Phone: (310) 825-5111 Our USC Spine Center surgeons offer tailored treatment options for all types of spine conditions, from simple to complex. His staff are friendly, and very helpful. Your review has been sent successfully. Based on some preliminary studies done in primates early in his career it was discovered that cerebral blood flow could be augmented by various manipulations of the cardiovascular system. , Los Angeles He specializes in brain tumors, cerebrovascular neurosurgery, brain aneurysms, and brain AVMs. 1409 E Briggsmore Ave, Modesto, CA, 95355. All Kaiser Permanente Medical Group physicians and network physicians are subject to the same quality review processes and certifications. This page was last updated on: 03/03/2023, Kaiser Permanente health plans around the country: Kaiser Foundation Health Plan, Inc., in Northern and Southern California and Hawaii Kaiser Foundation Health Plan of Colorado Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont Road NE, Atlanta, GA 30305, 404-364-7000 Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., in Maryland, Virginia, and Washington, D.C., 2101 E. Jefferson St., Rockville, MD 20852 Kaiser Foundation Health Plan of the Northwest, 500 NE Multnomah St., Suite 100, Portland, OR 97232 Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc.,1300 SW 27thSt., Renton, WA 98057, Selecting these linkswill take you away from KP.org. Dr. Baron will do everything he can to help you and guide you through your procedure. Find the Best Neurosurgeon near you in Oceanside, CA . A hands-on approach by leaders in the neurology and neuroscience field, who are delivering your care. Neurosurgeon/Spine Surgeon Dr. Lobo is a neurosurgeon who specializes in the treatment of brain tumors that arise from the base of the skull and the pituitary gland. Here are the top 50 hospitals for neurosurgery and neurology: Note: Some hospitals were tied in ranking based on their scores. external page. You can also call Medi-Cal Rx Customer Service at 1-800-977-2273, 24 hours a day, 7 days a week (TTY 711 Monday through Friday, 8 a.m. to 5 p.m.). Residency, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Florida. Website: www.gregory-p-lekovic-md-phd.business.site, He is the best doctor. In 2008, he joined the world famous House Clinic in L.A. Received a Laminectomy, Compression, fusion and rods..15 days later, I am feeling so much better. It does not have to be a Kaiser Permanente network pharmacy. . I have a passion for improving systems and how they work. He and his entire staff were so great! Your message has been successfully sent to the business owner. He returned my calls several times to reassure me and ally my fears before surgery, and later, between surgeries, when I experienced unusual pain. Great surgeon. Please try later. Kaiser Permanente San Diego is also an integral part of UCLA's Neurotology Fellowship Program. 1. 2125 Arizona Ave., Dr. Ostrup has been practicing medicine since 1993 and was board certified in Neurosurgery in 1991. Neurology, Neurological Surgery. Because of Dr. Fox, I have no more pain at my neck after a successful ACDF surgery! Dr. Mark has been practicing in Escondido for over 30 years. Kaiser Permanente uses the same geographic distribution consideration to select hospitals in Marketplace plans as it does for all other Kaiser Foundation Health Plan (KFHP) products and lines of business. WebMD does not provide medical advice, diagnosis or treatment. He completed his residency at the prestigious Barrow Neurological Institute, where he also obtained advanced fellowship training in Skull Base / Cerebrovascular Surgery, Radiosurgery, and Complex Spine Surgery. I have been working as a regional chief of neurosurgery to improve delivery of neurosurgery services. As well as working in private practice as a Doctor of Chiropractic, Ms. Aoys was an Assistant Professor and clinical supervisor at the Southern California University of Health Sciences teaching clinical and diagnostic skills to chiropractic students for 11 years. Our movement disorders team at our Los Angeles Medical Center is one of the three busiest centers in the United States when it comes to the number of patients we see. If you have questions, please call us at 1-800-464-4000 (toll free). He understands that dealing with neurological illnesses is often an uncertain time in an individuals life and that many of these illnesses can be painful and debilitating. 