DR. DAVID JAMES ABRAHAM M.D.
NPI 1205897964
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in Wyomissing, PA
Quality Rating: 60 out of 100 score
NPI Status: Active since March 31, 2006
Contact Information
1270 BROADCASTING RD
WYOMISSING, PA
ZIP 19610
Phone: (610) 372-1140
Fax: (610) 372-7684
- Individual
- Male
- Orthopaedic Surgery
- Orthopaedic Surgery of the Spine
- PECOS Enrolled
- Medicare Quality Reporting
About DAVID ABRAHAM
David Abraham is a provider established in Wyomissing, Pennsylvania and his medical specialization is Orthopaedic Surgery with a focus in orthopaedic surgery of the spine . The healthcare provider is registered in the NPI registry with number 1205897964 assigned on March 2006. The practitioner's primary taxonomy code is 207XS0117X with license number MD054229L (PA). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1205897964
- Provider Name
- DR. DAVID JAMES ABRAHAM M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1270 BROADCASTING RD WYOMISSING, PA 19610
- Location Phone
- (610) 372-1140
- Location Fax
- (610) 372-7684
- Mailing Address
- 1270 BROADCASTING RD WYOMISSING, PA 19610
- Mailing Phone
- (610) 927-1636
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-31-2006
- Last Update Date
- 03-07-2023
- Code Navigator
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 60, 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 following quality measures were reported for this provider: care plan, pneumococcal vaccination status for older adults, preventive care and screening: body mass index (bmi) screening and follow-up plan and screening for osteoporosis for women aged 65-85 years of age.
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
Orthopaedic Surgery Orthopaedic Surgery of the Spine
- Taxonomy Code
- 207XS0117X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD054229L
- License State
- PA
- Taxonomy Description
- Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive.
Location Map
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Railroad Medicare
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 |
---|---|---|---|
DA6715 | OTHER (01) | PA | RAILROAD MEDICARE |
MD05842296 | OTHER (01) | PA | MED LIC # |
PECOS Enrollment and Medicare Participation Status
David Abraham 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.
Prosthetic and Orthotic Devices
Prosthetic/Orthotic devices (D1F)
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf (HCPCS:L0650)
2 DME suppliers used 12 Medicare Claims 12 Services Paid
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.
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Final Score: 60 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.
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Quality Score: N/A
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.
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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: N/A
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.
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 |
---|---|---|
Care Plan | 100% | 262 |
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
Pneumococcal Vaccination Status for Older Adults | 81% | 240 |
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 | 100% | 278 |
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 | ||
Screening for Osteoporosis for Women Aged 65-85 Years of Age | 72% | 107 |
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis |
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.
- 38
Partial removal of spine bone with release of spinal cord and/or nerves (HCPCS:63048)
- 20
Partial removal of middle spine bone with release of spinal cord and/or nerves (HCPCS:63047)
Reviews for DR. DAVID JAMES ABRAHAM 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 | 2 | 0 | 5 | 8 | 9 | 7 | 9 | 6 | 4 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 0 | 5 | 16 | 9 | 14 | 9 | 12 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 2 + 0 + 5 + 1 + 6 + 9 + 1 + 4 + 9 + 1 + 2 + 24 = 66 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 66 = 4 | 4 |
The NPI number 1205897964 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 14 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1427059906 | MRS. ANDREA M YANNELLI-CLARK PT Individual | Physical Therapist | 1270 BROADCASTING RD WYOMISSING, PA 19610 (610) 372-1586 |
1841292836 | DEBORA L BOONE PT Individual | Physical Therapist | 1270 BROADCASTING RD WYOMISSING, PA 19610 (610) 372-1140 |
1043206899 | THE READING NECK AND SPINE CENTER Organization | Orthopaedic Surgery (Orthopaedic Surgery of the Spine) | 1270 BROADCASTING RD WYOMISSING, PA 19610 (610) 372-1140 |
1487610663 | JEFFREY L MARTINEZ P.A. Individual | Physician Assistant | 1270 BROADCASTING RD WYOMISSING, PA 19610 (610) 372-1140 |
1316090517 | THE READING NECK AND SPINE CENTER Organization | Physical Therapist (Orthopedic) | 1270 BROADCASTING RD WYOMISSING, PA 19610 (610) 372-1140 |
1346541034 | KEYSTONE ORTHOPAEDIC SPECIALISTS LLC Organization | Durable Medical Equipment & Medical Supplies | 1270 BROADCASTING RD WYOMISSING, PA 19610 (610) 372-1140 |
1326323098 | KEYSTONE ORTHOPAEDIC SPECIALISTS GROUP LLC Organization | Orthopaedic Surgery | 1270 BROADCASTING RD WYOMISSING, PA 19610 (610) 376-5600 |
1891064036 | KEYSTONE ORTHOPAEDIC SPECIALISTS GROUP LLC Organization | Physical Therapist | 1270 BROADCASTING RD WYOMISSING, PA 19610 (610) 376-5600 |
1740507912 | KEYSTONE ORTHOPAEDIC SPECIALISTS Organization | Durable Medical Equipment & Medical Supplies | 1270 BROADCASTING RD REAR WYOMISSING, PA 19610 (610) 376-5600 |
1255666012 | KEYSTONE ORTHOPAEDIC SPECIALISTS, LLC Organization | Orthopaedic Surgery | 1270 BROADCASTING RD WYOMISSING, PA 19610 (610) 376-5600 |
1831602747 | BERKSHIRE ORTHOPEDICS LLC Organization | Durable Medical Equipment & Medical Supplies | 1270 BROADCASTING RD WYOMISSING, PA 19610 (610) 372-1140 |
1144708173 | LEONARD J MARCHINSKI, MD PC Organization | Durable Medical Equipment & Medical Supplies | 1270 BROADCASTING RD WYOMISSING, PA 19610 (484) 709-1515 |
1811079171 | LEONARD J MARCHINSKI MD PC Organization | Orthopaedic Surgery | 1270 BROADCASTING RD WYOMISSING, PA 19610 (484) 709-1515 |
1326644998 | STEPHANY ANN BAUGHMAN Individual | Health Educator | 1270 BROADCASTING RD WYOMISSING, PA 19610 (717) 413-6349 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205897964, enumerated in the NPI registry as an "individual" on March 31, 2006
The provider is located at 1270 Broadcasting Rd Wyomissing, Pa 19610 and the phone number is (610) 372-1140
The provider's speciality is Orthopaedic Surgery with taxonomy code 207XS0117X with a focus in Orthopaedic Surgery of the Spine
The provider might be accepting Accepts: Railroad Medicare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 21, 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 most common procedures or services performed by this practitioner are: Partial removal of spine bone with release of spinal cord and/or nerves and Partial removal of middle spine bone with release of spinal cord and/or nerves.
This NPI record was last updated on March 31, 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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