MARIANNE STERN
NPI 1972039402
Nurse Practitioner - Adult Health in North Bergen, NJ


Quality Rating: 91.59 out of 100 score

NPI Status: Active since May 03, 2017

Contact Information

8100 KENNEDY BLVD
NORTH BERGEN, NJ
ZIP 07047
Phone: (973) 287-4361
Fax: (201) 866-6770

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  • Individual
  • Female
  • Nurse Practitioner
  • Adult Health
  • PECOS Enrolled

About MARIANNE STERN

Marianne Stern is a provider established in North Bergen, New Jersey and her medical specialization is Nurse Practitioner with a focus in adult health . The healthcare provider is registered in the NPI registry with number 1972039402 assigned on May 2017. The practitioner's primary taxonomy code is 363LA2200X with license number 26NJ00713200 (NJ). The provider is registered as an individual and her NPI record was last updated 7 years ago.

NPI
1972039402
Provider Name
MARIANNE STERN
Gender
Female
Entity Type
Individual
Location Address
8100 KENNEDY BLVD NORTH BERGEN, NJ 07047
Location Phone
(973) 287-4361
Location Fax
(201) 866-6770
Mailing Address
8100 KENNEDY BLVD NORTH BERGEN, NJ 07047
Mailing Phone
(201) 866-6770
Is Sole Proprietor?
No
Enumeration Date
05-03-2017
Last Update Date
11-08-2017
Code Navigator

A nurse practitioner (NP) like Marianne Stern is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 91.59, 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.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Adult Health

Taxonomy Code
363LA2200X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
26NJ00713200
License State
NJ

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Ambetter Health of Delaware

    • Clear Gold - EPO
    • Clear Gold + Vision + Adult Dental - EPO
    • Clear Silver - EPO
    • Clear Silver + Vision + Adult Dental - EPO
    • Complete Gold - EPO
    • Complete Gold + Vision + Adult Dental - EPO
    • Elite Bronze - EPO
    • Elite Bronze + Vision + Adult Dental - EPO
    • Everyday Bronze - EPO
    • Everyday Bronze + Vision + Adult Dental - EPO
    • Everyday Gold - EPO
    • Everyday Gold + Vision + Adult Dental - EPO
    • Everyday Silver - EPO
    • Everyday Silver + Vision + Adult Dental - EPO
    • Focused Silver - EPO
    • Focused Silver + Vision + Adult Dental - EPO
    • Premier Bronze HSA - EPO
    • Premier Bronze HSA + Vision + Adult Dental - EPO
    • Standard Expanded Bronze - EPO
    • Standard Expanded Bronze + Vision + Adult Dental - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

PECOS Enrollment and Medicare Participation Status

Marianne Stern 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.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Other DME (D1E)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    12 DME suppliers used 34 Medicare Claims 52 Services Paid

  • Other DME (D1E)

    Lancets, per box of 100 (HCPCS:A4259)

    7 DME suppliers used 14 Medicare Claims 16 Services Paid

  • Other DME (D1E)

    Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty (HCPCS:E0181)

    1 DME suppliers used 24 Medicare Claims 24 Services Paid

  • Hospital beds (D1B)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

    1 DME suppliers used 68 Medicare Claims 68 Services Paid

  • Other DME (D1E)

    Powered pressure-reducing air mattress (HCPCS:E0277)

    1 DME suppliers used 17 Medicare Claims 17 Services Paid

  • Hospital beds (D1B)

    Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress (HCPCS:E0303)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

  • Other DME (D1E)

    Respiratory suction pump, home model, portable or stationary, electric (HCPCS:E0600)

    2 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Other DME (D1E)

    Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) (HCPCS:E0630)

    2 DME suppliers used 77 Medicare Claims 77 Services Paid

  • Wheelchairs (D1D)

    Transport chair, adult size, patient weight capacity up to and including 300 pounds (HCPCS:E1038)

    1 DME suppliers used 25 Medicare Claims 25 Services Paid

  • Oxygen and supplies (D1C)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    1 DME suppliers used 13 Medicare Claims 13 Services Paid