293 reviews of Southern California Orthopedic Institute "I recently had elbow-related surgery at this facility and the results were good, at least in terms of reducing the pain and correcting a large, ugly scar thanks to the less-than-satisfactory efforts of a surgeon from another medical group. CNI focuses its care in the communities of Santa Clarita (Valencia), San Fernando Valley (Encino) and Bakersfield. He is licensed to treat patients in California. Learn more. To help you find the best Neurosurgeons located near you in Los Angeles, our team at, 1520 San Pablo St #3800, Los Angeles, CA 90033, 2100 W 3rd St #111, Los Angeles, CA 90057, Sierra Neuroscience Institute, 1500 E Chevy Chase Dr Suite 204, Glendale, CA 91206, 300 Stein Plaza Driveway Suite 420, Los Angeles, CA 90095, 8436 W 3rd St #800, Los Angeles, CA 90048, www.gregory-p-lekovic-md-phd.business.site. After graduation Dr. Liker was employed on Wall Street for four years in a variety of investment banking and corporate finance positions and earned the prestigious Chartered Financial Analyst designation. He has a primary interest in performing spinal disorders, pain . Santa Monica, CA 90404, 11645 Wilshire Blvd., #600, Timothy is a NCCPA certified physician assistant. California Neurosurgical Institute(CNI) is always seeking qualified people to join our team. It's" more 2. Phone: (310) 746-5918 Below is a list of the top and leading Neurosurgeons in Los Angeles. After you've searched for doctors by specialty, click the "Insurance" option in the search filter and then select your specific insurance provider. Our Spine Surgery Department is located at our Orange County, Fontana, San Diego, Downey, and Los Angeles Medical Centers. The location you tried did not return a result. Medical school, University Mohammed V, Rabat, Morocco. Dr.Lee is an amazing Surgeon. He finished his medical school in 1998 at the Finch University of Health Sciences/Chicago Medical School, North Chicago, IL. Stereotactic radiosurgery is a type of very precise radiation therapy we use to treat many brain and spine disorders. He completed a neuro-interventional endovascular fellowship at St. John Providence Health System in Detroit, Michigan, in 2013. "Best orthopedic surgeon on the West Coast . All the big names and practices in Orange County did not even return my calls after multiple attempts. Thus, after obtaining a comprehensive history of the illness from the patient, he likes to break down how specific treatments, including non-surgical management, may alleviate symptoms and then makes the decision together with the patient about the best course of treatment. He works in Los Angeles, CA and 4 other locations and specializes in Neurological Surgery. These California hospitals were ranked best by US News & World Report for treating neurology & neurosurgery and scores factor in patient . Recently his attention has turned to looking at ethnic differences in the presentation of cerebral vascular disorders. I would recommend Dr. Lee for any serious cranial operation. Accessibility of medical offices and medical centers in this directory: All Kaiser Permanente facilities are accessible to members. He communicates with patients in Yiddish, Russian, Hebrew, and English. Most recently, as an elected member of the board, I'm doing my part to make our health care delivery system a more convenient, high tech, high quality, and innovative system. He traded the desert landscape to return to Southern California and is committed to empowering and educating patients about their health. Only the services of interpreters and qualified staff are used to provide language assistance. From consult to surgery, the experts you meet at your first visit will be with you all along the way to help you reach optimal health. I had a work injury and was trying to be seen everywhere. Through Dr. Abumeri's extensive experience and training, he strives to provide state of the art care for all neurological diseases. Within spine surgery, I perform a variety of minimally invasive surgeries. Balloon Compression, Cingulotomy, Deep Brain Stimulation, Dorsal Root Entry Zone (DREZ), Microvascular Decompression, Motor Cortex Stimulation, Myelotomy, Nerve Decompression for Headache, Radiofrequency Ablation, Radiosurgery, Stereotactic Radiosurgery, Spinal Cord and Peripheral Stimulation, Address:300 Stein Plaza Driveway Suite 420, Los Angeles, CA 90095 He also serves on the editorial boards of leading skull base and neurosurgical journals and he is a frequent speaker at national and international meetings. He completed his physician assistant training at Midwestern UniversityGlendale and developed a passion to become a surgical physician assistant during his clinical rotations in general surgery, orthopedic surgery, and neurocritical care. DISC Surgery Center at Newport