DR. TATIANA ACOSTA M.D., M.P.H
NPI 1891228870
Obstetrics & Gynecology in Raleigh, NC


Quality Rating: 91.1 out of 100 score

NPI Status: Active since April 06, 2017

Contact Information

4414 LAKE BOONE TRL STE 405
RALEIGH, NC
ZIP 27607
Phone: (919) 876-8225

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  • Individual
  • Female
  • Obstetrics & Gynecology
  • Accepts Insurance
  • PECOS Enrolled

About TATIANA ACOSTA

This page provides the complete NPI Profile along with additional information for Tatiana Acosta, a women's health care provider established in Raleigh, North Carolina with a medical specialization in Obstetrics & Gynecology. The healthcare provider is registered in the NPI registry with number 1891228870 assigned on April 2017. The practitioner's primary taxonomy code is 207V00000X with license number 2021-02329 (NC). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1891228870
Provider Name
DR. TATIANA ACOSTA M.D., M.P.H
Gender
Female
Entity Type
Individual
Location Address
4414 LAKE BOONE TRL STE 405 RALEIGH, NC 27607
Location Phone
(919) 876-8225
Mailing Address
4414 LAKE BOONE TRL STE 405 RALEIGH, NC 27607
Mailing Phone
(919) 876-8225
Is Sole Proprietor?
No
Enumeration Date
04-06-2017
Last Update Date
01-13-2022
Code Navigator

Women's health care providers like Tatiana Acosta treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

Location Map

Secondary Locations

  • 2301 Erwin Rd
    Durham, NC 27705
    (919) 684-8111
  • 4551 New Bern Ave Ste 160
    Raleigh, NC 27610
    (919) 556-1008

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

Obstetrics & Gynecology

Taxonomy Code
207V00000X
Type
Allopathic & Osteopathic Physicians
License No.
2021-02329
License State
NC
Taxonomy Description
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207VX0000XAllopathic & Osteopathic Physicians

Obstetrics & Gynecology
Obstetrics

2021-02329 (NC)

Insurance Plans Accepted

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

  • Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Bronze Standard | Nationwide Doctors - PPO
  • Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Gold Standard A | Nationwide Doctors - PPO
  • Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Silver Standard | Nationwide Doctors - PPO
  • Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
  • Blue Care Bronze Standard | Statewide Doctors - HMO
  • Blue Care Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors - HMO
  • Blue Care Gold Standard A | Statewide Doctors - HMO
  • Blue Care Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors - HMO
  • Blue Care Silver Standard | Statewide Doctors - HMO
  • Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with UNC Health Alliance - EPO
  • Blue Home Bronze Complete | $60 PCP | $20 Tier 1 Rx | with UNC Health Alliance - EPO
  • Blue Home Bronze HSA Eligible | Integrated | with UNC Health Alliance - EPO
  • Blue Home Bronze Standard | with UNC Health Alliance - EPO
  • Blue Home Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | with UNC Health Alliance - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Standard+ Dental + Vision (No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Silver Standard (No Referrals) - HMO
  • UHC Silver Value ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO

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

Medicare Participation & PECOS Enrollment Status

Tatiana Acosta 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.

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.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

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 27607 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $125.01
  • Minimum New Patient Price $54.12
  • Maximum New Patient Price $165.09
  • Average New Patient Copayment $31.25
  • Minimum New Patient Copayment $13.53
  • Maximum New Patient Copayment $41.27

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.72
  • Minimum Established Patient Price $17.21
  • Maximum Established Patient Price $134.61
  • Average Established Patient Copayment $16.93
  • Minimum Established Patient Copayment $4.3
  • Maximum Established Patient Copayment $33.65

* 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 91.1, 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 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: 91.1 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: 90.09

    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: 80.24

    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: 80.24

    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.

Reviews for DR. TATIANA ACOSTA M.D., M.P.H

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1891228870, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
1
Unchanged
Pos 5
2
Doubled → 4
Pos 6
2
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
8
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 2 → 4 8 → 16 → 7 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 1 + 8 + 1 + 4 + 2 + 1 + 6 + 8 + 1 + 4 + 24 = 70

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1891228870.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Obstetrics & Gynecology
4414 LAKE BOONE TRL STE 405
RALEIGH, NC 27607
Obstetrics & Gynecology
4414 LAKE BOONE TRL STE 405
RALEIGH, NC 27607
Nurse Practitioner (Family)
4414 LAKE BOONE TRL STE 405
RALEIGH, NC 27607
Obstetrics & Gynecology (Obstetrics)
4414 LAKE BOONE TRL STE 405
RALEIGH, NC 27607
Nurse Practitioner (Family)
4414 LAKE BOONE TRL STE 405
RALEIGH, NC 27607
Obstetrics & Gynecology
4414 LAKE BOONE TRL STE 405
RALEIGH, NC 27607
Physician Assistant (Surgical)
4414 LAKE BOONE TRL STE 405
RALEIGH, NC 27607

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1891228870, enumerated as an "individual" on April 06, 2017.

The provider is located at 4414 LAKE BOONE TRL STE 405 RALEIGH, NC 27607 and the phone number is (919) 876-8225.

Obstetrics & Gynecology with taxonomy code 207V00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of NC and. Please consult your insurance carrier or call the provider to verify.