PAUL STANLEY USBORNE M.D.
NPI 1871513077
Family Medicine in Covina, CA

Active since July 20, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
256 W SAN BERNARDINO RD, COVINA, CA 91723(626) 938-1080(626) 938-1087 Get Directions Write a Review

NPPES record last updated: March 31, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Paul Stanley Usborne M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PAUL STANLEY USBORNE M.D. (NPI 1871513077) is an individual family medicine provider in Covina, California, licensed in California (A94585) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1871513077
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NamePAUL STANLEY USBORNECredential: M.D.
Location Address256 W SAN BERNARDINO RDCovina, CA 91723-1515
Mailing Address256 W San Bernardino RdCovina, CA 91723-1515 · (626) 938-1080 · Fax (626) 938-1087
Fax(626) 938-1087
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateJuly 20, 2006
Last NPPES UpdateMarch 31, 2015
NPI 1871513077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in CA · A94585
Definition
Family 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.
256 W SAN BERNARDINO RD, Covina, CA 91723

Other Identifiers 4

Medicare PINCB213249CA
Medicare PINBW556ACA
Medicare UPINI 67654
OtherP00770345CA · Railroad Medicare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Paul Stanley Usborne M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8325040041
PECOS Enrollment IDI20070209000177
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 37

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
560 services221 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
373 services183 patients
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487
Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.
302 services136 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
298 services30 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
294 services212 patients
Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month 99491
Chronic care management services involve a healthcare professional personally providing care for patients with two or more chronic conditions. This service, offered monthly, focuses on the first 30 minutes of care, helping manage and coordinate the patient's health needs.
267 services149 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91723 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Reported Quality Measures

Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 58% · 113 patients
Patients 4MonthsOfStart: 56% · 104 patients
60%103 patients
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
78%184 patients4/55-star benchmark: 99%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
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…
35%1,453 patients2/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
30%1,065 patients2/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 94% · 1,184 patients
Patients tobacco: 11% · 80 patients
89%1,184 patients4/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 15

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
14 suppliers32 claims71 services$6.29 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
10 suppliers14 claims18 services$1.09 avg. paid by Medicare
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each A4390
DME-Orthotic Devices · category DF010N
1 supplier11 claims220 services$9.29 avg. paid by Medicare
Adhesive remover, wipes, any type, each A4456
DME-Medical/Surgical Supplies · category DA000N
1 supplier11 claims550 services$0.23 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
1 supplier11 claims275 services$0.23 avg. paid by Medicare
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix B4197
Other-Enteral and Parenteral · category OB005N
1 supplier52 claims362 services$280.39 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
256 W SAN BERNARDINO RD
COVINA, CA 91723
Physician Assistant
256 W SAN BERNARDINO RD
COVINA, CA 91723

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Usborne's NPI number?

The NPI number for Paul Usborne is 1871513077. It was assigned to this individual provider in the NPPES registry on July 20, 2006.

Where is Paul Usborne located?

Paul Usborne practices at 256 W San Bernardino Rd, Covina, CA 91723. The listed phone number is (626) 938-1080.

What is Paul Usborne's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Paul Usborne enrolled in Medicare?

Yes. Paul Usborne is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Paul Usborne was last updated on March 31, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.