Beach 38 Medical Centers Sports Medicine Neurologist "Dr Robert Bray JR is the genius world renowned neurosurgeon who designed this surgery center. We accept most insurance plans and work with managed care networks. Minimally invasive cranial surgery is performed at our Orange County, Fontana, San Diego, and Los Angeles Medical Centers. Our functional neurosurgery program offers a variety of surgical treatments for movement disorders, epilepsy and pain. Department, 1505 N Edgemont St I grew up in India, England, and the United States. My husband had brain surgery by Dr.Lee.Another amazing thing about Dr.Lee, he is very caring about my husband after the operation and the whole time in the hospital until he was discharged. We perform many spine surgeries through a small incision (no bigger than a nickel) to reduce your post-op pain and speed your recovery. My relative had a resection of benign meningioma, Dr.Lee was excellent, as he removed it with ease, and recovery was very fast as well. I ", "I was having a serious case of bleeding hemorrhoids that lasted for 3 weeks. My first surgery and I am 80 years old. We offer a very competitive compensation salary with benefits to include medical, vision, dental, PTO including holidays, 401k, and CME reimbursement/days. For more information on the procedures we perform, please click here. Medicare Members: To request a hard copy of Kaiser Permanentes provider directory, please call our Member Services department at 1-800-443-0815, seven days a week, 8 a.m. to 8 p.m. Kaiser Permanente will mail a hard copy of the provider directory to you within three (3) business days of your request. Dr. Yashar then attended The Feinberg School of Medicine of Northwestern University. He finished his residency and fellowship at the University of Miami. Dr. Liker continues to pursue academic research as well as an assistant professor and faculty member at USC Keck Medical Center where he directs the Center for Deep Brain Stimulation. 2019 California Neurosurgical Institute, Top 1% of Neurosurgeons* at the Forefront of Emerging Technologies, Meet the Team at California Neurosurgical Institute, Click on provider photos to read their bio. Dr. Khawar Siddique is a Board-Certified Neurosurgeon, specializing in minimally invasive spinal surgeries for degenerative spinal conditions and complex spinal ailments. Neurosurgeons near Riverside, CA 23 Results All Results AS Dr. Ajay Kumar Shukla, MD Neurology, Neurological Surgery 49 32 Years Experience 7117 Brockton Ave, Riverside, CA 92506 0.30 miles " Dr. I perform a variety of surgeries for brain tumors, hydrocephalus, brain injury and trauma, cerebral aneurysms, pituitary tumors, and congenital abnormalities. He truly takes hi. Best Neurosurgeons in United States. Please try later or you can also send your review to reviews@threebestrated.com. Im grateful for having Dr. Badr as my neurosurgeon, my surgery was a success thanks to god first, Dr. Badr and his amazing nurses and staff. WebMD Care makes it easy to find doctors who take your insurance plan. The whole medical team and staff are caring and know what they are doing. Dr. Lobo is a neurosurgeon who specializes in the treatment of brain tumors that arise from the base of the skull and the pituitary gland. 38925 Trade Center Dr, Palmdale, CA, 93551. Neurological Surgery, Otolaryngology-Head & Neck Surgery, Plastic Surgery. The top rated Neurosurgeons in Los Angeles are: Dr. Steven L. Giannotta, Chair of Neurological Surgery, joined the Department of Neurosurgery at USC in 1980. Kristin Alderisio is a physician assistant in San Francisco, CA. He has performed over 200 new meningioma surgeries annually and headed over 1200 cases. Thank You. I was nervous but my Gallbladder was removed, Botta bing Botta boom. Best Neurosurgeons in Los Angeles, CA Featured Dr. Richard B. Kim Neurosurgeon Accepting new patients 1 - 10 of 175 results Dr. Eli M. Baron Neurosurgeon 4.5 (18 reviews) " Dr. Baron and his staff are amazing. Physicians, fellows, residents and nurses looking to further their knowledge in the neurosciences, Brain Matters Newsletter Feb 2023 Vikkis Incredible Transformation at the Treatment & Research in Psychedelics (TRIP) Program Now Enrolling: Research & Clinical Trials PNI Stories -, Will & Cary Singleton Donate $40 Million to Pacific Neuroscience Institutes Brain Health Center for Alzheimers Treatment & Research SANTA MONICA (July 7, 2020) A $40 million donation from Will and Cary Singleton will support the Pacific Neuroscience Institute (PNI) Brain Health Center at Providence. check . Loma Linda University Health Center, Loma Linda, CA, 92354. With