MARK ALLEN WILLARD MD
NPI 1013053503
Internal Medicine in New Albany, OH
Quality Rating: 60 out of 100 score
NPI Status: Active since January 30, 2007
Contact Information
7277 SMITHS MILL RD
SUITE#250
NEW ALBANY, OH
ZIP 43054
Phone: (614) 221-3725
Fax: (614) 221-5613
- Individual
- Male
- Years of Experience 26
- Internal Medicine
- PECOS Enrolled
- Accepts Medicare Approved Payment
- Medicare Quality Reporting
About MARK WILLARD
Mark Willard is an internist established in New Albany, Ohio and his medical specialization is Internal Medicine with more than 26 years of experience. He graduated from Southern Illinois University School Of Medicine in 1998. The healthcare provider is registered in the NPI registry with number 1013053503 assigned on January 2007. The practitioner's primary taxonomy code is 207R00000X with license number 35080144 (OH). The provider is registered as an individual and his NPI record was last updated one year ago.
| NPI | 1013053503 |
| Provider Name | MARK ALLEN WILLARD MD |
| Location Address | 7277 SMITHS MILL RD SUITE#250 NEW ALBANY, OH 43054 |
| Location Phone | (614) 221-3725 |
| Mailing Address | 6480 HARRISON AVE STE 201 CINCINNATI, OH 45247 |
| Gender | Male |
| Entity Type | Individual |
| Medical School Name | SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1998 |
| Is Sole Proprietor? | No |
| Enumeration Date | 01-30-2007 |
| Last Update Date | 07-21-2023 |
| Code Navigator |
An internist like Mark Willard 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.
Mark Willard 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 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: engagement of new medicaid patients and follow-up, preventive care and screening: body mass index (bmi) screening and follow-up plan and provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record.
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.89 for a new patient copayment and $25.3 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.
- 35080144
- License State
- OH
- 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.
- NPI Profile Information
- Primary Taxonomy
- Insurance Plans Accepted
- PECOS Enrollment and Medicare Participation Status
- Physician Visit Costs
- Overall MIPS Quality Performance
- Quality Reporting
- Clinician Services
- Hospital Affiliations
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
Location Map
Mailing Address
6480 HARRISON AVE STE 201
CINCINNATI, OH
ZIP 45247
Phone: (614) 221-3725
Fax: (614) 221-5613
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 |
|---|---|---|---|
| 2285129 | MEDICAID (05) | OH |
PECOS Enrollment and Medicare Participation Status
Mark Willard 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: 6608761614
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: I20040218000848
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 43054 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $131.59
- Minimum New Patient Price $56.74
- Maximum New Patient Price $173.94
- Average New Patient Copayment $32.89
- Minimum New Patient Copayment $14.18
- Maximum New Patient Copayment $43.48
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $101.2
- Minimum Established Patient Price $17.31
- Maximum Established Patient Price $141.66
- Average Established Patient Copayment $25.3
- Minimum Established Patient Copayment $4.32
- Maximum Established Patient Copayment $35.41
* 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: 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.
-
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.
-
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 |
|---|---|---|
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 100% | 620 |
| 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. | ||
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.
- 361
Insertion of needle into vein for collection of blood sample (HCPCS:36415)
- 343
Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report (HCPCS:93010)
- 327
Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)
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. Mark Willard is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| GRANT MEDICAL CENTER | 111 SOUTH GRANT AVENUE COLUMBUS, OH 43215 | (614) 566-8952 | Acute Care Hospitals | |
| MOUNT CARMEL EAST & WEST | 6001 EAST BROAD STREET COLUMBUS, OH 43213 | (614) 234-5000 | Acute Care Hospitals | |
| GRADY MEMORIAL HOSPITAL | 561 WEST CENTRAL AVENUE DELAWARE, OH 43015 | (740) 368-5145 | Acute Care Hospitals | |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL | 7333 SMITH'S MILL ROAD NEW ALBANY, OH 43054 | (614) 775-6600 | Acute Care Hospitals | |
| DUBLIN METHODIST HOSPITAL | 7500 HOSPITAL AVENUE DUBLIN, OH 43016 | (614) 544-8694 | Acute Care Hospitals |
