MARK EDWARD ALLISON MD NPI 1891795480
Ophthalmology in Tulsa, OK
About MARK EDWARD ALLISON MD
Mark Allison is a provider established in Tulsa, Oklahoma and his medical specialization is Ophthalmology with more than 43 years of experience. He graduated from University Of Oklahoma College Of Medicine in 1980. The NPI number of this provider is 1891795480 and was assigned on July 2005. The practitioner's primary taxonomy code is 207W00000X with license number 13302 (OK). The provider is registered as an individual and his NPI record was last updated 15 years ago.
| NPI | 1891795480 |
| Provider Name | MARK EDWARD ALLISON MD |
| Location Address | 6160 S YALE AVE TULSA, OK 74136 |
| Location Phone | (918) 497-3937 |
| Mailing Address | 6600 S YALE AVE STE 1400 TULSA, OK 74136 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE |
| Graduation Year | 1980 |
| Is Sole Proprietor? | No |
| Enumeration Date | 07-26-2005 |
| Last Update Date | 02-28-2008 |
Mark Allison 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.
Mark Allison 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.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 74.7, 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 provider also has detailed performance information the following quality measures: advance care plan, chronic care and preventative care management for empaneled patients, clinical data registry reporting, diabetes: eye exam, documentation of current medications in the medical record, engagement of patients through implementation of improvements in patient portal, implementation of medication management practice improvements, preventive care and screening: body mass index (bmi) screening and follow-up plan, primary open-angle glaucoma (poag): optic nerve evaluation, provide patients electronic access to their health information, public health registry reporting, security risk analysis, tobacco use and use of decision support and standardized treatment protocols.
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.94 for a new patient copayment and $17.3 for an established patient copayment.
Primary Taxonomy
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.
| Taxonomy Code | 207W00000X |
| Classification | Ophthalmology |
| Type | Allopathic & Osteopathic Physicians |
| License No. | 13302 |
| License State | OK |
| Taxonomy Description | An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
6160 S YALE AVE
TULSA, OK
ZIP 74136
Phone: (918) 497-3937
Fax: (918) 492-0959
Mailing Address
6600 S YALE AVE
STE 1400
TULSA, OK
ZIP 74136
Phone: (918) 488-6001
Location Map
PECOS Enrollment and Medicare Participation Status
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 ID | 6800865809 |
| PECOS Enrollment ID | I20040927000985 |
| 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 Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
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 74136 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99204 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $54.97 | $168.9 | $127.76 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $13.74 | $42.22 | $31.94 |
| 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 |
| $16.8 | $137.83 | $69.21 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.2 | $34.45 | $17.3 |
* 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% | 62.2 | |
|
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. |
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| Promoting Interoperability (PI) | 25% | 85 | |
|
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. |
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| 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. |
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| 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. |
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| MIPS Final Score | - | 74.7 | |
| 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. | |||
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Advance Care Plan | 0% | 105 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation 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. | ||
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| In order to receive credit for this activity, a MIPS eligible clinician must manage chronic and preventive care for empaneled patients (that is, patients assigned to care teams for the purpose of population health management), which could include one or more of the following actions:- Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions;- Use evidence based, condition-specific pathways for care of chronic conditions (for example, hypertension, diabetes, depression, asthma, and heart failure). These might include, but are not limited to, the NCQA Diabetes Recognition Program (DRP) and the NCQA Heart/Stroke Recognition Program (HSRP);- Use pre-visit planning, that is, preparations for conversations or actions to propose with patient before an in-office visit to optimize preventive care and team management of patients with chronic conditions;- Use panel support tools, (that is, registry functionality) or other technology that can use clinical data to identify trends or data points in patient records to identify services due;- Use predictive analytical models to predict risk, onset and progression of chronic diseases; and/orUse reminders and outreach (e.g., phone calls, emails, postcards, patient portals, and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Clinical Data Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to a clinical data registry. | ||
| Diabetes: Eye Exam | 99% | 390 |
| Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period. | ||
| Documentation of Current Medications in the Medical Record | 81% | 1658 |
| Percentage of visits for patients aged 18 years and older for which the MIPS 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. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following:Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups;Integrate a pharmacist into the care team; and/orConduct periodic, structured medication reviews. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 0% | 157 |
| 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. | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 50% | 422 |
| 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 usera. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months.b. Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention.c. 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: Tobacco Use: Screening and Cessation Intervention | 48% | 422 |
| 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 usera. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months.b. Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention.c. 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. | ||
| Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 66% | 116 |
| Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months. | ||
| Provide Patients Electronic Access to Their Health Information | 83% | 436 |
| For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified electronic health record technology (CEHRT). | ||
| Public Health Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit data to public health registries. | ||
| 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 electronic health record technology (CEHRT) in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 164.306(d)(3), 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. | ||
| 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. | ||
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.
