Jay Ellworth Champlin, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD2019-0524 Issued in NM

Practice address

5230 Centre Ave
Pittsburgh, PA 15232-1304

Phone

(412) 623-2465

NPI assigned

Mar 27, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

University of Pittsburgh School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology Associates of Albuquerque PAGroup PAC ID 2860304482, 103 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021
• Presbyterian Santa Fe Medical Center Hospital, Santa Fe, NM, CCN 320090
• Plains Regional Medical Center Hospital, Clovis, NM, CCN 320022

Merit-based Incentive Payment System (MIPS)

Final score

89.28 of 100Reported as group

Quality

90

Improvement activities

40

Cost

77.05

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Radiology Associates of Albuquerque, PA

  • Diagnostic Radiology Physician
  • Albuquerque, NM
  • NPI 1881666998
  Medicare reassignment Care Compare group NPD
• Advanced Imaging LLC

  • Diagnostic Radiology Physician
  • Albuquerque, NM
  • NPI 1558416974
  Medicare reassignment NPD
• Advanced Imaging LLC

  • Body Imaging Physician
  • Albuquerque, NM
  • NPI 1851363972
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  Care Compare affiliation
• Presbyterian Healthcare Services

  • Psychiatric Hospital Unit
  • Albuquerque, NM
  • NPI 1598740482
  Care Compare affiliation
• Presbyterian Healthcare Services

  • Rural Acute Care Hospital
  • Clovis, NM
  • NPI 1629053509
  Care Compare affiliation
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1730684853
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1407199540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UW RADIOLOGY DEPT RR 210",
            "address_2": "1959 N.E. PACIFIC STREET, BOX 357115",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981957115",
            "telephone_number": "206-598-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 CENTRE AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152321304",
            "telephone_number": "412-623-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPLIN",
        "first_name": "JAY",
        "middle_name": "ELLWORTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-27",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NM",
            "license": "MD2019-0524",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MD2019-0524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnie R Champ, RN CRNP
• Pierre-Olivier Champagne, MD
• Jesse Champi, M.D.
• Cynthia Fuller Champion, MT, AMT,HEW
• Kimberly Champion, PSYD
• Nadine Champsi, MD
• Jauhleene Chamu
• Janet Chan Gomez, MD
• Audrey A Chan, MD
• Brandon W Chan, MD

• Diagnostic Radiology Physician in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.