his broad experience, interest, and accomplishments in Spine, Brain, and Neuro-Interventional procedures, Dr. Yashar has become a preeminent Neurosurgeon in Los Angeles and an integral Partner This program ultimately evolved into what has come to be recognized as hyperdynamic therapy. He is renowned for brain aneurysms, cranial trauma surgery, and interventional neuroradiology treatments. Subscribe on YouTube. His research interests have always been related to cerebral blood flow and cerebral protection from ischemia. Pouratian is my neurosurgeon and performed DBS (deep brain stimulation) surgery on me in 2012. After completing high school at Harvard-Westlake School, Dr Pouratian earned 3 degrees at his alma mater UCLA, including a bachelors in Neuroscience, a PhD in neuroscience, and his medical degree. Highly specialized medical professionals with vast experience across a wide spectrum of neurological and cranial disorders. Very professional and kind. Dr. Liker, founding and senior partner at California Neurosurgical Institute, is a board-certified and accomplished neurosurgeon with a broad range of technical and clinical expertise mastering both complex open and minimally invasive spine surgery, complex brain surgery, functional neurosurgery, stereotactic neurosurgery and radiosurgery. of Virginia Medical Center. The top rated Neurosurgeons in Los Angeles are: Dr. Steven L. Giannotta - Keck School of Medicine of USC Dr. Gregory P. Lekovic - Gregory P Lekovic, MD PhD Dr. Yaser Badr - Sierra Neuroscience Institute Dr. Nader Pouratian - Nader Pouratian, MD Dr. Khawar Siddique - Beverly Hills Spine Surgery Keck School of Medicine of USC Dr. Arjang Ahmadpour is a neurosurgeon in Sacramento, CA, and has been in practice between 510 years. I am a neurosurgeon, board certified by the American Board of Surgeons, and I have subspecialty training in reconstructive and minimally invasive spine surgery. View profile & reviews Search based on your schedule Video visits Available today Available in the next 3 days Available before 10am Available after 5pm After completing medical school, he completed his neurosurgical training in Charlottesville, Virginia at the University of Virginia under the mentorship of Drs John Jane, Edward Laws, Edward Oldfield, and Jeff Elias. Common causes of traumatic injuries are car or motorcycle accidents, falls, violence, and sports injuries. Conditions Treated by The Top Spine Surgeons in Southern California. UC, Davis Sch of Med, Sacramento, CA, 94203. Dr. Joung is the co-medical director of the Hollywood Presbyterian Neuroscience Inst. Our founder location is Santa Clarita. Brain Tumors, Spine Disease, Neurovascular Disease, Address:Sierra Neuroscience Institute, 1500 E Chevy Chase Dr Suite 204, Glendale, CA 91206 1719 E 19th Ave, Denver, CO, 80002. Dr. Sanjay N. Misra Neurosurgeon. Our USC Spine Center team combines the expertise of orthopedic, neurological surgeons and interventional physiatrists to treat a wide range of spine conditions. A herniated disc is a condition in which the inner gel-like substance pushes through the disc's outer layer and applies pressure on nearby nerves. Dr. Stern and his team researched and refined the surgical procedures they perform, so that our patients receive the quality care they deserve. King, MD. Dr. King graduated from the Johns Hopkins University School of Medicine in 1984. They may be called on to correct problems with the blood supply to the brain or even to perform surgical . Southern California Institute of Neurological Surgery is a recognized leader in neurosurgery, offering advanced treatments for spinal disorders, brain tumors, brain aneurysms, and other neurological disorders. We offer a wide range of surgical services to help prevent, diagnose and treat conditions that affect your brain, head and neck, spine, and spinal cord. He completed fellowship training in neuroendovascular neurosurgery at St. John Providence Hospital in Detroit, Michigan. Burak Ozgur, M.D. You can live in one of the most active and outdoor oriented communities in the world. Phone: (213) 353-7067 Gainesville You can also call the Medical Board of California at 916-263-2382, orvisit their website. Our neurointerventional surgery services are offered at our Los Angeles, San Diego, Orange County, and Fontana Medical Centers. After reading the good reviews on yelp I called Dr. Alexander to make an appointment and was very surprised and grateful that I could get in the next day. Contact your plan administrator for details. Phone: (818) 827-3898 David Cheng, MD . With years of experience in neurological Spine care, he specializes in