KATHLEEN DRESCHER STEPHENS PT NPI 1891910782

Physical Therapist in East Lansing, MI

Individual Female Years of Experience 44 Physical Therapist Accepts Medicare Approved Payment MIPS Quality Score 96.9 Medicare Quality Reporting

About KATHLEEN DRESCHER STEPHENS PT

Kathleen Stephens is a provider established in East Lansing, Michigan and her medical specialization is Physical Therapist with more than 44 years of experience. The NPI number of Kathleen Stephens is 1891910782 and was assigned on April 2007. The practitioner's primary taxonomy code is 225100000X with license number 5501003275 (MI). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI

1891910782

Provider Name KATHLEEN DRESCHER STEPHENS PT
Provider Location Address4660 S HAGADORN RD STE 400 EAST LANSING, MI 48823
Provider Mailing Address804 SERVICE RD STE A109B EAST LANSING, MI 48824
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1979
Is Sole Proprietor?Yes
Enumeration Date04-16-2007
Last Update Date07-17-2019

Kathleen Stephens 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 96.9, 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: clinical data registry reporting, documentation of current medications in the medical record, implementation of medication management practice improvements, measurement and improvement at the practice and panel level, preventive care and screening: body mass index (bmi) screening and follow-up plan, provide patients electronic access to their health information, public health registry reporting, security risk analysis and use of decision support and standardized treatment protocols.

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.68 for a new patient copayment and $17.7 for an established patient copayment.



Primary Taxonomy

Taxonomy Code225100000X
ClassificationPhysical Therapist
TypeRespiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.5501003275
License StateMI
Taxonomy DescriptionPhysical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Business Address

KATHLEEN DRESCHER STEPHENS PT
4660 S HAGADORN RD STE 400
EAST LANSING, MI
ZIP 48823
Phone: (517) 355-7648
Fax: (517) 432-1319

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Mailing Address

KATHLEEN DRESCHER STEPHENS PT
804 SERVICE RD STE A109B
EAST LANSING, MI
ZIP 48824
Phone: (517) 355-7648
Fax: (517) 432-1319


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.

PECOS PAC ID42454605
PECOS Enrollment IDI20130920000471
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.

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 48823 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
$56.39 $172.8 $130.74
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.09 $43.2 $32.68
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
$17.24 $140.86 $70.8
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.31 $35.21 $17.7

* 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% 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% 78.4
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% 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.
MIPS Final Score - 96.9
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
Clinical Data Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to a clinical data registry.
Documentation of Current Medications in the Medical Record 3% 292
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
Implementation of medication management practice improvementsYesN/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.
Measurement and Improvement at the Practice and Panel LevelYesN/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.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 34% 287
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 encounterNormal Parameters: Age 18 years and older BMI => 18.5 and < 25 kg/m2
Provide Patients Electronic Access to Their Health Information 87% 373
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 ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit data to public health registries.
Security Risk AnalysisYesN/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.
Use of decision support and standardized treatment protocolsYesN/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.

  • 383Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes (HCPCS:97110)
  • 120Manual (physical) therapy techniques to 1 or more regions, each 15 minutes (HCPCS:97140)
  • 63Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes (HCPCS:97112)
  • 36Physical therapy evaluation (HCPCS:97001)

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.
1891910782
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
281811810716
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 1 + 8 + 1 + 1 + 8 + 1 + 0 + 7 + 1 + 6 + 24 = 68
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 68 = 22

The NPI number 1891910782 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 10 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1992712053MICHIGAN STATE UNIVERSITY
Organization
Physical Therapist4660 S HAGADORN RD STE 400
EAST LANSING, MI 48823
(517) 355-7648
1003009739 RACHELLE MARIE THOMAS PT
Individual
Physical Therapist4660 S HAGADORN RD STE 400
EAST LANSING, MI 48823
(517) 355-7648
1780771386MS. GRETCHEN G CLASSENS P.T.
Individual
Physical Therapist4660 S HAGADORN RD STE 400
EAST LANSING, MI 48823
(517) 355-7648
1578105151 DANIEL ADAM BALOGH PT
Individual
Physical Therapist4660 S HAGADORN RD STE 400
EAST LANSING, MI 48823
(517) 355-7648
1689767469 RYAN WHITTAKER PT
Individual
Physical Therapist4660 S HAGADORN RD STE 400
EAST LANSING, MI 48823
(517) 355-7648
1811085996 CATHRYN GAYLE DURNIN PT
Individual
Physical Therapist4660 S HAGADORN RD STE 400
EAST LANSING, MI 48823
(517) 355-7648
1861554487 MARGARET ANNE AMENDT O.T.R.
Individual
Occupational Therapist4660 S HAGADORN RD STE 400
EAST LANSING, MI 48823
(517) 355-7648
1073675567 NANCY TUCKER P.T.
Individual
Physical Therapist4660 S HAGADORN RD STE 400
EAST LANSING, MI 48823
(517) 355-7648
1033271598 MARY CAROL THIEL PT
Individual
Physical Therapist4660 S HAGADORN RD STE 400
EAST LANSING, MI 48823
(517) 355-7648
1689206419MSU HEALTH CARE INC.
Organization
Physical Therapist4660 S HAGADORN RD STE 400
EAST LANSING, MI 48823
(517) 355-7648

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
Kathleen Drescher Stephens Pt 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.