Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BRION MACKIE WINSTON MD
NPI 1932201159
Internal Medicine - Cardiovascular Disease in Cooperstown, NY

Q: What is Brion Winston's NPI number?

The NPI number for Brion Winston is 1932201159. It was assigned to this individual provider in the NPPES registry on September 1, 2006.

Q: What is Brion Winston's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Brion Winston was last updated on October 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 01, 2006PECOS Enrolled

81.44/100

CMS Quality Rating

1 ATWELL RD, COOPERSTOWN, NY 13326(607) 547-3456 Get Directions Write a Review

NPPES record last updated: October 28, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Oct 28, 2026, Jan 13, 2026 (2 updates tracked since 2026).

On this page

About Brion Mackie Winston Md NPPES

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

BRION MACKIE WINSTON MD (NPI 1932201159) is an individual cardiovascular disease provider in Cooperstown, New York, licensed in New York (238092) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Berkshire Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1932201159

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameBRION MACKIE WINSTONCredential: MD

Location Address1 ATWELL RDCooperstown, NY 13326-1301

Mailing Address1 Atwell RdCooperstown, NY 13326-1301

Phone(607) 547-3456

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateSeptember 1, 2006

Last NPPES UpdateOctober 28, 20262 updates tracked since enumeration

NPPES CertifiedOctober 28, 2026

✔ NPI 1932201159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

Licenses✔ Licensed in NY · 238092✔ Licensed in SD · 8104

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X · License 238092 (NY)

1 ATWELL RD, Cooperstown, NY 13326

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Secondary Practice Locations 2

Location 12 Palisades DrAlbany, NY 12205-1438 · Phone (518) 458-2000 · Fax (518) 458-1524

Location 27 Southwoods Blvd, Capital Cardiology Associates, PCAlbany, NY 12211-2526 · Phone (518) 292-6000 · Fax (518) 292-6050

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brion Mackie Winston Md 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 ID2567469505

PECOS Enrollment IDI20131002000190, I20250910003100

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.

Medicare Billing Reassignments

Medicare enrollment records show Brion Winston reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mary Imogene Bassett Hospital

Same address

Multi-Specialty

1 ATWELL RD
Cooperstown, NY 13326

Reassigned Medicare billing, New York enrollment
1,052 clinicians in this Medicare group

NPI 1083664221 (607) 547-6858

St. Peter's Health Partners Medical Associates, P.C.

55 mi

Internal Medicine

1240 NEW SCOTLAND RD SUITE 205
Slingerlands, NY 12159

Reassigned Medicare billing, New York enrollment
742 clinicians in this Medicare group

NPI 1568707222 (518) 475-9235

Capital Cardiology Associates PLLC

59 mi

Cardiovascular Disease

7 SOUTHWOODS BLVD
Albany, NY 12211

Reassigned Medicare billing, New York enrollment
33 clinicians in this Medicare group

NPI 1518952332 (518) 292-6000

Southwestern Vermont Medical Center Inc.

88 mi

Oncology

140 HOSPITAL DR, SUITE 116
Bennington, VT 05201

Reassigned Medicare billing, Vermont enrollment
Also billed through NPI 1740682921 (Vermont)
143 clinicians in this Medicare group

NPI 1962650556 (802) 447-1836

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 60

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.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

2,052 services24 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

794 services515 patients

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.

743 services460 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

386 services103 patients

Principal care management services for a single high-risk disease, first 30 minutes of clinical staff time directed by health care professional, per calendar month 99426

Principal care management services focus on managing a single high-risk disease. This involves a health care professional directing clinical staff for the first 30 minutes each month. The aim is to monitor your health, coordinate care, and provide necessary support for your disease management.

376 services105 patients

Injection, regadenoson, 0.1 mg J2785

Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.

252 services63 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

236 services205 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

220 services83 patients

Evaluation of cardiac rhythm monitor system, remote up to 30 days 93298

This procedure involves remotely monitoring your heart rhythm for up to 30 days. A small device will record your heart's activity, which can be accessed by your healthcare team. This aids in diagnosing any irregularities or issues with your heart function.