diskectomies, cervical and lumbar laminectomies, fusions, artificial disks, and some spinal deformity. I bring medicine based on current evidence and research into my practice to deliver good outcomes for members. Giannotta and his whole team are great. He saved my dads life. -Morium Akter. I never questioned his abilities for a minute. Our Radiosurgery Program was established in 1989, making it one of the oldest and most experienced programs in the western United States. Southern California Permanente Medical Group (SCPMG) offers rewarding and lucrative neurosurgery careers for Neurosurgeon, Neurosurgeon Neurovascular, Neurosurgeon Pediatrics, Neurosurgeon Skull, and Neurosurgeon Spine including positions that incorporate the unique talents and skills of each subspecialty. Our surgeons perform minimally-invasive surgery through a small incision (no bigger than a nickel) to reduce your post-op pain and speed your recovery. Philip Salzarulo age 63 Norco Ca" more 3. Neurosurgery is a specialty branch of care that diagnoses, treats, and manages disorders of the nervous system. Learn the signs, symptoms, and treatment options with Neurologist and MS Specialist Barbara Giesser, MD. Dr. Imad Abumeri is a neurosurgeon in Bakersfield, CA, and has been in practice more than 20 years. This is a review for neurologist in Orange County, CA: "I highly recommend One Brain & Spine Center. Navigation Menu - Opens a Simulated Dialog, Neurosurgery DK. We perform cerebrovascular neurosurgery to treat complex problems with the blood vessels that carry blood to and from the brain and central nervous system. Dr. Fox recently performed a disc decompression and fusion on my spine in my cervical area. 2023 Kaiser Foundation Health Plan, Inc. Are you sure you want to leave your new member task list? , FL, Rochester He has been an honored guest speaker at many surgical societies and conferences worldwide, including Korea, Mexico, Japan, China & Brazil. He has been in practice more than 20 years. Find the. I like to help people, and medicine lets me do that every day. There is no way to repay you for your great work, One of the rare people doing the work that has to be done. Over the course of his career, he has authored over 40 peer-reviewed manuscripts and chapters and has given over 40 national and international invited presentations on a variety of Dr. Nader Pouratian is a native of Southern California. Escondido & Vista (760) 489-9490 | Fax: (760) 489-7638. Dr. Yaser strives to use his extensive training to provide excellent care in all aspects of spine and brain diseases. This rating is based on actual ratings from real patients like you. Dr Devin Binder 50 Surgeons Spine Surgeons "then look to Dr. Devin Binder "The DaVinci of Neurosurgeons ". Movement Disorders include Parkinsons disease, tremors, and dystonia. 8010 Frost St Ste 400, San Diego, CA 92123 0.58 miles. Dr. Yashar joined the California Neurosurgical Institute after completing his fellowship and residency in 2012. Along with spine surgeons, our team includes rehabilitation doctors, pain management specialists and physical and occupational therapists who work together to provide treatment options just for you. Pain Surgery may ease the pain of certain neurological conditions including trigeminal neuralgia (chronic pain of the face), phantom limb pain, stroke, and headache. Ms. Aoys graduated from the University of California, Los Angeles with a Bachelor of Science degree in Kinesiology and Psychology. Our services: Cerebrovascular Neurosurgery Neurointerventional Surgery Stereotactic Radiosurgery Skull Base Surgery Neurotrauma Spine Surgery Functional Neurosurgery He then completed his residency in Neurological Surgery at the Cleveland Clinic Foundation, one of the top four hospitals in the country. Zocdoc helps you find Neurosurgeons in Los Angeles and other locations with verified patient reviews and appointment availability that accept your insurance. Being 80 years old definitely made me apprehensive . Pacific Neuroscience Institute hosts this exciting annual CME event. He has authored over fifty peer-reviewed publications, also he is a past winner of the Vesalius Award from the American Association of Neurological Surgery, and he has been selected as a Southern California Super Doctor since 2013. After graduating, he worked as an EMT, gaining experience in basic and critical care ambulance transports. Dr. Abumeri had the unique opportunity to train at the prestigious Universit Paris Descartes, Facult de mdicne Paris Descartes, France and at University of Miami Miller School of Medicine/Jackson Memorial Hospital, Florida. Website: www.drpouratian.com, Dr. Dr. Gregory P. Lekovic is a board-certified neurosurgeon and leading national expert on the treatment of skull base tumors, cerebrovascular disorders, and NF2. Dr. Wesley A. Our neurosurgery team performs hundreds of these complex procedures every year so we have the expertise and experience to care for you and ease your fears. Our state-of-the-art treatment generally involves deep brain stimulation, using the Medtronic Activa system. Prior neurological surgical clinic experience is preferred. They made me feel comfortable. 