Reviews for MARK ALLEN WILLARD MD
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
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 | 1 | 3 | 0 | 5 | 3 | 5 | 0 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 2 | 3 | 0 | 5 | 6 | 5 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 2 + 3 + 0 + 5 + 6 + 5 + 0 + 24 = 47 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 47 = 3 | 3 | ||||||||
The NPI number 1013053503 is valid because the calculated check digit 3 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 |
|---|---|---|---|
| 1568467124 | CHAD E DYER CRNA Individual | Nurse Anesthetist, Certified Registered | 7277 SMITHS MILL RD STE 370 NEW ALBANY, OH 43054 (614) 939-5416 |
| 1386607943 | MS. ANITHA MOHAN MPT Individual | Physical Therapist | 7277 SMITHS MILL RD SUITE 100 NEW ALBANY, OH 43054 (614) 855-8030 |
| 1124181227 | MR. DEREK MICHAEL EGGERS PROVIDER CODE 22 Individual | Specialist/Technologist (Athletic Trainer) | 7277 SMITHS MILL RD NEW ALBANY, OH 43054 (614) 440-1577 |
| 1811051147 | MR. PAUL MCMULLEN PT Individual | Physical Therapist | 7277 SMITHS MILL RD NEW ALBANY, OH 43054 (614) 855-8304 |
| 1558407049 | JAMES D BLOCH DO Individual | Internal Medicine | 7277 SMITHS MILL RD SUITE # 250 NEW ALBANY, OH 43054 (614) 221-3725 |
| 1013047489 | KRISTI VOSS JOHNSTON PT Individual | Physical Therapist | 7277 SMITHS MILL RD SUITE 100 NEW ALBANY, OH 43054 (614) 855-8030 |
| 1679603526 | MRS. CHERYL CARMEN HALL PT Individual | Physical Therapist | 7277 SMITHS MILL RD NEW ALBANY, OH 43054 (614) 855-8030 |
| 1679782379 | MARTHA GILLIAM RN Individual | Registered Nurse (Home Health) | 7277 SMITHS MILL RD NEW ALBANY, OH 43054 (614) 855-7171 |
| 1376791632 | SHAUN WILLIAM COFFMAN DPT Individual | Physical Therapist | 7277 SMITHS MILL RD STE 100 NEW ALBANY, OH 43054 (614) 855-8030 |
| 1245595636 | DR. KARA AILEEN GOREY PT Individual | Physical Therapist | 7277 SMITHS MILL RD 100 NEW ALBANY, OH 43054 (614) 855-8030 |
| 1538447990 | KRISTINA ELIZABETH ZELLNER DPT, PT Individual | Physical Therapist | 7277 SMITHS MILL RD NEW ALBANY, OH 43054 (614) 855-8030 |
| 1174968705 | WHITE FENCE ANESTHESIA LLC Organization | Anesthesiology | 7277 SMITHS MILL RD SUITE 300 NEW ALBANY, OH 43054 (786) 251-5741 |
| 1407248354 | KATHERINE SIMA Individual | Nurse Anesthetist, Certified Registered | 7277 SMITHS MILL RD SUITE 370 NEW ALBANY, OH 43054 (614) 939-5416 |
| 1992006753 | CHRISTOPHER M HOBAN PA-C Individual | Physician Assistant (Surgical) | 7277 SMITHS MILL RD SUITE 200 NEW ALBANY, OH 43054 (614) 221-6331 |
| 1023465192 | DR. ROBERT HINTON DPT Individual | Physical Therapist | 7277 SMITHS MILL RD 100 NEW ALBANY, OH 43054 (614) 855-8030 |
| 1013455021 | MR. JOHN MATTHEW LANNING II PA-C Individual | Physician Assistant | 7277 SMITHS MILL RD SUITE 200 NEW ALBANY, OH 43054 (614) 221-6331 |
| 1033654934 | EMILY EVANS Individual | Physical Therapist | 7277 SMITHS MILL RD #100 NEW ALBANY, OH 43054 (614) 855-8030 |
| 1740360262 | PHYSIOTHERAPY ASSOCIATES INC Organization | Physical Therapist | 7277 SMITHS MILL RD SUITE 100 NEW ALBANY, OH 43054 (614) 855-8030 |
| 1548245566 | STARPATH ORTHOPAEDICS & SPORTS MEDICINE, INC. Organization | Orthopaedic Surgery | 7277 SMITHS MILL RD SUITE 200 NEW ALBANY, OH 43054 (614) 220-0398 |
| 1033468400 | WHITE FENCE SURGICAL SUITES, LLC Organization | Clinic/Center (Ambulatory Surgical) | 7277 SMITHS MILL RD SUITE 300 NEW ALBANY, OH 43054 (786) 251-5741 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1013053503, enumerated in the NPI registry as an "individual" on January 30, 2007
The provider is located at 7277 Smiths Mill Rd Suite#250 New Albany, Oh 43054 and the phone number is (614) 221-3725
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider has more than 26 years of experience. He graduated from Southern Illinois University School Of Medicine in 1998.
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 $131.59 with an average copayment of $32.89 for new patient appointments. Established patients should expect a typical charge of $101.2 and an average copayment of 25.3. 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: Insertion of needle into vein for collection of blood sample, Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report and Routine ekg using at least 12 leads including interpretation and report.
The practitioner is affiliated to the following hospital(s): GRANT MEDICAL CENTER, MOUNT CARMEL EAST & WEST, GRADY MEMORIAL HOSPITAL, MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL and DUBLIN METHODIST 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 January 30, 2007. 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.