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DR. IRINA INNA KAPLAN MD
NPI 1942382718
Family Medicine in Waterford, NY

Active since October 20, 2006PECOS EnrolledAccepts Medicare Assignment
158 SARATOGA AVE, WATERFORD, NY 12188(518) 233-1162(518) 233-0903 Get Directions Write a Review

NPPES record last updated: December 11, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 11, 2020, Oct 22, 2019, Dec 14, 2015 and 1 more (4 updates tracked since 2015).

About Dr. Irina Inna Kaplan Md NPPES

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

DR. IRINA INNA KAPLAN MD (NPI 1942382718) is an individual family medicine provider in Waterford, New York, licensed in New York (214690) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS, is affiliated with St Peter's Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1942382718
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. IRINA INNA KAPLANCredential: MD
Location Address158 SARATOGA AVEWaterford, NY 12188-2205
Mailing AddressPo Box 14890Albany, NY 12212-4890 · (518) 525-5634 · Fax (518) 649-4094
Phone(518) 233-1162
Fax(518) 233-0903
Sole ProprietorNo
Medical School CMSOtherGraduated 1987
Enumeration DateOctober 20, 2006
Last NPPES UpdateDecember 11, 20204 updates tracked since enumeration
NPPES CertifiedDecember 11, 2020
✔ NPI 1942382718 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 214690
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
158 SARATOGA AVE, Waterford, NY 12188
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Secondary Practice Locations 2

Location 155 Mohawk St Ste 105Cohoes, NY 12047-2600 · Phone (518) 235-7282
Location 235 Lower Hudson AveGreen Island, NY 12183-1014 · Phone (518) 270-9413

Other Identifiers 1

Medicaid01976952NY

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. Irina Inna Kaplan 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 ID1658343207
PECOS Enrollment IDI20040812000814
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 4

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.
430 services204 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
146 services146 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.
47 services38 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.
36 services34 patients

Hospital Affiliations CMS Care Compare 3

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

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

Sunnyview Hospital And Rehabilitation Center

Acute Care Hospitals · Schenectady, NY
OwnershipVoluntary non-profit - Private
CMS Certification Number330406
Location1270 Belmont AvenueSchenectady, NY 12308 · Schenectady County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12188 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
70%254 patients4/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
75%461 patients4/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
66%146 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.
99%4,652 patients5/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
12%662 patients1/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
85%444 patients2/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
78%1,037 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
43%602 patients2/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
42%1,036 patients2/55-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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
6%1,036 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
14%1,036 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 4

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers28 claims68 services$6.58 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
4 suppliers12 claims16 services$1.11 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
2 suppliers11 claims8,529 services$0.27 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$114.99 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

MARGARET ANNE KELLY PA-C
Physician Assistant
158 SARATOGA AVE
WATERFORD, NY 12188
Saratoga County (518) 233-1162
ANDREW GREENBERG FNP-BC
Nurse Practitioner (Family)
158 SARATOGA AVE
WATERFORD, NY 12188
Saratoga County (518) 233-1162
SAMARITAN HOSPITAL OF TROY, NEW YORK
Family Medicine
158 SARATOGA AVE
WATERFORD, NY 12188
Saratoga County (518) 233-1162

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Irina Kaplan's NPI number?

The NPI number for Irina Kaplan is 1942382718. It was assigned to this individual provider in the NPPES registry on October 20, 2006.

Where is Irina Kaplan located?

Irina Kaplan practices at 158 Saratoga Ave, Waterford, NY 12188. The listed phone number is (518) 233-1162.

What is Irina Kaplan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Irina Kaplan enrolled in Medicare?

Yes. Irina Kaplan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Irina Kaplan affiliated with any hospitals?

According to CMS data, Irina Kaplan is affiliated with St Peter's Hospital, Samaritan Hospital Of Troy, New York and Sunnyview Hospital And Rehabilitation Center.

When was this NPI record last updated?

The NPPES record for Irina Kaplan was last updated on December 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.