  • Drugs Administered through DME (D1G)

    Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)

    6 DME suppliers used 18 Medicare Claims 2514 Services Paid

  • Drugs Administered through DME (D1G)

    Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

    4 DME suppliers used 12 Medicare Claims 780 Services Paid

  • Drugs Administered through DME (D1G)

    Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)

    5 DME suppliers used 11 Medicare Claims 966 Services Paid

  • Wheelchairs (D1D)

    Standard wheelchair (HCPCS:K0001)

    1 DME suppliers used 20 Medicare Claims 20 Services Paid

Drugs and Nutritional Products

  • Other drugs (O1E)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    9 DME suppliers used 29 Medicare Claims 29 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 07047 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $101.4
  • Minimum New Patient Price $66.45
  • Maximum New Patient Price $198.48
  • Average New Patient Copayment $25.35
  • Minimum New Patient Copayment $16.61
  • Maximum New Patient Copayment $49.62

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $116.86
  • Minimum Established Patient Price $21.27
  • Maximum Established Patient Price $162.58
  • Average Established Patient Copayment $29.21
  • Minimum Established Patient Copayment $5.31
  • Maximum Established Patient Copayment $40.64

* The physician office visit costs information is generated by 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 CMS 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.

  • Final Score: 91.59 out of 100

    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.

  • Quality Score: 92.8

    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 Score: 83.96

    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 Score: 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 activities measure category compromises 15% providers final MPIS scores.

    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 Score: 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.

  • Cost Score: 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.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 42

    Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)

  • 26

    Administration of influenza virus vaccine (HCPCS:G0008)

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NPI Validation Check Digit Calculation


The following table explains the step by step 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.
1972039402
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
29142031840
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 4 + 2 + 0 + 3 + 1 + 8 + 4 + 0 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 22

The NPI number 1972039402 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 8 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1558347583MARC GOLDSTEIN
Organization
Internal Medicine (Geriatric Medicine)8100 KENNEDY BLVD
NORTH BERGEN, NJ 07047
(201) 866-6770
1821268350MR. SABA FATIMA AZHAR M.D
Individual
Internal Medicine8100 KENNEDY BLVD
NORTH BERGEN, NJ 07047
(201) 866-6770
1780790568DR. MARCIA M GONZALEZ MD
Individual
Internal Medicine8100 KENNEDY BLVD
NORTH BERGEN, NJ 07047
(201) 866-6770
1518063577 BEATRICE LAUFER MD
Individual
Internal Medicine8100 KENNEDY BLVD
NORTH BERGEN, NJ 07047
(201) 866-6770
1508029042MRS. BILJANA SCOPULOVIC-NIKOLIC
Individual
Internal Medicine8100 KENNEDY BLVD
NORTH BERGEN, NJ 07047
(201) 866-6770
1518198563MRS. LESLIE HOPE GOLDSTEIN R.D.
Individual
Dietitian, Registered8100 KENNEDY BLVD
NORTH BERGEN, NJ 07047
(201) 655-3365
1770569568DR. MARC GOLDSTEIN D.O.C.M.D.
Individual
Family Medicine8100 KENNEDY BLVD
NORTH BERGEN, NJ 07047
(201) 866-6770
1609366780 ALENA TORONTO
Individual
Nurse Practitioner (Gerontology)8100 KENNEDY BLVD
NORTH BERGEN, NJ 07047
(201) 866-6770

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1972039402, enumerated in the NPI registry as an "individual" on May 03, 2017

The provider is located at 8100 Kennedy Blvd North Bergen, Nj 07047 and the phone number is (973) 287-4361

The provider's speciality is Nurse Practitioner with taxonomy code 363LA2200X with a focus in Adult Health

The provider might be accepting Accepts: Ambetter Health of Delaware. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 14, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $101.4 with an average copayment of $25.35 for new patient appointments. Established patients should expect a typical charge of $116.86 and an average copayment of 29.21. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Injection beneath the skin or into muscle for therapy, diagnosis, or prevention and Administration of influenza virus vaccine.

This NPI record was last updated on May 03, 2017. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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