DR. ERIC LEE M.D. NPI 1851538441

Anesthesiology (Pediatric Anesthesiology) in Somerset, NJ

NPI 1851538441 Individual Male Years of Experience 18 Anesthesiology Pediatric Anesthesiology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 90

NPI Profile for DR. ERIC LEE M.D.

Eric Lee is a provider established in Somerset, New Jersey and his medical specialization is anesthesiology (pediatric anesthesiology) with more than 18 years of experience. He graduated from State University Of New York At Buffalo School Of Medicine in 2005. The NPI number of Eric Lee is 1851538441 and was assigned on January 2009. The practitioner's primary taxonomy code is 207LP3000X with license number 25MA08816500 (NJ). The provider is registered as an individual and his NPI record was last updated 3 years ago. Eric Lee operates as a single speciality business group with one or more individual providers who practice the same area of specialization.

Eric Lee 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.

Eric Lee 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 Saint Peter's University Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90, 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: $37.64 for a new patient copayment and $20.64 for an established patient copayment.

NPI

1851538441

Provider NameDR. ERIC LEE M.D.
Provider Location Address285 DAVIDSON AVE STE 204 SOMERSET, NJ 08873
Provider Mailing Address285 DAVIDSON AVE STE 204 SOMERSET, NJ 08873
GenderMale
NPI Entity TypeIndividual
Medical School NameSTATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
Graduation Year2005
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date01-19-2009
Last Update Date07-02-2019


Primary Taxonomy

Taxonomy Code207LP3000X
ClassificationAnesthesiology
TypeAllopathic & Osteopathic Physicians
SpecializationPediatric Anesthesiology
License No.25MA08816500
License StateNJ
Taxonomy DescriptionAn anesthesiologist who has had additional skill and experience in and is primarily concerned with the anesthesia, sedation, and pain management needs of infants and children. A pediatric anesthesiologist generally provides services including the evaluation of complex medical problems in infants and children when surgery is necessary, planning and care for children before and after surgery, pain control, anesthesia and sedation for any procedures out of the operating room such as MRI, CT scan, and radiation therapy.

Business Address

DR. ERIC LEE M.D.
285 DAVIDSON AVE STE 204
SOMERSET, NJ
ZIP 08873
Phone: (732) 271-1400
Fax: (732) 271-3544

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Mailing Address

DR. ERIC LEE M.D.
285 DAVIDSON AVE STE 204
SOMERSET, NJ
ZIP 08873
Phone: (732) 271-1400
Fax: (732) 271-3544



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 ID7315110657
PECOS Enrollment IDI20111101000405
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 08873 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
$66.45 $198.48 $150.56
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$16.61 $49.62 $37.64
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
$21.27 $162.58 $82.58
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.31 $40.64 $20.64

* 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% 85.6
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% N/A
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% N/A
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 - 90
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.

  • 28Anesthesia for procedure on gastrointestinal tract using an endoscope (HCPCS:00740)
  • 13Anesthesia for procedure on lower intestine using an endoscope (HCPCS:00810)

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. Eric Lee is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
SAINT PETER'S UNIVERSITY HOSPITAL254 EASTON AVE
NEW BRUNSWICK, NJ 8901
(732) 745-8600Acute Care Hospitals310070

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

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.
1851538441
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
281011031648
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 1 + 0 + 1 + 1 + 0 + 3 + 1 + 6 + 4 + 8 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1851538441 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 12 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1689928749 MARGARET A LIDDY C.R.N.A.
Individual
Nurse Anesthetist, Certified Registered285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1992064778 ALAN WILFRED ROMERO CACES MD
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1649448317DR. SAMIR NATAVAR PATEL M.D.
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1205197480 SAMIR N SHAH M.D.
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1427347897 BRETT JOSEPH MOSES M.D.
Individual
Anesthesiology (Pediatric Anesthesiology)285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1003011065DR. LAURA LEI MD
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1871799015DR. STEPHANIE JEAN-NOEL M.D.
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1417156381DR. KRISTA R RUEDY M.D.
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1144226093 JOHN E KRESGE CRNA
Individual
Nurse Anesthetist, Certified Registered285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1114001211DR. ANILCHANDRA I. BHAGAT M.D.
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1588084974 BHARATH KUMAR MITTAPALLI M.D.
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1972263044SPECIALIZED ANESTHESIA SERVICES
Organization
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(215) 850-6727

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. Eric Lee 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.