DR. MICHAEL J CARBONI O.D. NPI 1851373385

Optometrist in Albertville, AL

NPI 1851373385 Individual Male Years of Experience 43 Optometrist PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About MICHAEL CARBONI

Michael Carboni is a provider established in Albertville, Alabama and his medical specialization is optometrist with more than 43 years of experience. He graduated from University Alabama Birmingham - School Of Optometry in 1979. The NPI number of Michael Carboni is 1851373385 and was assigned on November 2005. The practitioner's primary taxonomy code is 152W00000X with license number S453TA283 (AL). The provider is registered as an individual and his NPI record was last updated 10 years ago.

Michael Carboni is enrolled in PECOS and is eligible to order or refer healthcare 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)

Michael Carboni 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.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: closing the referral loop: receipt of specialist report, diabetes: eye exam, documentation of current medications in the medical record, e-prescribing, health information exchange exclusion, implementation of medication management practice improvements, implementation of use of specialist reports back to referring clinician or group to close referral loop, onc direct review attestation, onc-acb surveillance attestation (optional), patient-specific education, pi bonus for submission of eligible improvement activities using cehrt, primary open-angle glaucoma (poag): optic nerve evaluation, 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 and view, download, or transmit (vdt). The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

NPI

1851373385

Provider NameDR. MICHAEL J CARBONI O.D.
Provider Location Address7419 US HIGHWAY 431 ALBERTVILLE, AL 35950
Provider Mailing Address7419 US HIGHWAY 431 ALBERTVILLE, AL 35950
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY ALABAMA BIRMINGHAM - SCHOOL OF OPTOMETRY
Graduation Year1979
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date11-18-2005
Last Update Date10-05-2011


Primary Taxonomy

Taxonomy Code152W00000X
ClassificationOptometrist
TypeEye and Vision Services Providers
License No.S453TA283
License StateAL
Taxonomy DescriptionDoctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Business Address

DR. MICHAEL J CARBONI O.D.
7419 US HIGHWAY 431
ALBERTVILLE, AL
ZIP 35950
Phone: (256) 878-0125
Fax: (256) 878-0898

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Mailing Address

DR. MICHAEL J CARBONI O.D.
7419 US HIGHWAY 431
ALBERTVILLE, AL
ZIP 35950
Phone: (256) 878-0125
Fax: (256) 878-0898



Medicare Participation

Registered in PECOS? Yes 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.
PECOS PAC ID4385837814
PECOS Enrollment IDI20101018000103
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 DevicesNo

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.

  • 661Photography of the retina (HCPCS:92250)
  • 574Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
  • 375Diagnostic imaging of optic nerve of eye (HCPCS:92133)
  • 175Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
  • 57Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)
  • 22Diagnostic imaging of retina (HCPCS:92134)

Quality Reporting

The following quality measures meets 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 Rate Number of Patients
Closing the Referral Loop: Receipt of Specialist Report 32% 71
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
Diabetes: Eye Exam 100% 304
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
Documentation of Current Medications in the Medical Record 98% 3135
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
e-Prescribing 100% 91
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Patient-Specific Education 73% 939
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.
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation 99% 67
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
Provide Patient Access 74% 943
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% 943
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.
View, Download, or Transmit (VDT) 1% 943
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

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
06834MEDICARE ID-TYPE UNSPECIFIED (04)AL
051506834MEDICAID (05)AL
T69150MEDICARE UPIN (02)
1074080021MEDICARE NSC (07)AL
1053466821OTHER (01)
06834MEDICARE PIN (08)AL

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
The code describing 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.