DR. NICOLE L SROKA M.D. NPI 1861668337
Surgery in Fayetteville, GA

Individual Female Years of Experience 21 Surgery PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 96.1 Medicare Quality Reporting

About DR. NICOLE L SROKA M.D.

Nicole Sroka is a provider established in Fayetteville, Georgia and her medical specialization is Surgery with more than 21 years of experience. She graduated from University Of Wisconsin School Of Medicine in 2002. The NPI number of Nicole Sroka is 1861668337 and was assigned on May 2008. The practitioner's primary taxonomy code is 208600000X with license number 57191 (GA). The provider is registered as an individual and her NPI record was last updated 7 years ago. Nicole Sroka operates as a single speciality business group with one or more individual providers who practice the same area of specialization.

NPI
1861668337
Provider NameDR. NICOLE L SROKA M.D.
Provider Location Address1279 HIGHWAY 54 W SUITE 210 FAYETTEVILLE, GA 30214
Provider Mailing Address235 NEWHAVEN DR FAYETTEVILLE, GA 30215
GenderFemale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduation Year2002
Is Sole Proprietor?Yes
Enumeration Date05-05-2008
Last Update Date02-17-2016

A surgeon like Dr. Nicole L Sroka M.d. treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.Nicole Sroka 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.

Nicole Sroka 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 she has hospital affiliations with Piedmont Fayette Hospital, Piedmont Newnan Hospital, Inc and Piedmont Henry 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 96.1, 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 following quality measures were reported for this provider: care plan, colorectal cancer screening, pneumococcal vaccination status for older adults, preventive care and screening: body mass index (bmi) screening and follow-up plan and screening for osteoporosis for women aged 65-85 years of age.

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.62 for a new patient copayment and $18.4 for an established patient copayment.



Primary Taxonomy

Taxonomy Code208600000X
ClassificationSurgery
TypeAllopathic & Osteopathic Physicians
License No.57191
License StateGA
Taxonomy DescriptionA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Business Address

DR. NICOLE L SROKA M.D.
1279 HIGHWAY 54 W
SUITE 210
FAYETTEVILLE, GA
ZIP 30214
Phone: (770) 719-5710
Fax: (678) 817-4360

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Mailing Address

DR. NICOLE L SROKA M.D.
235 NEWHAVEN DR
FAYETTEVILLE, GA
ZIP 30215
Phone: (678) 628-7177


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 ID4880760578
PECOS Enrollment IDI20080903000506
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 30214 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$58.88 $178.51 $90.51
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.72 $44.62 $22.62
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
$18.36 $145.86 $73.63
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.59 $36.46 $18.4

* 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% 100
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% 78.6
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 - 96.1
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.

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
Care Plan 24% 246
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Colorectal Cancer Screening 67% 178
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Pneumococcal Vaccination Status for Older Adults 59% 246
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 58% 261
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
Screening for Osteoporosis for Women Aged 65-85 Years of Age 74% 213
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis

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.

  • 29Partial removal of breast (HCPCS:19301)
  • 26Biopsy or removal of lymph nodes of under the arm, open procedure (HCPCS:38525)

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. Nicole Sroka is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
PIEDMONT FAYETTE HOSPITAL1255 HIGHWAY 54 WEST
FAYETTEVILLE, GA 30214
(770) 719-7000Acute Care Hospitals110215
PIEDMONT NEWNAN HOSPITAL, INC745 POPLAR ROAD
NEWNAN, GA 30265
(770) 400-2300Acute Care Hospitals110229
PIEDMONT HENRY HOSPITAL1133 EAGLE'S LANDING PARKWAY
STOCKBRIDGE, GA 30281
(678) 604-1000Acute Care Hospitals110191

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 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.
1861668337
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
281211261636
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 1 + 2 + 1 + 1 + 2 + 6 + 1 + 6 + 3 + 6 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 77

The NPI number 1861668337 is valid because the calculated check digit 7 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
1629062153 MICHLENE BROADNEY MD
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1942284922 HEATHER S. TURNER M.D.
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1427098276DR. DEBORAH KAY SHEPARD M.D.
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1295741379DR. EDWIN BELLO M.D.
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1346251121DR. WILLIAM DARRELL MARTIN M.D.
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1154332542DR. CRYSTAL O SLADE MD
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1285645671DR. BENITA L BONSER MD
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1477565083DR. ELIZABETH W KILLEBREW MD
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1427061589SOUTHERN CRESCENT WOMEN'S HEALTHCARE
Organization
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1750490504DR. SHARON A LYNCH-MILLER MD
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1689753360 SHERRY K FLOWERS RN, CNM
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1942419973 CHARLOTTE THOMPSON CNM
Individual
Advanced Practice Midwife1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1902007321 SHIRLEY WILLIAMS NP
Individual
Nurse Practitioner (Women's Health)1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1790985653DR. KRISTIE YANCY DYSON MD
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1093950685GEORGIA CANCER SPECIALISTS I PC
Organization
Internal Medicine (Hematology & Oncology)1279 HIGHWAY 54 W SUITE 210
FAYETTEVILLE, GA 30214
(770) 719-1299
1922382274 JAKKI NICOLE ROBINSON CNM, FNP-BC
Individual
Advanced Practice Midwife1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1740250992MRS. SHERRI DEANNE FRANKLIN CNM
Individual
Advanced Practice Midwife1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1003017526 TANYA DENISE BECKFORD M.D.
Individual
Obstetrics & Gynecology1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200
1891860094 AMBER RENEE MAYFIELD PA-C
Individual
Physician Assistant (Medical)1279 HIGHWAY 54 W SUITE 100
FAYETTEVILLE, GA 30214
(770) 460-8988
1841491032 KAREN UYESUGI CNM
Individual
Advanced Practice Midwife1279 HIGHWAY 54 W SUITE 220
FAYETTEVILLE, GA 30214
(770) 991-2200

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. Nicole L Sroka 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.