DR. NATHAN ROBERTS M.D. NPI 1942526165

Urology in Lansdowne, VA

NPI 1942526165 Individual Male Years of Experience 13 Urology PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 80.2

NPI Profile for DR. NATHAN ROBERTS M.D.

Nathan Roberts is a provider established in Lansdowne, Virginia and his medical specialization is urology with more than 13 years of experience. He graduated from Jefferson Medical College Of Thomas Jefferson University in 2010. The NPI number of Nathan Roberts is 1942526165 and was assigned on April 2010. The practitioner's primary taxonomy code is 208800000X with license number 0101259989 (VA). The provider is registered as an individual and his NPI record was last updated 5 years ago.

Nathan Roberts 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.

Nathan Roberts 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. According to Medicare claims data he has hospital affiliations with Inova Loudoun Hospital, Stonesprings Hospital Center and Reston Hospital Center.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 80.2, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $33.75 for a new patient copayment and $18.37 for an established patient copayment.

NPI

1942526165

Provider NameDR. NATHAN ROBERTS M.D.
Provider Location Address19415 DEERFIELD AVE SUITE 112 LANSDOWNE, VA 20176
Provider Mailing Address19415 DEERFIELD AVE SUITE 112 LANSDOWNE, VA 20176
GenderMale
NPI Entity TypeIndividual
Medical School NameJEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduation Year2010
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date04-13-2010
Last Update Date02-20-2017


Primary Taxonomy

Taxonomy Code208800000X
ClassificationUrology
TypeAllopathic & Osteopathic Physicians
License No.0101259989
License StateVA
Taxonomy DescriptionA urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Business Address

DR. NATHAN ROBERTS M.D.
19415 DEERFIELD AVE
SUITE 112
LANSDOWNE, VA
ZIP 20176
Phone: (703) 724-1195

Get Directions


Mailing Address

DR. NATHAN ROBERTS M.D.
19415 DEERFIELD AVE
SUITE 112
LANSDOWNE, VA
ZIP 20176
Phone: (703) 724-1195



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.

Registered in PECOS? Yes
PECOS PAC ID6305079112
PECOS Enrollment IDI20160815000870, I20160913002459
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

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 20176 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
$58.76 $178.23 $135
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.69 $44.55 $33.75
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
$18.32 $145.63 $73.51
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.58 $36.4 $18.37

* 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% 92.6
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% 41
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 - 80.2
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.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nathan Roberts is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
INOVA LOUDOUN HOSPITAL44045 RIVERSIDE PARKWAY
LEESBURG, VA 20176
(703) 858-6600Acute Care Hospitals490043
STONESPRINGS HOSPITAL CENTER24440 STONE SPRINGS BOULEVARD
DULLES, VA 20166
(571) 349-4000Acute Care Hospitals490145
RESTON HOSPITAL CENTER1850 TOWN CENTER PARKWAY
RESTON, VA 20190
(703) 689-9000Acute Care Hospitals490107

NPI Validation Check Digit Calculation


The following table explains step by step the 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.
1942526165
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
298210212112
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 8 + 2 + 1 + 0 + 2 + 1 + 2 + 1 + 1 + 2 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1942526165 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1205836798DR. MANDEEP SANDHU MD
Individual
Internal Medicine19415 DEERFIELD AVE SUITE 115
LANSDOWNE, VA 20176
(703) 729-2626
1871593202DR. KARNAIL SINGH MD
Individual
Internal Medicine19415 DEERFIELD AVE SUITE 115
LANSDOWNE, VA 20176
(703) 729-2626
1649271750DR. RAVNEET GREWAL M.D.
Individual
Specialist19415 DEERFIELD AVE SUITE 107
LANSDOWNE, VA 20176
(703) 729-6030
1649263195 VAN TRONG HA MD
Individual
Dermatology19415 DEERFIELD AVE STE 314
LEESBURG, VA 20176
(703) 723-7171
1649264185 GREGORY S SCHENK MD
Individual
Urology19415 DEERFIELD AVE SUITE 112
LEESBURG, VA 20176
(703) 724-1195
1073508610DR. CAROLYN M WALSH MD
Individual
Internal Medicine19415 DEERFIELD AVE SUITE 307
LANSDOWNE, VA 20176
(703) 723-7713
1881682482MRS. MARILYN J WISEMAN MSN, CRNP,CRNFA,CNOR
Individual
Nurse Practitioner (Family)19415 DEERFIELD AVE SUITE 112
LANSDOWNE, VA 20176
(703) 724-1195
1649256603DR. TARA MANGAT MD
Individual
Psychiatry & Neurology (Psychiatry)19415 DEERFIELD AVE 310
LANSDOWNE, VA 20176
(703) 858-0076
1811965981MRS. LEYLA NAJAFI OD
Individual
Optometrist19415 DEERFIELD AVE SUITE 106
LANSDOWNE, VA 20176
(703) 723-9633
1144289661DULLES EYE ASSOCIATES
Organization
Ophthalmology19415 DEERFIELD AVE STE 106
LANSDOWNE, VA 20176
(703) 723-9633
1750339800DR. MICHAEL MUTTER D.C.
Individual
Chiropractor19415 DEERFIELD AVE SUITE 101
LANSDOWNE, VA 20176
(703) 723-8802
1275564403MCDONALD PEDIATRICS PC
Organization
Pediatrics19415 DEERFIELD AVE STE 105
LANSDOWNE, VA 20176
(571) 223-2229
1386662971ADULT AND GERIATRIC PSYCHIATRY
Organization
Psychiatry & Neurology (Psychiatry)19415 DEERFIELD AVE STE 310
LANSDOWNE, VA 20176
(703) 858-0076
1184642761LOUDOUN MEDICAL CARE PC
Organization
Internal Medicine19415 DEERFIELD AVE STE 115
LANSDOWNE, VA 20176
(703) 729-2626
1093895518 ANGIE MARIE PAGE FNP
Individual
Nurse Practitioner (Family)19415 DEERFIELD AVE SUITE 213
LANSDOWNE, VA 20176
(703) 729-9220
1982776217ASHBURN STERLING INTERNAL MEDICINE AND PEDIATRICS INC
Organization
Internal Medicine19415 DEERFIELD AVE SUITE 213
LANSDOWNE, VA 20176
(703) 729-9220
1699842187DR. SRINAGESH PALUVOI M.D.
Individual
Allergy & Immunology (Allergy)19415 DEERFIELD AVE SUITE #210
LANSDOWNE, VA 20176
(703) 729-8830
1972670446SOBHA R PALUVOI MD PC
Organization
Psychiatry & Neurology (Geriatric Psychiatry)19415 DEERFIELD AVE SUITE #210
LANSDOWNE, VA 20176
(703) 729-8830
1649347014ALLERGY & ASTHMA AFFILIATES, INC.
Organization
Allergy & Immunology (Allergy)19415 DEERFIELD AVE SUITE #210
LANSDOWNE, VA 20176
(703) 729-8830
1154499598DR. REZA NIKPOURFARD D.D.S.
Individual
Dentist (General Practice)19415 DEERFIELD AVE SUITE 309
LANSDOWNE, VA 20176
(703) 729-1818

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
Dr. Nathan Roberts M.d. 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.