ANDREA SYLVESTER NP
NPI 1942608005
Nurse Practitioner in Ludington, MI
Active since December 05, 2014PECOS EnrolledAccepts Medicare Assignment
About Andrea Sylvester Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREA SYLVESTER NP (NPI 1942608005) is an individual nurse practitioner in Ludington, Michigan, licensed in Michigan (4704249490) and active in the NPI registry since December 2014. She is enrolled in Medicare PECOS, is affiliated with Mercy Health Saint Mary's, and is a graduate of Other (2014).
NPPES Registry Identity
NPI1942608005
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameANDREA SYLVESTERCredential: NP
Location Address922 LAWNDALE STLudington, MI 49431-1928
Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560
Phone(231) 845-7380
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateDecember 5, 2014
Last NPPES UpdateSeptember 18, 2015
✔ NPI 1942608005 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MI · 4704249490
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
922 LAWNDALE ST, Ludington, MI 49431
Other Names 1
Former Name (1)Andrea Mccoy Np
Accepted Insurance
The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community 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
Andrea Sylvester Np 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 ID2062736036
PECOS Enrollment IDI20150122000297
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 10
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.
Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month 99489
Complex chronic care management is a service for patients with multiple chronic conditions. It involves an additional 60 minutes per month of clinical staff time directed by a healthcare professional. This service assists in managing your health conditions effectively.
373 services76 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
307 services110 patients
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
301 services95 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
281 services85 patients
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487
Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.
269 services99 patients
Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350
An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.
163 services79 patients
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mercy Health Saint Mary's
Acute Care Hospitals · Grand Rapids, MIOwnershipVoluntary non-profit - Church
CMS Certification Number230059
Location200 Jefferson Avenue SEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly
Holland Community Hospital
Acute Care Hospitals · Holland, MIOwnershipVoluntary non-profit - Private
CMS Certification Number230072
Location602 Michigan AveHolland, MI 49423 · Ottawa County
Emergency services Birthing friendly
University Of Michigan Health - West
Acute Care Hospitals · Wyoming, MIOwnershipVoluntary non-profit - Private
CMS Certification Number230236
Location5900 Byron Center Avenue, SWWyoming, MI 49519 · Kent County
Emergency services Birthing friendly
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49431 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $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.
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
60%149 patients3/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
69%211 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
56%204 patients3/55-star benchmark: 85%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 4% · 26 patients
4%24 patients
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
6%33 patients1/55-star benchmark: 100%
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
6%32 patients1/55-star benchmark: 98%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
88%33 patients4/55-star benchmark: 99%
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.
88%641 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.
90%270 patients3/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
9%74 patients1/55-star benchmark: 99%
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.
99%155 patients4/55-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.
99%190 patients5/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
33%75 patients2/55-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…
38%416 patients2/55-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
46%310 patients3/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
11%316 patients1/55-star benchmark: 96%
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 tobacco: 89% · 158 patients
100%158 patients
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…
100%190 patients5/55-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…
34%190 patients2/55-star benchmark: 89%
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+: 1% · 75 patients
8%75 patients3/55-star benchmark: 100%
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.
61%190 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 11
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Walker, folding, wheeled, adjustable or fixed height E0143
DME-Other DME · category DE000N
1 supplier24 claims24 services$44.65 avg. paid by Medicare
Seat attachment, walker E0156
DME-Other DME · category DE000N
1 supplier15 claims15 services$14.34 avg. paid by Medicare
Commode chair, mobile or stationary, with fixed arms E0163
DME-Other DME · category DE000N
1 supplier13 claims13 services$4.52 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
5 suppliers126 claims126 services$38.70 avg. paid by Medicare
Heel loop/holder, any type, with or without ankle strap, each E0951
DME-Wheelchairs · category DD000N
6 suppliers12 claims22 services$11.58 avg. paid by Medicare
Manual wheelchair accessory, anti-tipping device, each E0971
DME-Wheelchairs · category DD021N
6 suppliers22 claims22 services$26.78 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 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Clinic/Center (Rural Health)
922 LAWNDALE ST
LUDINGTON, MI 49431
LUDINGTON, MI 49431
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 Andrea Sylvester's NPI number?
The NPI number for Andrea Sylvester is 1942608005. It was assigned to this individual provider in the NPPES registry on December 5, 2014. The provider is also known as Andrea Mccoy Np.
Where is Andrea Sylvester located?
Andrea Sylvester practices at 922 Lawndale St, Ludington, MI 49431. The listed phone number is (231) 845-7380.
What is Andrea Sylvester's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Andrea Sylvester enrolled in Medicare?
Yes. Andrea Sylvester 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.
What insurance does Andrea Sylvester accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community, Priority Health and UnitedHealthcare list Andrea Sylvester as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Andrea Sylvester affiliated with any hospitals?
According to CMS data, Andrea Sylvester is affiliated with Mercy Health Saint Mary's, Holland Community Hospital and University Of Michigan Health - West.
When was this NPI record last updated?
The NPPES record for Andrea Sylvester was last updated on September 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Andrea Sylvester, NP · NPI 1942608005
Nurse Practitioner physician in Ludington, Michigan. Individual provider, active in the CMS NPPES registry since December 5, 2014.
## Identity
- **NPI:** 1942608005 (Entity type: Individual)
- **Enumerated:** December 5, 2014
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 4704249490 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 922 LAWNDALE ST, Ludington, MI 49431-1928
- **Phone:** (231) 845-7380
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** September 18, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1942608005) · Data from the CMS NPPES public registry.