KELLY JUNE CASPERSON M.D.
NPI 1992828743
Urology in Bellingham, WA

Quality Rating: 88.18 out of 100 score

NPI Status: Active since April 09, 2007

Contact Information

3232 SQUALICUM PKWY
BELLINGHAM, WA
ZIP 98225
Phone: (360) 733-7687
Fax: (360) 756-2008

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Table of Contents

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
Overall Quality Performance
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Urology
Accepts Insurance
PECOS Enrolled
Opted-Out Medicare
Medicare Quality Reporting

About KELLY CASPERSON

This page provides the complete NPI Profile along with additional information for Kelly Casperson, a provider established in Bellingham, Washington with a medical specialization in Urology. The healthcare provider is registered in the NPI registry with number 1992828743 assigned on April 2007. The practitioner's primary taxonomy code is 208800000X with license number MD60270123 (WA). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI: 1992828743
Provider Name: KELLY JUNE CASPERSON M.D.
Gender: Female
Entity Type: Individual
Location Address: 3232 SQUALICUM PKWY BELLINGHAM, WA 98225
Location Phone: (360) 733-7687
Location Fax: (360) 756-2008
Mailing Address: 3232 SQUALICUM PKWY BELLINGHAM, WA 98225
Mailing Phone: (360) 733-7687
Mailing Fax: (360) 756-2008
Is Sole Proprietor?: No
Enumeration Date: 04-09-2007
Last Update Date: 05-28-2021
Code Navigator

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Kelly Casperson opted out of Medicare effective on 02-06-2025 until 02-06-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.

Location Map

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: Urology
Taxonomy Code: 208800000X
Type: Allopathic & Osteopathic Physicians
License No.: MD60270123
License State: WA
Taxonomy Description: A 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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	208800000X	Allopathic & Osteopathic Physicians	Urology	2051 (CO)

Insurance Plans Accepted

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

PacificSource Health Plans

Core Bronze HSA 10600 - EPO
Core Bronze HSA 7500 - EPO
Core Bronze HSA 8300 - EPO
Core Gold 1500 - EPO
Core Gold 3000 - EPO
Core Silver 3500 - EPO
Core Silver 4500 - EPO
Core Silver 5000 - EPO
Core Silver 7500 - EPO
Core Standard Expanded Bronze HSA - EPO
Core Standard Gold - EPO
Core Standard Silver - EPO
PacificSource Oregon Standard Bronze HSA Plan Core - EPO
PacificSource Oregon Standard Gold Plan Core - EPO
PacificSource Oregon Standard Silver Plan Core - EPO

Premera Blue Cross Blue Shield of Alaska

Premera Blue Cross Alaska One Gold - PPO
Premera Blue Cross Preferred Bronze 5800 HSA - PPO
Premera Blue Cross Preferred Bronze 6350 - PPO
Premera Blue Cross Preferred Gold 1500 - PPO
Premera Blue Cross Preferred Silver 4500 - PPO
Premera Blue Cross Standard Bronze II - PPO
Premera Blue Cross Standard Gold - PPO
Premera Blue Cross Standard Silver - PPO
Premera Blue Cross Family Dental - PPO
Premera Blue Cross Pediatric Dental - PPO

Providence Health Plan

HSA-E Qualified 7500 Bronze - Signature Network - EPO
Providence Oregon Standard Bronze Plan - Signature Network - EPO
Providence Oregon Standard Gold Plan - Signature Network - EPO
Providence Oregon Standard Silver Plan - Signature Network - EPO

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

Medicare Participation & PECOS Enrollment Status

Kelly Casperson 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
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 02-06-2025
Opt-Out End Date: 02-06-2027
Eligible to Order and Refer? 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

DME-Medical/Surgical Supplies (DA000N)
Lubricant, individual sterile packet, each (HCPCS:A4332)
1 DME suppliers used 14 Medicare Claims 2100 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Male external catheter, with or without adhesive, disposable, each (HCPCS:A4349)
1 DME suppliers used 14 Medicare Claims 454 Services Paid

Orthotic Devices

DME-Orthotic Devices (DF000N)
Urinary catheter anchoring device, adhesive skin attachment, each (HCPCS:A4333)
1 DME suppliers used 20 Medicare Claims 28 Services Paid
DME-Orthotic Devices (DF000N)
Urinary catheter anchoring device, leg strap, each (HCPCS:A4334)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Orthotic Devices (DF008N)
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)
4 DME suppliers used 58 Medicare Claims 9780 Services Paid
DME-Orthotic Devices (DF000N)
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each (HCPCS:A4357)
2 DME suppliers used 12 Medicare Claims 16 Services Paid
DME-Orthotic Devices (DF000N)
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each (HCPCS:A4358)
1 DME suppliers used 23 Medicare Claims 46 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Automated urinalysis test
Bacterial colony count, urine
Biopsy of prostate gland
Complex measurement of pressure of urine flow in bladder with voiding pressure studies
Diagnostic exam of bladder and urethra using an endoscope
Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming
Electronic assessment of bladder emptying
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 30-39 minutes
Exam with injections of chemical for destruction of bladder using an endoscope
Injection of implant material beneath lining of bladder and/or urethra using an endoscope
Insertion of device into abdomen with pressure and urine flow rate study
Insertion of needle into vein for collection of blood sample
Insertion of peripheral or gastric neurostimulator generator
Insertion of sacral nerve neurostimulator electrode array
Insertion of stent in ureter using an endoscope
New patient office or other outpatient visit, 45-59 minutes
Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings
Prostate resection
Psa (prostate specific antigen) measurement, total
Repair of pelvic ligaments through vagina
Ultrasonic guidance for needle placement
Ultrasound measurement of bladder capacity after voiding
X-ray of abdomen, 1 view

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 98225 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $130.99
Minimum New Patient Price $57.27
Maximum New Patient Price $172.8

Average New Patient Copayment $32.74
Minimum New Patient Copayment $14.31
Maximum New Patient Copayment $43.2

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $71.29
Minimum Established Patient Price $18.56
Maximum Established Patient Price $141.11

Average Established Patient Copayment $17.82
Minimum Established Patient Copayment $4.64
Maximum Established Patient Copayment $35.27

* 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 provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 88.18, 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 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: 88.18 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: 98.39

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: N/A

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: 62.74

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: 62.74

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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Documentation of Current Medications in the Medical Record	94%	1106
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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing	98%	436
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Falls: Screening for Future Fall Risk	56%	568
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Medication Reconciliation	94%	220
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.
Patient-Specific Education	45%	442
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.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	41%	897
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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access	84%	442
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 certain information.
Secure Messaging	32%	442
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 message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Tobacco use	Yes	N/A
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence.
Use of High-Risk Medications in the Elderly	1% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	568
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. 2) Percentage of patients who were ordered at least two of the same high-risk medication

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1992828743, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 77. The final step is to find the difference between that total and the next multiple of ten (80 - 77 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 16 → 1 + 6

Pos 6

Unchanged

Pos 7

Doubled → 16 → 1 + 6

Pos 8

Unchanged

Pos 9

Doubled → 8

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 8 → 16 → 7 8 → 16 → 7 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 1 + 8 + 2 + 1 + 6 + 2 + 1 + 6 + 7 + 8 + 24 = 77

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 77 is 80. The difference is the calculated check digit.

80 - 77 = 3

This NPI is valid

The calculated check digit is 3, which matches the last digit of 1992828743.