DR. MICHAEL E. FALKENHAIN M.D.
NPI 1922007657
Internal Medicine - Nephrology in Westerville, OH

Q: What is Michael Falkenhain's NPI number?

The NPI number for Michael Falkenhain is 1922007657. It was assigned to this individual provider in the NPPES registry on July 15, 2005.

Q: What is Michael Falkenhain's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Active since July 15, 2005PECOS EnrolledAccepts Medicare Assignment

83.63/100

CMS Quality Rating

595 COPELAND MILL RD, SUITE 2D, WESTERVILLE, OH 43081(614) 823-8500(614) 823-8501 Get Directions Write a Review

NPPES record last updated: September 24, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Michael E. Falkenhain M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL E. FALKENHAIN M.D. (NPI 1922007657) is an individual nephrology provider in Westerville, Ohio, licensed in Ohio (35063298) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Mount Carmel St Ann's, and is a graduate of Saint Louis University School Of Medicine (1988).

NPPES Registry Identity

NPI1922007657

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. MICHAEL E. FALKENHAINCredential: M.D.

Location Address595 COPELAND MILL RD, SUITE 2DWesterville, OH 43081-8908

Mailing Address595 Copeland Mill Rd, Suite 2dWesterville, OH 43081-8908 · (614) 823-8500 · Fax (614) 823-8501

Phone(614) 823-8500

Fax(614) 823-8501

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 1988

Enumeration DateJuly 15, 2005

Last NPPES UpdateSeptember 24, 2015

✔ NPI 1922007657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in OH · 35063298

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

595 COPELAND MILL RD, Westerville, OH 43081

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Other Identifiers 7

Medicaid0928358OH

Medicare PIN4116611PW

Medicare PIN0873428OH

Medicare PIN4116613OH

Medicare UPINF57781OH

Medicare PIN0873429OH

Medicare PIN4116612OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michael E. Falkenhain M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820987464

PECOS Enrollment IDI20040312000284

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

273 services160 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

205 services96 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

147 services81 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

91 services29 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

87 services75 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

81 services77 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

37 services25 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

27 services14 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

21 services14 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

15 services15 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

14 services12 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mount Carmel St Ann's

Acute Care Hospitals · Westerville, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360012

Location500 South Cleveland AvenueWesterville, OH 43081 · Franklin County

Emergency services Birthing friendly

Mount Carmel East & West

Acute Care Hospitals · Columbus, OH

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360035

Location6001 East Broad StreetColumbus, OH 43213 · Franklin County

Emergency services Birthing friendly

Fairfield Medical Center

Acute Care Hospitals · Lancaster, OH

1/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360072

Location401 North Ewing StreetLancaster, OH 43130 · Fairfield County

Emergency services Birthing friendly

Marietta Memorial Hospital

Acute Care Hospitals · Marietta, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360147

Location401 Matthew StreetMarietta, OH 45750 · Washington County

Emergency services Birthing friendly

Hocking Valley Community Hospital

Critical Access Hospitals · Logan, OH

OwnershipVoluntary non-profit - Other

CMS Certification Number361330

Location601 State Route 664NLogan, OH 43138 · Hocking County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43081 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.63/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

64.87

Improvement Activities

Cost

75.6

Reported Quality Measures

Clinical Information Reconciliation

For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.

88%1,533 patients4/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred

63%38 patients3/55-star benchmark: 95%

Diabetes: Foot Exam

The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year

54%181 patients3/55-star benchmark: 98%

Documentation of Current Medications in the Medical Record

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.

85%3,957 patients3/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

94%1,490 patients4/55-star benchmark: 100%

Patient-Generated Health Data

Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for at least one unique patient seen by the MIPS eligible clinician during the performance period.

0%1,106 patients

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…

89%1,106 patients4/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

81%656 patients4/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

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…

99%916 patients5/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

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

Patients screenedForUse: 91% · 496 patients

Patients tobacco: 91% · 496 patients

94%49 patients4/55-star benchmark: 98%

Provide Patient Access

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…

87%1,106 patients4/55-star benchmark: 100%

Request/Accept Summary of Care

1%1,527 patients1/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…

74%1,106 patients4/55-star benchmark: 75%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 656 patients

0%656 patients5/55-star benchmark: 100%

View, Download and Transmit (VDT)

During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.

2%1,106 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503

Treatment-Chemotherapy · category RH002N

3 suppliers19 claims6,840 services$1.18 avg. paid by Medicare

Tacrolimus, immediate release, oral, 1 mg J7507