DR. JOHN K BOTSON M.D., RPH
NPI 1881700334
Internal Medicine - Rheumatology in Anchorage, AK

Quality Rating: 69.52 out of 100 score

NPI Status: Active since August 21, 2006

Contact Information

3890 UNIVERSITY LAKE DR STE 110
ANCHORAGE, AK
ZIP 99508
Phone: (907) 562-2277

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Table of Contents

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Overall Quality Performance
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 22
Internal Medicine
Rheumatology
Accepts Insurance
Accepts Medicare Approved Payment
Medicare Quality Reporting

About JOHN BOTSON

This page provides the complete NPI Profile along with additional information for John Botson, an internist established in Anchorage, Alaska with a medical specialization in Internal Medicine, focusing in rheumatology and more than 22 years of experience. He graduated from Ohio State University College Of Medicine in 2004. The healthcare provider is registered in the NPI registry with number 1881700334 assigned on August 2006. The practitioner's primary taxonomy code is 207RR0500X with license number 6100 (AK). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI: 1881700334
Provider Name: DR. JOHN K BOTSON M.D., RPH
Gender: Male
Entity Type: Individual
Location Address: 3890 UNIVERSITY LAKE DR STE 110 ANCHORAGE, AK 99508
Location Phone: (907) 562-2277
Mailing Address: 3801 LAKE OTIS PKWY STE 300 ANCHORAGE, AK 99508
Mailing Phone: (907) 562-2277
Mailing Fax
Medical School Name: OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year: 2004
Is Sole Proprietor?: No
Enumeration Date: 08-21-2006
Last Update Date: 02-11-2025
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An internist like John Botson is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Secondary Locations

161 Wailea Ike Pl Ste A104
Kihei, HI 96753
(808) 757-6106
3801 Lake Otis Pkwy Suite 300
Anchorage, AK 99508
(907) 562-2277

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Internal Medicine Rheumatology
Taxonomy Code: 207RR0500X
Type: Allopathic & Osteopathic Physicians
License No.: 6100
License State: AK
Taxonomy Description: An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

HMSA

HMSA Bronze PPO I - PPO
HMSA Bronze PPO II HSA - PPO
HMSA Catastrophic Plan - PPO
HMSA Gold PPO I - PPO
HMSA Gold PPO II - PPO
HMSA Platinum PPO - PPO
HMSA Silver PPO - PPO

Moda Health Plan, Inc.

Moda Pioneer Alaska Standard Bronze - PPO
Moda Pioneer Alaska Standard Gold - PPO
Moda Pioneer Alaska Standard Silver - PPO
Moda Pioneer Bronze 6500 - PPO
Moda Pioneer Bronze HDHP 5500 - PPO
Moda Pioneer Gold 1500 - PPO
Moda Pioneer Silver 4500 - PPO

Premera Blue Cross Blue Shield of Alaska

Premera Blue Cross Alaska One Gold - PPO
Premera Blue Cross Preferred Bronze 5800 HSA - PPO
Premera Blue Cross Preferred Bronze 6350 - PPO
Premera Blue Cross Preferred Gold 1500 - PPO
Premera Blue Cross Preferred Silver 4500 - PPO
Premera Blue Cross Standard Bronze II - PPO
Premera Blue Cross Standard Gold - PPO
Premera Blue Cross Standard Silver - PPO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
1009500	MEDICAID (05)	AK

Medicare Participation & PECOS Enrollment Status

John Botson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

PECOS PAC ID: 4284785007
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20090707000479, I20210618000857
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
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.

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of chemotherapy into vein, 1 hour or less
Administration of chemotherapy into vein, each additional hour
Aspiration and/or injection of fluid from large joint
Aspiration and/or injection of fluid from small joint using ultrasound guidance
Aspiration and/or injection of fluid large joint using ultrasound guidance
Dxa bone density measurement of hip, pelvis, spine
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less
Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less
Injection of drug or substance under skin or into muscle
Injection, denosumab, 1 mg
Injection, infliximab, excludes biosimilar, 10 mg
Injection, methylprednisolone sodium succinate, up to 125 mg
Injection, rituximab, 10 mg
Injection, tocilizumab, 1 mg
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Injection, zoledronic acid, 1 mg
Insertion of needle into vein for collection of blood sample
New patient office or other outpatient visit, 60-74 minutes
Telephone medical discussion with physician, 21-30 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $42.05 for a new patient copayment and $32.18 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 99508 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $168.2
Minimum New Patient Price $71.33
Maximum New Patient Price $222.64

Average New Patient Copayment $42.05
Minimum New Patient Copayment $17.83
Maximum New Patient Copayment $55.66

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $128.73
Minimum Established Patient Price $21.84
Maximum Established Patient Price $181.48

Average Established Patient Copayment $32.18
Minimum Established Patient Copayment $5.46
Maximum Established Patient Copayment $45.37

* The physician office visit costs information is generated by 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 provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 69.52, 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 Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS 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.

Final Score: 69.52 out of 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 Score: 81.15

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 Score: 100

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 Score: 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 activities measure category compromises 15% providers final MPIS scores.

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 Score: 17.25

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.
Cost Score: 17.25

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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. 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
Annual registration in the Prescription Drug Monitoring Program	Yes	N/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Consultation of the Prescription Drug Monitoring Program	Yes	N/A
Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance.
Documentation of Current Medications in the Medical Record	88%	1616
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
Engagement of patients through implementation of improvements in patient portal	Yes	N/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
e-Prescribing	62%	715
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Functional Outcome Assessment	16%	1609
Percentage of visits for patients aged 18 years and older with documentation of a current functional outcome assessment using a standardized functional outcome assessment tool on the date of the encounter AND documentation of a care plan based on identified functional outcome deficiencies on the date of the identified deficiencies
Implementation of formal quality improvement methods, practice changes, or other practice improvement processes	Yes	N/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.
Implementation of improvements that contribute to more timely communication of test results	Yes	N/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop	Yes	N/A
Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology.
Measurement and Improvement at the Practice and Panel Level	Yes	N/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.
Medication Reconciliation	84%	38
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Osteoarthritis (OA): Function and Pain Assessment	39%	246
Percentage of patient visits for patients aged 21 years and older with a diagnosis of osteoarthritis (OA) with assessment for function and pain
Pain Assessment and Follow-Up	19%	1609
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
Patient-Specific Education	4%	459
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.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	18%	767
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
Preventive Care and Screening: Influenza Immunization	7%	616
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
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	93%	525
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
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling	54%	525
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access	78%	459
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.
Rheumatoid Arthritis (RA): Functional Status Assessment	94%	256
Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) for whom a functional status assessment was performed at least once within 12 months
Screening for Osteoporosis for Women Aged 65-85 Years of Age	9%	113
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
Secure Messaging	75%	459
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.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Tobacco use	Yes	N/A
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence.
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older	100%	187
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
Use of decision support and standardized treatment protocols	Yes	N/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.
Use of High-Risk Medications in the Elderly	6% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	251
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication

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.
1	8	8	1	7	0	0	3	3	4
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	8	16	1	14	0	0	3	6
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 1 + 6 + 1 + 1 + 4 + 0 + 0 + 3 + 6 + 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 = 4									4

The NPI number 1881700334 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.