- 615Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
- 351Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)
- 173Measurement of field of vision during daylight conditions (HCPCS:92083)
- 155Diagnostic imaging of optic nerve of eye (HCPCS:92133)
- 22Diagnostic imaging of retina (HCPCS:92134)
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 |
|---|---|---|
| D34333 | MEDICARE UPIN (02) |
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 | 9 | 1 | 7 | 9 | 5 | 4 | 8 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 18 | 1 | 14 | 9 | 10 | 4 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 1 + 8 + 1 + 1 + 4 + 9 + 1 + 0 + 4 + 1 + 6 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1891795480 is valid because the calculated check digit 0 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 |
|---|---|---|---|
| 1891794640 | JOHN ELLIS MOREHEAD DPM Individual | Podiatrist | 6160 S YALE AVE TULSA, OK 74136 (918) 492-7200 |
| 1578562336 | CHRISTOPHER GURNEE GIFFORD MD Individual | Allergy & Immunology | 6160 S YALE AVE TULSA, OK 74136 (918) 495-2636 |
| 1639178494 | JAMES WILLIAM ANTHAMATTEN DO Individual | Ophthalmology | 6160 S YALE AVE TULSA, OK 74136 (918) 497-3050 |
| 1023017878 | SARA LEE NEWELL M.D. Individual | Internal Medicine (Rheumatology) | 6160 S YALE AVE TULSA, OK 74136 (918) 497-3140 |
| 1467451237 | JOHN LONNIE KING JR. MD Individual | Surgery | 6160 S YALE AVE TULSA, OK 74136 (918) 497-3090 |
| 1427057264 | MARTIN EDWARD SCOTT MD Individual | Internal Medicine | 6160 S YALE AVE TULSA, OK 74136 (918) 497-3002 |
| 1053310375 | DONNA CAROLE PUCKETT MD Individual | Pediatrics | 6160 S YALE AVE TULSA, OK 74136 (918) 497-3004 |
| 1740289966 | MELITA LOUISE TATE MD Individual | Internal Medicine | 6160 S YALE AVE TULSA, OK 74136 (918) 495-2600 |
| 1518966548 | ANU R. PRABHALA M.D. Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 6160 S YALE AVE TULSA, OK 74136 (918) 497-3140 |
| 1962402743 | BARBARA ANN BAKER MD Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 6160 S YALE AVE TULSA, OK 74136 (918) 497-3140 |
| 1316924186 | KIM M EVANS R.D. Individual | Dietitian, Registered | 6160 S YALE AVE TULSA, OK 74136 (918) 499-4700 |
| 1720065634 | VICKI KARNEY CDE Individual | Nutritionist (Nutrition, Education) | 6160 S YALE AVE TULSA, OK 74136 (918) 499-4700 |
| 1174590145 | MARY S AMES R.D. Individual | Dietitian, Registered | 6160 S YALE AVE 3RD FLOOR TULSA, OK 74136 (918) 499-4700 |
| 1447285978 | SAILATHA PADMANABHAN THOMAS MD Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 6160 S YALE AVE TULSA, OK 74136 (918) 497-3140 |
| 1720006612 | KAY ROBY ROMERO MS.,RD.,KD.,CDP,CDE Individual | Dietitian, Registered | 6160 S YALE AVE TULSA, OK 74136 (918) 499-4700 |
| 1588686216 | JENNIFER REDINGER PHELPS R.D., L.D. Individual | Dietitian, Registered | 6160 S YALE AVE TULSA, OK 74136 (918) 499-4700 |
| 1013091156 | MAY'S DRUG STORES, INC. Organization | Pharmacy (Community/Retail Pharmacy) | 6160 S YALE AVE TULSA, OK 74136 (918) 492-7400 |
| 1497871941 | SAINT FRANCIS HOSPITAL INC Organization | Clinic/Center (Ambulatory Surgical) | 6160 S YALE AVE TULSA, OK 74136 (918) 502-8010 |
| 1912170515 | STEPHANIE MEISSEN DO Individual | Family Medicine | 6160 S YALE AVE TULSA, OK 74136 (918) 495-2600 |
| 1831463611 | DAVILYN R WORTHINGTON PA-C Individual | Physician Assistant | 6160 S YALE AVE TULSA, OK 74136 (918) 495-2600 |
Frequently Asked Questions
What is Mark Allison MD NPI number?
The NPI number assigned to this healthcare provider is 1891795480, registered as an "individual" on July 26, 2005
Where is Mark Allison MD located?
The provider is located at 6160 S Yale Ave Tulsa, Ok 74136 and the phone number is (918) 497-3937
Which is Mark Allison MD specialty?
The provider's speciality is Ophthalmology
How many years of experience does Mark Allison MD have?
The provider has more than 43 years of experience. He graduated from University Of Oklahoma College Of Medicine in 1980.
What insurance does Mark Allison MD accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Mark Allison MD registered in PECOS?
Yes, as of January 10, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary 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 are Mark Allison MD Quality Ratings?
The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information. The provider obtained a high score in the following performance measures: Diabetes: Eye Exam , Provide Patients Electronic Access to Their Health Information. The quality ratings are based on unbiased reviews and reported submissions to Medicare's Quality Payment Program.
How much is a visit to Mark Allison MD?
Medicare beneficiaries should expect a typical cost of $127.76 with an average copayment of $31.94 for new patient appointments. Established patients should expect a typical charge of $69.21 and an average copayment of 17.3. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Mark Allison MD?
The most common procedures or services performed by this practitioner are: Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits, Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits, Measurement of field of vision during daylight conditions, Diagnostic imaging of optic nerve of eye and Diagnostic imaging of retina.
How do I update my NPI information?
The NPI record of Mark Allison MD was last updated on July 26, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]