Palma Intercommunity Hospital, West Anaheim Medical Center, Placentia Linda Hospital, Ahmc Anaheim Regional Medical Center and Orange County Global Medical Center.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: collection and use of patient experience and satisfaction data on access, documentation of current medications in the medical record, implementation of medication management practice improvements, participation in cahps or other supplemental questionnaire, preventive care and screening: body mass index (bmi) screening and follow-up plan and use of high-risk medications in the elderly. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

The typical physician office visit costs for Medicare beneficiaries in this area are: $36.95 for a new patient copayment and $20.28 for an established patient copayment.



Primary Taxonomy

Taxonomy Code207RC0000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationCardiovascular Disease
License No.C39836
License StateCA
Taxonomy DescriptionAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Business Address

DR. SAMI MOHAMMAD SHOUKAIR M.D.
5471 LA PALMA AVE
SUITE 203
LA PALMA, CA
ZIP 90623
Phone: (714) 523-7122
Fax: (714) 523-9813

Get Directions


Mailing Address

DR. SAMI MOHAMMAD SHOUKAIR M.D.
424 ELMHURST PL
FULLERTON, CA
ZIP 92835
Phone: (714) 523-7122
Fax: (714) 523-9813


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 ID9537155189
PECOS Enrollment IDI20090723000020
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 90623 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
$65.18 $194.87 $147.83
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$16.29 $48.71 $36.95
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$20.89 $159.82 $81.14
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.22 $39.95 $20.28

* 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.

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
Collection and use of patient experience and satisfaction data on accessYesN/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 75% 2030
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
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Participation in CAHPS or other supplemental questionnaireYesN/A
Participation in the Consumer Assessment of Healthcare Providers and Systems Survey or other supplemental questionnaire items (e.g., Cultural Competence or Health Information Technology supplemental item sets).
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 32% 774
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
Use of High-Risk Medications in the Elderly 1% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
449
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

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.

  • 834Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report (HCPCS:93010)
  • 49Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)
  • 38Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • 37Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report (HCPCS:93280)
  • 27Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report (HCPCS:93018)
  • 12Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart (HCPCS:93458)

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. Sami Shoukair is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
LA PALMA INTERCOMMUNITY HOSPITAL7901 WALKER STREET
LA PALMA, CA 90623
(714) 670-7400Acute Care Hospitals50580
WEST ANAHEIM MEDICAL CENTER3033 W ORANGE AVENUE
ANAHEIM, CA 92804
(714) 827-3000Acute Care Hospitals50426
PLACENTIA LINDA HOSPITAL1301 N ROSE DRIVE
PLACENTIA, CA 92870
(714) 993-2000Acute Care Hospitals50589
AHMC ANAHEIM REGIONAL MEDICAL CENTER1111 W LA PALMA AVENUE
ANAHEIM, CA 92801
(714) 774-1450Acute Care Hospitals50226
ORANGE COUNTY GLOBAL MEDICAL CENTER1001 NORTH TUSTIN AVENUE
SANTA ANA, CA 92705
(714) 953-3610Acute Care Hospitals50746

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
A37233MEDICARE UPIN (02)CA

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.
1851319560
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
281016118512
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 1 + 0 + 1 + 6 + 1 + 1 + 8 + 5 + 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 1851319560 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 8 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1346262615 HASHEM M FATEMI
Individual
Internal Medicine (Cardiovascular Disease)5471 LA PALMA AVE SUITE 203
LA PALMA, CA 90623
(714) 523-7122
1023106846LAWRENCE M NICHOLS MD INC
Organization
Dermatology5471 LA PALMA AVE SUITE 202
LA PALMA, CA 90623
(714) 522-2041
1548338189 NORMAN KUO M.D.
Individual
Internal Medicine (Gastroenterology)5471 LA PALMA AVE SUITE 105
LA PALMA, CA 90623
(714) 521-0239
1003001017DR. LAWRENCE MARTIN NICHOLS M.D
Individual
Dermatology5471 LA PALMA AVE STE. 202
LA PALMA, CA 90623
(714) 522-2041
1306180112MARVI IQBAL MD INC
Organization
Dermatology5471 LA PALMA AVE SUITE 103
LA PALMA, CA 90623
(714) 670-1261
1215057443INTERCOMMUNITY CARDIOLOGY A MEDICAL GROUP
Organization
Internal Medicine (Cardiovascular Disease)5471 LA PALMA AVE 103
LA PALMA, CA 90623
(714) 523-7122
1447334826NORMAN KUO MD PHD PROFESSIONAL CORPORATION
Organization
Internal Medicine (Gastroenterology)5471 LA PALMA AVE SUITE 105
LA PALMA, CA 90623
(714) 521-0239
1356605836 JONGJIN KIM M.D.
Individual
Internal Medicine5471 LA PALMA AVE
LA PALMA, CA 90623
(714) 752-6088

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
Dr. Sami Mohammad Shoukair M.d. 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.