DR. NATASHA A FUKSINA M.D.
NPI 1053398065
Internal Medicine in Newark, NJ
NPI Status: Active since December 30, 2005
Contact Information
550 BLOOMFIELD AVE
NEWARK, NJ
ZIP 07107
Phone: (973) 483-1500
Fax: (973) 483-4577
- Individual
- Female
- Years of Experience 27
- Internal Medicine
- PECOS Enrolled
- Accepts Medicare Approved Payment
- Medicare Quality Reporting
About NATASHA FUKSINA
Natasha Fuksina is an internist established in Newark, New Jersey and her medical specialization is Internal Medicine with more than 27 years of experience. She graduated from Albany Medical College Of Union University in 1997. The healthcare provider is registered in the NPI registry with number 1053398065 assigned on December 2005. The practitioner's primary taxonomy code is 207R00000X with license number 25MA07003100 (NJ). The provider is registered as an individual and her NPI record was last updated 16 years ago.
| NPI | 1053398065 |
| Provider Name | DR. NATASHA A FUKSINA M.D. |
| Location Address | 550 BLOOMFIELD AVE NEWARK, NJ 07107 |
| Location Phone | (973) 483-1500 |
| Mailing Address | 550 BLOOMFIELD AVE NEWARK, NJ 07107 |
| Gender | Female |
| Entity Type | Individual |
| Medical School Name | ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY |
| Graduation Year | 1997 |
| Is Sole Proprietor? | No |
| Enumeration Date | 12-30-2005 |
| Last Update Date | 05-01-2008 |
| Code Navigator |
An internist like Natasha Fuksina is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Natasha Fuksina is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
The provider participated in CMS Quality Payment Program and the following quality measures were reported: diabetes: medical attention for nephropathy, documentation of current medications in the medical record, e-prescribing, falls: screening for future fall risk, implementation of improvements that contribute to more timely communication of test results, medication reconciliation, patient-specific education, pneumococcal vaccination status for older adults, preventive care and screening: body mass index (bmi) screening and follow-up plan, preventive care and screening: influenza immunization, preventive care and screening: tobacco use: screening and cessation intervention, provide patient access, regular training in care coordination, secure messaging and security risk analysis. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.
The typical physician office visit costs for Medicare beneficiaries in this area are: $37.64 for a new patient copayment and $29.21 for an established patient copayment.
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
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25MA07003100
- License State
- NJ
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Location Map
Mailing Address
550 BLOOMFIELD AVE
NEWARK, NJ
ZIP 07107
Phone: (973) 483-1500
Fax: (973) 483-4577
Insurance Plans Accepted
The NPI profile data suggests this provider may be accepting health plans from these insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 364544263 | OTHER (01) | NJ | TAX ID NUMBER |
| H49343 | MEDICARE UPIN (02) | NJ | |
| 051520 | MEDICARE ID-TYPE UNSPECIFIED (04) | NJ |
PECOS Enrollment and Medicare Participation Status
Natasha Fuksina 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
PECOS PAC ID: 7315932258
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20051227000012
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.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 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
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 07107 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $150.56
- Minimum New Patient Price $66.45
- Maximum New Patient Price $198.48
- Average New Patient Copayment $37.64
- 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.
Quality Reporting
The following quality measures meet Medicare's statistical reporting standards for the year 2018. 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 |
|---|---|---|
| Diabetes: Medical Attention for Nephropathy | 53% | 49 |
| 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 | ||
| Documentation of Current Medications in the Medical Record | 86% | 802 |
| 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 | 87% | 12656 |
| 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 | 3% | 58 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Implementation of improvements that contribute to more timely communication of test results | Yes | N/A |
| Timely communication of test results defined as timely identification of abnormal test results with timely follow-up. | ||
| Medication Reconciliation | 99% | 4144 |
| 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 | 87% | 996 |
| 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. | ||
| Pneumococcal Vaccination Status for Older Adults | 50% | 58 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 46% | 365 |
| 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 | ||
| Preventive Care and Screening: Influenza Immunization | 43% | 318 |
| 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 | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 13% | 52 |
| 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 | ||
| Provide Patient Access | 0% | 996 |
| 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. | ||
| Regular training in care coordination | Yes | N/A |
| Implementation of regular care coordination training. | ||
| Secure Messaging | 0% | 996 |
| 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. | ||
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.
- 56
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
- 40
Administration of influenza virus vaccine (HCPCS:G0008)
- 38
Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
- 26
Ultrasound study of arteries of both arms and legs (HCPCS:93922)
- 16
Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)
Reviews for DR. NATASHA A FUKSINA M.D.
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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. | |||||||||
| 1 | 0 | 5 | 3 | 3 | 9 | 8 | 0 | 6 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 10 | 3 | 6 | 9 | 16 | 0 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 0 + 3 + 6 + 9 + 1 + 6 + 0 + 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 = 5 | 5 | ||||||||
The NPI number 1053398065 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 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1801939723 | DR. MARIAM S RUBBANI MD Individual | Specialist | 550 BLOOMFIELD AVE NEWARK, NJ 07107 (973) 483-1500 |
| 1841528080 | ASTRA MD P C Organization | Internal Medicine | 550 BLOOMFIELD AVE NEWARK, NJ 07107 (973) 483-1500 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053398065, enumerated in the NPI registry as an "individual" on December 30, 2005
The provider is located at 550 Bloomfield Ave Newark, Nj 07107 and the phone number is (973) 483-1500
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider has more than 27 years of experience. She graduated from Albany Medical College Of Union University in 1997.
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of April 12, 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.
Medicare beneficiaries should expect a typical cost of $150.56 with an average copayment of $37.64 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: Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Administration of influenza virus vaccine, Injection beneath the skin or into muscle for therapy, diagnosis, or prevention, Ultrasound study of arteries of both arms and legs and Routine ekg using at least 12 leads including interpretation and report.
This NPI record was last updated on December 30, 2005. 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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