DR. MILES WAYNE ELLIS MD NPI 1871510644
Family Medicine in Phenix City, AL

Individual Male Family Medicine PECOS Enrolled MIPS Quality Score 100 Medicare Quality Reporting

About DR. MILES WAYNE ELLIS MD

Miles Ellis is a primary care provider established in Phenix City, Alabama and his medical specialization is Family Medicine. The NPI number of Miles Ellis is 1871510644 and was assigned on July 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 039782 (GA). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI
1871510644
Provider NameDR. MILES WAYNE ELLIS MD
Provider Location Address4401 RIVER CHASE DR EMERGENCY DEPT. PHENIX CITY, AL 36867
Provider Mailing Address1705 CREST DR COLUMBUS, GA 31906
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Enumeration Date07-16-2006
Last Update Date07-09-2007

A primary care provider (PCP) like Dr. Miles Wayne Ellis Md sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc Miles Ellis 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..

Miles Ellis is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, 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: implementation of an asp, implementation of formal quality improvement methods, practice changes, or other practice improvement processes, measurement and improvement at the practice and panel level and participation in an ahrq-listed patient safety organization..



Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.039782
License StateGA
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

DR. MILES WAYNE ELLIS MD
4401 RIVER CHASE DR
EMERGENCY DEPT.
PHENIX CITY, AL
ZIP 36867
Phone: (334) 732-3000
Fax: (334) 732-3020

Get Directions


Mailing Address

DR. MILES WAYNE ELLIS MD
1705 CREST DR
COLUMBUS, GA
ZIP 31906
Phone: (706) 324-4065


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
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

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% 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 - 100
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
Implementation of an ASPYesN/A
Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance
Implementation of formal quality improvement methods, practice changes, or other practice improvement processesYesN/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Participation in an AHRQ-listed patient safety organization.YesN/A
Participation in an AHRQ-listed patient safety organization.

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
G15145MEDICARE UPIN (02)GA

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.
1871510644
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
28141101068
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 1 + 4 + 1 + 1 + 0 + 1 + 0 + 6 + 8 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 44

The NPI number 1871510644 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 14 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1336133271 TANYA L DUNCAN-WILLIAMS AA-C
Individual
Anesthesiologist Assistant4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3000
1154318285 JENIFER D. NOBLES PAAA
Individual
Anesthesiologist Assistant4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3000
1023050101RUSSELL COUNTY COMMUNITY HOSPITAL LLC
Organization
General Acute Care Hospital4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3000
1679768311RUSSELL COUNTY COMMUNITY HOSPITAL, LLC
Organization
Emergency Medicine (Emergency Medical Services)4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3000
1639330632DREXIS, LLC.
Organization
Emergency Medicine4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(866) 593-3318
1982998050ANESTHESIA CARE OF ALABAMA PC
Organization
Anesthesiology4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3010
1417220666 JASON WAYNE SMITH RPH
Individual
Pharmacist4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3532
1245575471EMERGENCY STAFFING SOLUTIONS INC
Organization
Emergency Medicine4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3000
1063863082MR. ANDREW HORNSBY CRNA
Individual
Nurse Anesthetist, Certified Registered4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3969
1528625712DR. BENJAMIN CATOE DO
Individual
Student in an Organized Health Care Education/Training Program4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3000
1831561455MOON LAKE EMERGENCY PHYSICIANS LLC
Organization
Emergency Medicine4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(469) 401-2386
1538588769 SAMUEL THOMAS D.O.
Individual
Orthopaedic Surgery4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3022
1275649055SUMMIT ANESTHESIA CONSULTING, LLC
Organization
Anesthesiology4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3000
1831763283 THOMAS BRENT ANDERSON DO
Individual
Student in an Organized Health Care Education/Training Program4401 RIVER CHASE DR
PHENIX CITY, AL 36867
(334) 732-3080

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. Miles Wayne Ellis Md 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.