DR. CHONGHAO ZHAO M.D., PHD, DABMA NPI 1902930019
Specialist in San Gabriel, CA

About DR. CHONGHAO ZHAO M.D., PHD, DABMA

Chonghao Zhao is a provider established in San Gabriel, California and his medical specialization is Specialist with more than 37 years of experience. The NPI number of Chonghao Zhao is 1902930019 and was assigned on March 2007. The practitioner's primary taxonomy code is 174400000X with license number A66257 (CA). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1902930019
Provider NameDR. CHONGHAO ZHAO M.D., PHD, DABMA
Location Address420 W LAS TUNAS DR SAN GABRIEL, CA 91776
Location Phone(626) 457-1688
Mailing Address420 W LAS TUNAS DR SAN GABRIEL, CA 91776
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1986
Is Sole Proprietor?No
Enumeration Date03-14-2007
Last Update Date10-25-2017

Chonghao Zhao 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.

Chonghao Zhao 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 32, 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 following quality measures were reported for this provider: care coordination agreements that promote improvements in patient tracking across settings, collection and use of patient experience and satisfaction data on access, engagement of new medicaid patients and follow-up, e-prescribing, implementation of documentation improvements for practice/process improvements, implementation of medication management practice improvements, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, provide education opportunities for new clinicians and security risk analysis.



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 Code174400000X
ClassificationSpecialist
TypeOther Service Providers
License No.A66257
License StateCA
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

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

Business Address

DR. CHONGHAO ZHAO M.D., PHD, DABMA
420 W LAS TUNAS DR
SAN GABRIEL, CA
ZIP 91776
Phone: (626) 457-1688
Fax: (626) 457-1638

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Mailing Address

DR. CHONGHAO ZHAO M.D., PHD, DABMA
420 W LAS TUNAS DR
SAN GABRIEL, CA
ZIP 91776
Phone: (626) 457-1688
Fax: (626) 457-1638


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 ID3779524293
PECOS Enrollment IDI20050516000327
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 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% 26.7
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% 0
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% 0
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% 100
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 - 32
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 Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. 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
Care coordination agreements that promote improvements in patient tracking across settingsYesN/A
Establish effective care coordination and active referral management that could include one or more of the following: Establish care coordination agreements with frequently used consultants that set expectations for documented flow of information and MIPS eligible clinician or MIPS eligible clinician group expectations between settings. Provide patients with information that sets their expectations consistently with the care coordination agreements; Track patients referred to specialist through the entire process; and/or Systematically integrate information from referrals into the plan of care.
Collection and use of patient experience and satisfaction data on accessYesN/A
Collection of patient experience and satisfaction data on access to care and development of an improvement plan, such as outlining steps for improving communications with patients to help understanding of urgent access needs.
Engagement of New Medicaid Patients and Follow-upYesN/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
e-Prescribing 100% 38
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Implementation of documentation improvements for practice/process improvementsYesN/A
Implementation of practices/processes that document care coordination activities (e.g., a documented care coordination encounter that tracks all clinical staff involved and communications from date patient is scheduled for outpatient procedure through day of procedure).
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/or Conduct periodic, structured medication reviews.
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical RecordYesN/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 Education Opportunities for New CliniciansYesN/A
MIPS eligible clinicians acting as a preceptor for clinicians-in-training (such as medical residents/fellows, medical students, physician assistants, nurse practitioners, or clinical nurse specialists) and accepting such clinicians for clinical rotations in community practices in small, underserved, or rural areas.
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 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.

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.

  • 2434Manual (physical) therapy techniques to 1 or more regions, each 15 minutes (HCPCS:97140)
  • 757Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes (HCPCS:97110)
  • 690Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
  • 193Application of ultrasound to 1 or more areas, each 15 minutes (HCPCS:97035)
  • 182Injections of substances into lower or sacral spine (HCPCS:62311)
  • 150Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance (HCPCS:64483)
  • 90Injections of lower or sacral spine facet joint using imaging guidance (HCPCS:64493)
  • 90Injections of lower or sacral spine facet joint using imaging guidance (HCPCS:64494)
  • 87Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
  • 70Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • 54Injection, dexamethasone sodium phosphate, 1mg (HCPCS:J1100)
  • 18Impression and custom preparation of outer ear prosthesis (HCPCS:21085)

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
H76377MEDICARE UPIN (02)CA
WA66257AMEDICARE ID-TYPE UNSPECIFIED (04)CA

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.
1902930019
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2902183002
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 0 + 2 + 1 + 8 + 3 + 0 + 0 + 2 + 24 = 51
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 51 = 99

The NPI number 1902930019 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1669707063DR. STANLEY TOY JR. M.D.
Individual
General Practice420 W LAS TUNAS DR
SAN GABRIEL, CA 91776
(626) 296-9500
1427386390DREAMWEAVER CONSULTANCY, A MEDICAL CORPORATION
Organization
Clinic/Center (Urgent Care)420 W LAS TUNAS DR
SAN GABRIEL, CA 91776
(626) 296-9500
1366586992USC FAMILY MEDICINE INC.
Organization
Family Medicine420 W LAS TUNAS DR
SAN GABRIEL, CA 91776
(626) 296-9500
1790980258DR. DAN LE D.O.
Individual
Family Medicine420 W LAS TUNAS DR
SAN GABRIEL, CA 91776
(626) 296-9500

Frequently Asked Questions

What is Dr. Chonghao Zhao M.D., PHD, DABMA NPI number?

The NPI number assigned to Dr. Chonghao Zhao M.D., PHD, DABMA is 1902930019, registered as an "individual" on March 14, 2007

Where is Dr. Chonghao Zhao M.D., PHD, DABMA located?

The provider is located at 420 W Las Tunas Dr San Gabriel, Ca 91776 and the phone number is (626) 457-1688

Which is Dr. Chonghao Zhao M.D., PHD, DABMA specialty?

The provider's speciality is Specialist

How many years of experience does Dr. Chonghao Zhao M.D., PHD, DABMA have?

The provider has more than 37 years of experience.

What insurance does Dr. Chonghao Zhao M.D., PHD, DABMA accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Dr. Chonghao Zhao M.D., PHD, DABMA registered in PECOS?

Yes, as of November 14, 2022 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 some of the services provided by Dr. Chonghao Zhao M.D., PHD, DABMA?

The most common procedures or services performed by this practitioner are: Manual (physical) therapy techniques to 1 or more regions, each 15 minutes, Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes, Injection, methylprednisolone acetate, 40 mg, Application of ultrasound to 1 or more areas, each 15 minutes, Injections of substances into lower or sacral spine, Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance, Injections of lower or sacral spine facet joint using imaging guidance, Injections of lower or sacral spine facet joint using imaging guidance, Aspiration and/or injection of large joint or joint capsule, Injection, triamcinolone acetonide, not otherwise specified, 10 mg, Injection, dexamethasone sodium phosphate, 1mg and Impression and custom preparation of outer ear prosthesis.

How do I update my NPI information?

The NPI record of Dr. Chonghao Zhao M.D., PHD, DABMA was last updated on March 14, 2007. 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]