ACO Name and Location
Equity Care Partners, LLC
40 Burton Hills Blvd
Suite 370
Nashville, TN 37215
ACO Primary Contact
Primary Contact Name: Kristin Shaw, MPH, Director of Medicare ACO
Primary Contact Phone: 855-333-2070
Primary Contact Email: MSSPRevereACO@reveremedical.com
Organizational Information
ACO Participants
ACO Participants
ACO Participant in Joint Venture
JOSEPH GURKA
N
LAKEVILLE FAMILY MEDICINE PC
N
LIANNE INC
N
MEDICAL ASSOCIATES OF WARREN INC
N
PAUL BURNS
N
PRIME MEDICAL ASSOCIATES, LLC
N
RESIL MEDICAL ASSOCIATES PC
N
ANTHONY F MARINO MD PC
N
MITCHELL ABRAMSON
N
NEW BOSTON VILLAGE PRIMARY CARE PROFESSIONAL CORPORATION
N
NEW WILMINGTON FAMILY MEDICINE ASSOCIATES P C
N
CRIPPS, HOOPER & RHODY, PLLC
N
CROSSROADS MEDICAL GROUP, PLLC
N
WEST WILSON FAMILY PRACTICE CENTER PC
N
RHC GROUP PLLC
N
NORTHSIDE MEDICAL PROFESSIONALS, P.C.
N
Carol S Savage
N
I&B Medical Associates, PLLC
N
ACO Governing Body
Member First Name
Member Last Name
Member Title/Position
Member’s Voting Power (Expressed as a percentage or number)
Membership Type
ACO Participant Legal Business Name and D/B/A, if applicable
Charles
Mullins
Provider Manager
15%
ACO Participant Representative
CROSSROADS MEDICAL GROUP, PLLC
Charles
Grant Johnson
Provider Manager
15%
ACO Participant Representative
CROSSROADS MEDICAL GROUP, PLLC
Nicholas
Winchester
Provider Manager
15%
ACO Participant Representative
RHC Group, PLLC
Natalie
Gilley
Provider Manager
15%
ACO Participant Representative
CROSSROADS MEDICAL GROUP, PLLC
Danielle
Joslin
Provider Manager
15%
ACO Participant Representative
CROSSROADS MEDICAL GROUP, PLLC
Benson
Sloan
Member Manager
5%
Other
N/A
Mark
Jansen
Member Manager
5%
Other
N/A
Tommy
Jansen
Member Manager
5%
Other
N/A
Andrew
Herman
Member Manager
5%
Other
N/A
Joseph
Weinstein
Member Manager
5%
Other
N/A
TBD
Beneficiary Manager
0%
Medicare Beneficiary Representative
N/A
Key ACO Clinical and Administrative Leadership
ACO Executive: Kristin Shaw
Medical Director: Dr. Joseph Weinstein
Compliance Officer: Kimberly Anderson
Quality Assurance/Improvement Officer: Virgina Rego
Associated Committees and Committee Leadership
Committee Name
Committee Leader Name and Position
Revere Medicare ACO Compliance Committee
Kimberly Anderson, Director of Compliance
Types of ACO Participants, or Combinations of Participants, That Formed the ACO
- ACO professionals in a group practice arrangement
- Networks of Individual Practices
Performance Results
- N/A
Member First Name
Member Last Name
Member Title/Position
Membership Type
ACO Participant Legal Business Name and D/B/A, if applicable
Nabil
Aziz
Provider Manager
15%
ACO Participant Representative
Nabil W Aziz MD PA
Paul
Burns
15%
Burns
ACO Participant Representative
Paul Burns
Payment Rule Waivers
- N/A
Fraud and Abuse Waivers
- ACO Pre-Participation Waiver:
The following information describes each arrangement for which our ACO seeks protection under the ACO Pre-Participation Waiver, including any material amendment or modification to a disclosed arrangement: N/A - ACO Participation Waiver:
The following information describes each arrangement for which our ACO seeks protection under the ACO Participation Waiver, including any material amendment or modification to a disclosed arrangement: N/A