STEWART G ALBERT MD
NPI 1417967969
Internal Medicine - Endocrinology, Diabetes & Metabolism in St Louis, MO
Quality Rating: 87.46 out of 100 score
NPI Status: Active since August 08, 2006
Contact Information
3660 VISTA
ST LOUIS, MO
ZIP 63110
Phone: (314) 977-6157
Fax: (314) 977-5177
- Individual
- Male
- Years of Experience 53
- Internal Medicine
- Endocrinology, Diabetes & Metabolism
- PECOS Enrolled
- Accepts Medicare Approved Payment
About STEWART ALBERT
Stewart Albert is an internist established in St Louis, Missouri and his medical specialization is Internal Medicine with a focus in endocrinology, diabetes & metabolism with more than 53 years of experience. He graduated from Albert Einstein College Of Medicine Of Yeshiva University in 1971. The healthcare provider is registered in the NPI registry with number 1417967969 assigned on August 2006. The practitioner's primary taxonomy code is 207RE0101X with license number R6729 (MO). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1417967969
- Provider Name
- STEWART G ALBERT MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3660 VISTA ST LOUIS, MO 63110
- Location Phone
- (314) 977-6157
- Location Fax
- (314) 977-5177
- Mailing Address
- 3691 RUTGER AVE PROVIDER ENROLLMENT ST LOUIS, MO 63110
- Mailing Phone
- (314) 977-4440
- Medical School Name
- ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
- Graduation Year
- 1971
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-08-2006
- Last Update Date
- 01-12-2021
- Code Navigator
An internist like Stewart Albert 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.
Stewart Albert 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 under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 87.46, 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: $33.46 for a new patient copayment and $25.84 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 Endocrinology, Diabetes & Metabolism
- Taxonomy Code
- 207RE0101X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- R6729
- License State
- MO
- Taxonomy Description
- An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Location Map
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Aetna CVS Health
- Bronze 2 HSA: Aetna network of doctors & hospitals + MinuteClinic + Virtual Care 24/7 - EPO
- Bronze 4: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - EPO
- Bronze S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - EPO
- Gold 3: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - EPO
- Gold S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - EPO
Ambetter from Arkansas Health & Wellness
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Complete Silver - PPO
- Complete Silver + Vision + Adult Dental - PPO
Ambetter from Home State Health
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Clear Silver - EPO
Ambetter from Nebraska Total Care
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
Ambetter from Sunflower Health Plan
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
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
Ambetter of Illinois
- Central Bronze - HMO
- Central Bronze + Vision + Adult Dental - HMO
- Central Gold - HMO
- Central Gold + Vision + Adult Dental - HMO
- Central Silver - HMO
Ambetter of Oklahoma
- Clear Gold - PPO
- Clear Gold + Vision + Adult Dental - PPO
- Clear Silver - PPO
- Clear Silver + Vision + Adult Dental - PPO
- Complete Silver - PPO
Ambetter of Tennessee
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
Anthem Blue Cross and Blue Shield
- Anthem Bronze Pathway 20% for HSA - EPO
- Anthem Bronze Pathway 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 6500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500/50% Standard - EPO
- Anthem Bronze Pathway 9450 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Medica
- WellFirst by Medica Bronze Copay PCP 8000X (Free Virtual Visits) - EPO
- WellFirst by Medica Bronze Copay Plus 9400X (Free Virtual Visits) - EPO
- WellFirst by Medica Bronze Copay Plus 9400X (Free Virtual Visits) - HMO
- WellFirst by Medica Bronze HSA-E HDHP 7450X - EPO
- WellFirst by Medica Bronze HSA-E HDHP 7450X - HMO
Oscar Insurance Company
- Bronze Classic - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic PCP Saver Plus - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
Medicare
Medicaid
*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 |
---|---|---|---|
200700201 | MEDICAID (05) | MO | |
354671002 | MEDICAID (05) | IL |
PECOS Enrollment and Medicare Participation Status
Stewart Albert 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: 6800924770
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: I20100513000684
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
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)
42 DME suppliers used 105 Medicare Claims 402 Services Paid
Other DME (D1E)
Normal, low and high calibrator solution / chips (HCPCS:A4256)
3 DME suppliers used 12 Medicare Claims 12 Services Paid
Other DME (D1E)
Lancets, per box of 100 (HCPCS:A4259)
21 DME suppliers used 37 Medicare Claims 59 Services Paid
Other DME (D1E)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
6 DME suppliers used 47 Medicare Claims 47 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 63110 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $133.86
- Minimum New Patient Price $58.16
- Maximum New Patient Price $176.77
- Average New Patient Copayment $33.46
- Minimum New Patient Copayment $14.54
- Maximum New Patient Copayment $44.19
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $103.38
- Minimum Established Patient Price $18.08
- Maximum Established Patient Price $144.4
- Average Established Patient Copayment $25.84
- Minimum Established Patient Copayment $4.52
- Maximum Established Patient Copayment $36.1
* 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: 87.46 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: 93.03
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: 71
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.