218 services30 patients

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458

This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.

134 services49 patients

Natriuretic peptide (heart and blood vessel protein) level 83880

A natriuretic peptide level test is a blood test that helps doctors check for heart failure. It measures the amount of certain proteins that your heart and blood vessels produce when they are under stress. High levels may indicate heart disease.

130 services123 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

129 services123 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

120 services119 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

117 services111 patients

Magnesium level 83735

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

112 services106 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

98 services91 patients

Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries A9555

Rubidium Rb-82 is a radioactive drug used in a PET scan to help visualize the heart. It helps detect areas with poor blood flow, aiding in diagnosing heart conditions. The dose is up to 60 millicuries per study.

98 services49 patients

Troponin (protein) analysis, quantitative 84484

Troponin analysis is a blood test that checks for damage to the heart. Elevated levels of troponin, a protein in heart cells, can indicate a heart attack. This test helps in early detection and management of heart-related issues.

92 services90 patients

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment 99453

Remote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.

89 services89 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.

86 services76 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician 93015

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

82 services82 patients

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

74 services69 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.

74 services73 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

68 services68 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

66 services66 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional 93228

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

61 services61 patients

Electrocardiogram (ecg) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional 93229

An Electrocardiogram (ECG) is a test that records your heart's electrical activity for up to 30 days. You trigger a transmission if you feel symptoms, which is then reviewed by a healthcare professional. The report helps diagnose heart conditions.

61 services61 patients

Replacement of aortic valve through the skin and femoral artery 33361

This procedure, known as Transcatheter Aortic Valve Replacement (TAVR), involves replacing a damaged aortic valve through a small incision in the leg. A catheter is inserted into the femoral artery and guided up to the heart. The new valve is then positioned and deployed, restoring normal blood flow.

51 services51 patients

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

51 services51 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.

51 services46 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

50 services34 patients

Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan 78431

This is a diagnostic test where a tiny amount of radioactive material is used to examine your heart's blood flow at rest & during stress, alongside a CT scan for detailed images. It helps identify any heart-related issues like blockages or damage.

49 services49 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

49 services49 patients

Nuclear medicine study of heart muscle blood flow by pet 78434

A nuclear medicine study of heart muscle blood flow by PET is a non-invasive test that uses a small amount of radioactive substance to create detailed images of your heart's blood flow and function. It helps assess heart health and diagnose heart conditions.

48 services48 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

42 services40 patients

Placement and subsequent removal of device to protect brain from embolism through catheter using imaging guidance 33370

This procedure involves inserting a device through a catheter to shield the brain from harmful blood clots (embolism). The process is monitored using imaging technology. After serving its purpose, the device is carefully removed through the same pathway.

41 services41 patients

Technetium tc-99m sestamibi, diagnostic, per study dose A9500

Technetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.

40 services20 patients

Thyroxine (thyroid chemical), free 84439

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

38 services38 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.

36 services32 patients

Principal care management services for a single high-risk disease, each additional 30 minutes of clinical staff time directed by health care professional, per calendar month 99427

Principal Care Management (PCM) services focus on managing a single high-risk disease. It involves additional 30 minutes of clinical staff time per month, overseen by a healthcare professional. This includes monitoring your health, coordinating care, and developing a personalized treatment plan.

36 services21 patients

Repair of left upper heart chamber with implant with review by radiologist 33340

This is a procedure to fix a problem in your left upper heart chamber. An implant is used to correct the issue. After the procedure, a radiologist, a doctor who specializes in medical imaging, reviews the images to ensure everything is in order.

34 services34 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch 92928

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

26 services23 patients

Complete ultrasound study of arm and leg arteries 93923

This procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.

26 services25 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.

26 services24 patients

Infusion, normal saline solution , 1000 cc J7030

An infusion of normal saline solution, 1000 cc, is a common medical procedure. It involves introducing a saltwater solution into your bloodstream via an intravenous (IV) line. This helps to hydrate your body, correct electrolyte imbalances, and deliver medications if needed.

