KENNETH M. ROYLE MD NPI 1891873378
Obstetrics & Gynecology in Fresno, CA

Individual Male Obstetrics & Gynecology PECOS Enrolled MIPS Quality Score 86.2

About KENNETH M. ROYLE MD

Kenneth Royle is a women's health care provider established in Fresno, California and his medical specialization is Obstetrics & Gynecology. The NPI number of Kenneth Royle is 1891873378 and was assigned on November 2006. The practitioner's primary taxonomy code is 207V00000X with license number A43958 (CA). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI
1891873378
Provider Name KENNETH M. ROYLE MD
Provider Location Address7300 N FRESNO ST FRESNO, CA 93720
Provider Mailing Address1800 HARRISON ST FL 7 OAKLAND, CA 94612
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Enumeration Date11-01-2006
Last Update Date07-08-2007

Women's health care providers like Kenneth M. Royle Md 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.Kenneth Royle 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..

Kenneth Royle 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 86.2, 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.



Primary Taxonomy

Taxonomy Code207V00000X
ClassificationObstetrics & Gynecology
TypeAllopathic & Osteopathic Physicians
License No.A43958
License StateCA
Taxonomy DescriptionAn 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.

Business Address

KENNETH M. ROYLE MD
7300 N FRESNO ST
FRESNO, CA
ZIP 93720
Phone: (559) 448-4500

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Mailing Address

KENNETH M. ROYLE MD
1800 HARRISON ST FL 7
OAKLAND, CA
ZIP 94612
Phone: (510) 625-6262


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% 57
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% 68.3
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 - 86.2
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.

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
00A439580MEDICARE ID-TYPE UNSPECIFIED (04)

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.
1891873378
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
281811676314
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 1 + 8 + 1 + 1 + 6 + 7 + 6 + 3 + 1 + 4 + 24 = 72
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 72 = 88

The NPI number 1891873378 is valid because the calculated check digit 8 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
1821054644 ANN BEBENSEE M.D.
Individual
Psychiatry & Neurology (Neurology)7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-4173
1407962533MRS. SANDRA E CARLSEN MD
Individual
Radiology (Diagnostic Radiology)7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-5946
1588773105MR. ROBERT J CROUTCH MD
Individual
Radiology (Diagnostic Radiology)7300 N FRESNO ST
FRESNO, CA 93720
(559) 285-0141
1356445852 GARY W VANN MD
Individual
Specialist7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-4500
1285728345DR. SCOTT SHIMAMOTO PHARM.D.
Individual
Pharmacist7300 N FRESNO ST KAISER INPATIENT PHARMACY SEQ 3
FRESNO, CA 93720
(559) 448-3307
1861581605DR. CORBIN CHRISTOPHER BENNETT PHARM.D., MPH
Individual
Pharmacist7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-3472
1487744991 ROBERT LAWRENCE MCLANAHAN PHARM D.
Individual
Pharmacist7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-3305
1639269178MR. SAMUEL C LI RPH
Individual
Pharmacist7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-3305
1487744884 ELISE E. HEU PHARM. D.
Individual
Pharmacist7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-4500
1700968773 TOMMY VINH NGUYEN PHARMD
Individual
Pharmacist7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-3305
1891878260 PETER T TA PHARM.D.
Individual
Pharmacist7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-3305
1891878732 STEPHANIE CHRISTINE HOLCOMB PHARM.D.
Individual
Pharmacist7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-3305
1265518740DR. SEIFEDIN HABIB ABDULKARIM MD
Individual
Internal Medicine7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-4481
1770661662 CLAUDE MCGLORIE MD
Individual
Emergency Medicine7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-4500
1427136316 DAVID V. YOUNG MD
Individual
Surgery7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-4500
1598843484 KARL P. QUINN MD
Individual
Internal Medicine7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-4500
1518045418 BRIAN D. FRIESEN MD
Individual
Surgery7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-4500
1336227230 GABRIEL E. PINO MD
Individual
Pediatrics7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-4500
1154409050 ROBERT T. LONJERS MD
Individual
Internal Medicine7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-4500
1235217134 MICHAEL D. WAXMAN MD
Individual
Ophthalmology7300 N FRESNO ST
FRESNO, CA 93720
(559) 448-4500

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
Kenneth M. Royle 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.