90027, Loyola University Chicago Stritch School of Medicine, University of Florida College of Medicine, Strong Memorial Hospital of the University of Rochester, 4867 W Sunset Blvd, Los Angeles, CA 90027, Measuring care quality in our hospitals(PDF). Dr Joung Lee saved my life. I would recommend him highly. He has been in practice more than 20 years. Part of his enhanced neurosurgical training included 1 year of training in Auckland, New Zealand. Gupta has been practicing medicine for over 36 years and is highly rated in 27 conditions, according to our data. Great nurses, pre op, or nurse, post op. I went for follow up and he saw me pretty fast. University of California San Francisco Medical Center. Physicians, fellows, residents and nurses looking to further their knowledge in the neurosciences and neuro-oncology can take advantage of this great learning opportunity. College in New York and completed his residency at USC University Hospital. Instead, radiosurgery enables us to target tumors and other neurological problems with pinpoint precisionand no scalpels. Request for confidential communications forms, Advice/appointments/cancellations/messages, 711 (TTY for the hearing/speech impaired), a provider's office hours, search ourfacility directory, providers in yourplan or accepting new patients, call 1-800-464-4000 (toll free) or 711 (TTY for the hearing/speech impaired). My practice is very diverse, and I perform many types of surgery. I like to run, bike, or hike as often as I can. The availability of physicians, hospitals, providers, and services maychange. California Neurosurgeons U.S. News Doctor Finder includes nearly all U.S. physicians. Best Hospitals in California for Neurology & Neurosurgery. I enjoy careful microsurgery and the delicate handling of tissues to give members the quickest possible recovery. Learn more about interpreter services. Telemedicine visits are available. Theres no incision or cutting involved. Thank You! I was back to work in no time even after rods, screws, and spacers in 4 lumbar levels. He speaks Arabic and English. We are unable to complete your request right now. Dr. Badr has been in practice for 5 years and strives to use his extensive training to provide excellent care in all aspects of spine and brain diseases. 1. Torrance, CA 90503, 4201 Torrance Blvd., #520, Mission Hills, CA 91345. Since 1977. 400 Parnassus Ave, San Francisco, CA, 94143, Hospitals: UCSF Health-UCSF Medical Center. You can also call Medi-Cal Rx Customer Service at 1-800-977-2273, 24 hours a day, 7 days a week (TTY 711 Monday through Friday, 8 a.m. to 5 p.m.). At Dignity Health Southern California, our skilled neurosurgeons perform surgery and neurological procedures to find the root cause of neurological symptoms, repair damaged neurological structures, and create specialized treatment plans. If a surgical course is decided upon, he utilizes the most cutting edge technologies to provide precision care. Dr. Ostrup received his medical degree from the University of CA at Davis in 1979. We are unable to switch you to this area of care. Kaiser Permanente uses the same quality, member experience, or cost-related measures to select practitioners and facilities in Marketplace Silver-tier plans as it does for all other Kaiser Foundation Health Plan (KFHP) products and lines of business. You can get any drugs covered by Kaiser Permanente at one of these pharmacies. He completed his residency in Neurological Surgery at LAC+USC Medical Center/Keck School of Medicine and an international recognized Endovascular Fellowship under the mentorship of Dr. L. Nelson Hopkins and Dr. Elad I. or A friend of mine referred me to Dr. Melikian, and t", "Love Dr Essien. Nalin Gupta is a Neurosurgery expert in San Francisco, California. Dr. Abumeri is committed to finding the best treatment approach for each patient, maximizing the benefits of surgery while minimizing the risks. The measures may include, but are not limited to, HEDIS/CAHPS performance, member/patient complaints, patient safety scores, hospital quality measures, and geographic need.