23 services23 patients

Measurement c-reactive protein for detection of infection or inflammation, high sensitivity 86141

The high sensitivity C-reactive protein test is a blood test that helps detect low levels of inflammation in the body. It's often used to assess the risk of heart disease but can also indicate infection or other inflammatory conditions.

22 services22 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

20 services20 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test 85027

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

20 services20 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.

20 services20 patients

Ultrasound of leg arteries at rest and after exercise 93924

An ultrasound of leg arteries at rest and after exercise involves using sound waves to create images of the blood vessels in your legs. This helps to detect blockages or narrowing. You'll rest, then perform light exercise, and images are taken before and after to compare blood flow.

19 services18 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

18 services18 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

16 services11 patients

Repair of mitral valve through the skin, initial prosthesis 33418

This procedure, known as Transcatheter Mitral Valve Repair (TMVR), involves a small tube inserted through your skin into a blood vessel. A device is then guided to your heart to repair the mitral valve, using an initial prosthesis. This is a less invasive alternative to open-heart surgery.

15 services15 patients

Ct scan of blood vessels of chest with contrast 71275

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

14 services14 patients

Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel 93571

This procedure involves using ultrasound technology to examine the first blood vessel of your heart. It helps identify any abnormalities or issues, providing crucial information for diagnosis or treatment. It's a safe, non-invasive process.

14 services14 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

14 services13 patients

Urea nitrogen level to assess kidney function, quantitative 84520

The urea nitrogen level test is a routine blood test that checks the amount of urea nitrogen in your blood to evaluate how well your kidneys are working. If the levels are higher than normal, it may indicate that your kidneys are not functioning properly.

13 services12 patients

Blood creatinine level 82565

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

12 services11 patients

Insertion of tube in left lower heart chamber, coronary artery and bypass graft for diagnosis with review by radiologist 93459

This procedure involves placing a tube into your left lower heart chamber, coronary artery, and bypass graft. It's done for diagnostic purposes and is carefully reviewed by a radiologist. This helps determine the health of your heart and arteries, aiding in future treatment plans.

12 services12 patients

Insertion of heart rhythm monitor under skin 33285

The insertion of a heart rhythm monitor under the skin is a procedure to track your heart's activity. A small device is placed under your skin, recording your heart's rhythms continuously. This helps identify irregular heartbeats or conditions, aiding in your treatment.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Berkshire Medical Center

Acute Care Hospitals · Pittsfield, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number220046

Location725 North StreetPittsfield, MA 01201 · Berkshire County

Emergency services Birthing friendly

St Peter's Hospital

Acute Care Hospitals · Albany, NY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330057

Location315 South Manning BoulevardAlbany, NY 12208 · Albany County

Emergency services Birthing friendly

Samaritan Hospital Of Troy, New York

Acute Care Hospitals · Troy, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330180

Location2215 Burdett AvenueTroy, NY 12180 · Rensselaer County

Emergency services Birthing friendly

Southwestern Vermont Medical Center

Acute Care Hospitals · Bennington, VT

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number470012

Location100 Hospital DriveBennington, VT 05201 · Bennington County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13326 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

$126.40 typical visit price

range $54.87 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$68.57 typical visit price

range $17.54 – $136.14

Typical copayment $17.14 (range $4.38 – $34.03)

Most-billed visit code 99213

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.

81.44/100

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

Individually scored

Quality

74.03

Promoting Interoperability

100

Improvement Activities

Cost

64.1

Reported Quality Measures

Controlling High Blood Pressure

70%457 patients4/55-star benchmark: 91%

Coronary Artery Disease (CAD): Beta-Blocker Therapy Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <= 40%)

75%24 patients3/55-star benchmark: 99%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

94%135 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

90%2,594 patients4/55-star benchmark: 100%

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

92%1,525 patients4/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

29%1,085 patients2/55-star benchmark: 61%

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

Patients combinedPopulations: 97% · 511 patients

Patients screened: 97% · 511 patients

97%86 patients4/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

90%924 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

74%676 patients3/55-star benchmark: 91%

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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHIRLEY SCHUE ARNP

Nurse Practitioner (Pediatrics)