- 22
Hemoglobin a1c level (HCPCS:83036)
- 12
Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth (HCPCS:G0425)
Hospital Affiliations
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Stewart Albert is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL | 3635 VISTA AVE SAINT LOUIS, MO 63110 | (314) 577-8000 | Acute Care Hospitals |
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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 | 4 | 1 | 7 | 9 | 6 | 7 | 9 | 6 | 9 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 4 | 2 | 7 | 18 | 6 | 14 | 9 | 12 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 4 + 2 + 7 + 1 + 8 + 6 + 1 + 4 + 9 + 1 + 2 + 24 = 71 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
80 - 71 = 9 | 9 |
The NPI number 1417967969 is valid because the calculated check digit 9 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 |
---|---|---|---|
1548238397 | REBECCA FLORENCE WILKINS PAC Individual | Physician Assistant | 3660 VISTA STE 308 ST LOUIS, MO 63110 (314) 977-6150 |
1730157538 | MRS. EVE MARIE HOLZEMER ANP Individual | Nurse Practitioner (Adult Health) | 3660 VISTA ST LOUIS, MO 63110 (314) 977-6082 |
1225006612 | MRS. CAROLYN D PHILPOT GNP BC Individual | Registered Nurse | 3660 VISTA ST LOUIS, MO 63110 (314) 977-6055 |
1861460180 | PATRICIA ANN DETTENMEIER MSN CS Individual | Registered Nurse (Critical Care Medicine) | 3660 VISTA ST LOUIS, MO 63110 (314) 977-6190 |
1982665675 | DENNIS PAUL FULLER PHD CCC SLP Individual | Speech-Language Pathologist | 3660 VISTA ST LOUIS, MO 63110 (314) 977-5110 |
1043237019 | PREBEN BJERREGAARD MD Individual | Internal Medicine (Cardiovascular Disease) | 3660 VISTA SAINT LOUIS, MO 63110 (314) 577-8890 |
1124045703 | JOHN B SELHORST MD Individual | Psychiatry & Neurology (Neurology) | 3660 VISTA ST LOUIS, MO 63110 (314) 577-8738 |
1255358842 | THOMAS J DONOVAN MD Individual | Otolaryngology | 3660 VISTA ST LOUIS, MO 63110 (314) 577-8887 |
1164449757 | JOHN A STITH MD Individual | Otolaryngology | 3660 VISTA ST LOUIS, MO 63110 (314) 577-8887 |
1902824717 | MICHAEL J ODELL MD Individual | Otolaryngology | 3660 VISTA ST LOUIS, MO 63110 (314) 577-8887 |
1932117819 | MEDHAT M OSMAN MD Individual | Nuclear Medicine | 3660 VISTA ST LOUIS, MO 63110 (314) 577-8047 |
1710995568 | JOSEPH H FLAHERTY MD Individual | Internal Medicine (Geriatric Medicine) | 3660 VISTA ST LOUIS, MO 63110 (314) 977-8462 |
1730197617 | DANIEL F HOFT MD Individual | Internal Medicine (Infectious Disease) | 3660 VISTA ST LOUIS, MO 63110 (314) 577-8648 |
1366450231 | MARY S BURTON MD Individual | Internal Medicine (Gastroenterology) | 3660 VISTA SAINT LOUIS, MO 63110 (314) 577-8764 |
1326056292 | BERNARD R CHAITMAN MD Individual | Internal Medicine (Cardiovascular Disease) | 3660 VISTA ST LOUIS, MO 63110 (314) 725-4668 |
1851302418 | JOHN E MORLEY MD Individual | Internal Medicine (Geriatric Medicine) | 3660 VISTA ST LOUIS, MO 63110 (314) 977-8462 |
1063526978 | DONALD J KENNEDY MD Individual | Internal Medicine (Infectious Disease) | 3660 VISTA ST LOUIS, MO 63110 (314) 577-8648 |
1386851012 | MRS. MARY WELLS MOORE MSW LCSW Individual | Social Worker | 3660 VISTA 105 ST LOUIS, MO 63110 (314) 977-6008 |
1023026804 | CHANTRI TRINH MD Individual | Internal Medicine (Geriatric Medicine) | 3660 VISTA ST LOUIS, MO 63110 (314) 977-8462 |
1578650362 | JOSEPH ROLAND DIANO ESPIRITU MD, MSPH Individual | Internal Medicine (Sleep Medicine) | 3660 VISTA ST. LOUIS, MO 63110 (314) 577-8856 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417967969, enumerated in the NPI registry as an "individual" on August 08, 2006
The provider is located at 3660 Vista St Louis, Mo 63110 and the phone number is (314) 977-6157
The provider's speciality is Internal Medicine with taxonomy code 207RE0101X with a focus in Endocrinology, Diabetes & Metabolism
The provider has more than 53 years of experience. He graduated from Albert Einstein College Of Medicine Of Yeshiva University in 1971.
The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Arkansas Health &. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 10, 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.
Medicare beneficiaries should expect a typical cost of $133.86 with an average copayment of $33.46 for new patient appointments. Established patients should expect a typical charge of $103.38 and an average copayment of 25.84. 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: Hemoglobin a1c level and Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth.
The practitioner is affiliated to the following hospital(s): SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on August 08, 2006. 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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